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Eur J Clin Nutr. 2018 Aug;72(8):1187-1190. doi: 10.1038/s41430-018-0144-8. Epub 2018 Mar 26.

Nutritional risk assessment at admission can predict subsequent muscle loss in critically ill patients.

Author information

1
Division of Respiratory and Critical Care Medicine, University Medicine Cluster, National University Health System and National University of Singapore, Singapore, Singapore. amartya.mukherjee@gmail.com.
2
Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.
3
Division of Respiratory and Critical Care Medicine, University Medicine Cluster, National University Health System and National University of Singapore, Singapore, Singapore.
4
Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Singapore, Singapore.
5
Alice Lee Centre for Nursing Studies, National University of Singapore and National University Health System, Singapore, Singapore.
6
Intensive Care Department, Royal Free Hospital NHS Trust, Hampstead, United Kingdom.

Abstract

Muscle loss in critically ill patients may be related to nutrition. We study the association between modified NUTrition RIsk in the Critically ill (mNUTRIC) score obtained at admission to intensive care unit (ICU) and subsequent muscle loss. We measured rectus femoris cross-sectional area (RFCSA) by ultrasound on days 1, 3, 7, and 10 of ICU admission. We used linear mixed effects model following natural logarithmic transformation of the data. Forty-eight patients (median (IQR) age 66 (55-72.5) years, 71% male, APACHE II score 31 (25-34), BMI 24.2 (21.5-27.1) kg/m2) were analyzed. The high mNUTRIC score (>5) cohort (n = 35) lost significantly more muscle as compared to the low (≤5) group (n = 13); the adjusted ratio (high versus low group) of the geometric mean RFCSA were (0.58, 95% CI 0.46-0.75) for right and (0.61, 95% CI 0.49-0.77) for left, both p < 0.001. mNUTRIC score obtained at admission to ICU can identify patients at risk of subsequent muscle loss.

PMID:
29581561
DOI:
10.1038/s41430-018-0144-8

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