The associations between sarcopenia risk, malnutrition, and mortality in adults admitted to an intensive care unit: A prospective, cohort study
Courtney Wedemire, Julie Jamieson, Nanette Ng, Bonnie Louie, Andra Finlay, Allison Hawkins, Rebekah SandhuAbstract
Background
Sarcopenia and malnutrition are associated with mortality, including in adults admitted to an intensive care unit. However, their relationships with each other and with intensive care unit mortality, independently, in mechanically ventilated adults are unclear. This study explored the prevalence and relationships between sarcopenia risk and malnutrition and their association with intensive care unit mortality.
Methods
This was a pilot, prospective, observational study of adults requiring mechanical ventilation in an intensive care unit. Sarcopenia risk and malnutrition were assessed within 96 h of mechanical ventilation, and participants were followed prospectively until intensive care unit discharge. Three multivariable logistic regression models were developed for the dependent outcome of intensive care unit mortality.
Results
In total, 127 participants were included. Most were admitted with a medical diagnosis (88.2%). The mean APACHE II score was 25.2 ± 7.4, and intensive care unit mortality was 33.9%. Sarcopenia risk was present in 40.2% of participants, while 33.9% were mild to moderately malnourished and 4.7% were severely malnourished. Co‐existing sarcopenia risk and malnutrition was present in 22.8% of participants. Participants with sarcopenia risk had a significantly higher prevalence of malnutrition (56.9%) than patients without sarcopenia risk (26.3%, P < 0.001). There were no significant associations between sarcopenia risk or malnutrition and intensive care unit mortality in the crude and adjusted logistic regression models.
Conclusion
Malnutrition and sarcopenia risk are prevalent in mechanically ventilated adults and co‐exist in almost a quarter of patients. Malnutrition and sarcopenia risk were not independently associated with intensive care unit mortality.