• Ariel Jaitovich, Malik M H S Khan, Ria Itty, Hau C Chieng, Camille L Dumas, Pallavi Nadendla, John P Fantauzzi, Recai M Yucel, Paul J Feustel, and Marc A Judson.
• Division of Pulmonary and Critical Care Medicine, Albany Medical College, Albany, NY; Department of Molecular and Cell Physiology, Albany Medical College, Albany, NY. Electronic address: jaitova@amc.edu.
• Chest. 2019 Feb 1; 155 (2): 322-330.

BackgroundSkeletal muscle dysfunction occurring as a result of ICU admission associates with higher mortality. Although preadmission higher BMI correlates with better outcomes, the impact of baseline muscle and fat mass has not been defined. We therefore investigated the association of skeletal muscle and fat mass at ICU admission with survival and disability at hospital discharge.MethodsThis single-center, prospective, observational cohort study included medical ICU (MICU) patients from an academic institution in the Unites States. A total of 401 patients were evaluated with pectoralis muscle area (PMA) and subcutaneous adipose tissue (SAT) determinations conducted by CT scanning at the time of ICU admission, which were later correlated with clinical outcomes accounting for potential confounders.ResultsLarger admission PMA was associated with better outcomes, including higher 6-month survival (OR, 1.03; 95% CI, 1.01-1.04; P < .001), lower hospital mortality (OR, 0.96; 95% CI, 0.93-0.98; P < .001), and more ICU-free days (slope, 0.044 ± 0.019; P = .021). SAT was not significantly associated with any of the measured outcomes. In multivariable analyses, PMA association persisted with 6 months and hospital survival and ICU-free days, whereas SAT remained unassociated with survival or other outcomes. PMA was not associated with regaining of independence at the time of hospital discharge (OR, 0.99; 95% CI, 0.98-1.01; P = .56).ConclusionsIn this study cohort, ICU admission PMA was associated with survival during and following critical illness; it was unable to predict regaining an independent lifestyle following discharge. ICU admission SAT mass was not associated with survival or other measured outcomes.Published by Elsevier Inc.

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