Skeletal Muscle Mass Assessment in Pediatric Patients: Development of a Normative Equation and Assessment of Factors Associated With a Low Skeletal Muscle Mass in PICU Patients
Wakato Matsuoka, Soichi Mizuguchi, Noriyuki Kaku, Kanako Higashi, Kenichi Tetsuhara, Tomohiko Akahoshi, Shouichi Ohga- Critical Care and Intensive Care Medicine
- Pediatrics, Perinatology and Child Health
Objectives:
To develop an equation for defining a low skeletal muscle mass (SMM) in children and to investigate risk factors and outcomes associated with low SMM in critically ill pediatric patients.
Design:
Single-center retrospective pediatric cohorts, 2011–2018.
Setting:
Tertiary Emergency and Critical Care Center of Kyushu University Hospital in Japan.
Patients:
We studied two cohorts of pediatric patients 1–15 years old who underwent abdominal CT at the level of the third lumbar vertebra (L3). First a cohort of trauma patients presented to the emergency department in whom we developed an SMM regression equation. Second, a cohort of patients who had undergone abdominal CT within 3 days of PICU admission.
Interventions:
None.
Measurements and Main Results:
The equation for estimating normal SMM used sex, age, and weight. Low SMM was defined as less than 80% of normal. In the 112 patients in the PICU cohort, median (range) age was 68 (13–191) months, and 83 (74.1%) had underlying disease. There was low SMM in 54 patients (48.2%). Regarding associations, using odds ratio (OR) and 95% CI, we found that low dietary intake (OR 4.33 [95% CI, 1.37–13.70];
Conclusions:
In this retrospective PICU cohort from a single center in Japan, we found that low SMM at PICU admission was present in almost half the cases. Low SMM, as defined by being less than 80% of the normal, was associated with greater odds of low dietary intake and underlying chronic disease. Furthermore, low SMM was associated with longer hospital stays.