The association between sarcopenia and functional outcomes after hospital discharge among critically ill surgical patients

Abstract

Background: To determine the association between sarcopenia in surgical intensive care unit (SICU) patients and long-term functional outcomes.

Method: This prospective, cohort study enrolled patients aged >65 years admitted to SICUs at the tertiary care hospital. Their muscle mass and strength were measured by bioelectrical impedance vector analysis (BIVA) and handgrip-strength or manual-muscle-strength tests. The functional outcomes were evaluated with the Thai version of the Barthel index for activities of daily living (ADL).

Results: 120 patients were enrolled. A multivariate analysis identified 3 independent predictors associated with poor functional outcomes (ADL scores ≤70) at one month after hospital discharge including sarcopenia (adjusted odds ratio [aOR]: 3.33; 95% confidence interval [CI]: 1.25-8.87); duration of mechanical ventilation (aOR: 1.19; 95% CI: 1.02-1.38); and length of hospital stay (aOR: 1.05; 95% CI: 1.01-1.10). Cox proportional-hazards regression models found that sarcopenia (adjusted hazard ratio [aHR]: 2.07; 95% CI: 1.02-4.22) and admission severity (aHR: 1.13; 95% CI: 1.04-1.23) were predictors of 120-day mortality.

Conclusions: Sarcopenia was an independent predictor of poor functional outcomes at one month after hospital discharge.

Keywords: Bioelectrical impedance vector analysis (BIVA); Functional outcomes; Sarcopenia; Surgical intensive care unit.