CT fatty muscle fraction as a new parameter for muscle quality assessment predicts outcome in venovenous extracorporeal membrane oxygenation

CT fatty muscle fraction as a new parameter for muscle quality assessment predicts outcome in venovenous extracorporeal membrane oxygenation

Abstract Impaired skeletal muscle quality is a major risk factor for adverse outcomes in acute respiratory failure. However, conventional methods for skeletal muscle assessment are inapplicable in the critical care setting. This study aimed to determine the prognostic value of computed tomography (C...

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Autores principales: Anton Faron, Stefan Kreyer, Alois M. Sprinkart, Thomas Muders, Stefan F. Ehrentraut, Alexander Isaak, Rolf Fimmers, Claus C. Pieper, Daniel Kuetting, Jens-Christian Schewe, Ulrike Attenberger, Christian Putensen, Julian A. Luetkens
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Publicado: Nature Portfolio 2020
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Acceso en línea:https://doaj.org/article/fc0f42dd466b4653ae9802bd2914a5f7
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spelling oai:doaj.org-article:fc0f42dd466b4653ae9802bd2914a5f72021-12-02T15:12:41ZCT fatty muscle fraction as a new parameter for muscle quality assessment predicts outcome in venovenous extracorporeal membrane oxygenation10.1038/s41598-020-79495-52045-2322https://doaj.org/article/fc0f42dd466b4653ae9802bd2914a5f72020-12-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-79495-5https://doaj.org/toc/2045-2322Abstract Impaired skeletal muscle quality is a major risk factor for adverse outcomes in acute respiratory failure. However, conventional methods for skeletal muscle assessment are inapplicable in the critical care setting. This study aimed to determine the prognostic value of computed tomography (CT) fatty muscle fraction (FMF) as a biomarker of muscle quality in patients undergoing extracorporeal membrane oxygenation (ECMO). To calculate FMF, paraspinal skeletal muscle area was obtained from clinical CT and separated into areas of fatty and lean muscle based on densitometric thresholds. The cohort was binarized according to median FMF. Patients with high FMF displayed significantly increased 1-year mortality (72.7% versus 55.8%, P = 0.036) on Kaplan–Meier analysis. A multivariable logistic regression model was built to test the impact of FMF on outcome. FMF was identified as a significant predictor of 1-year mortality (hazard ratio per percent FMF, 1.017 [95% confidence interval, 1.002–1.033]; P = 0.031), independent of anthropometric characteristics, Charlson Comorbidity Index, Simplified Acute Physiology Score, Respiratory Extracorporeal Membrane Oxygenation Survival Prediction Score, and duration of ECMO support. To conclude, FMF predicted 1-year mortality independently of established clinical prognosticators in ECMO patients and may have the potential to become a new muscle quality imaging biomarker, which is available from clinical CT.Anton FaronStefan KreyerAlois M. SprinkartThomas MudersStefan F. EhrentrautAlexander IsaakRolf FimmersClaus C. PieperDaniel KuettingJens-Christian ScheweUlrike AttenbergerChristian PutensenJulian A. LuetkensNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 10, Iss 1, Pp 1-9 (2020)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Anton Faron
Stefan Kreyer
Alois M. Sprinkart
Thomas Muders
Stefan F. Ehrentraut
Alexander Isaak
Rolf Fimmers
Claus C. Pieper
Daniel Kuetting
Jens-Christian Schewe
Ulrike Attenberger
Christian Putensen
Julian A. Luetkens
CT fatty muscle fraction as a new parameter for muscle quality assessment predicts outcome in venovenous extracorporeal membrane oxygenation
description Abstract Impaired skeletal muscle quality is a major risk factor for adverse outcomes in acute respiratory failure. However, conventional methods for skeletal muscle assessment are inapplicable in the critical care setting. This study aimed to determine the prognostic value of computed tomography (CT) fatty muscle fraction (FMF) as a biomarker of muscle quality in patients undergoing extracorporeal membrane oxygenation (ECMO). To calculate FMF, paraspinal skeletal muscle area was obtained from clinical CT and separated into areas of fatty and lean muscle based on densitometric thresholds. The cohort was binarized according to median FMF. Patients with high FMF displayed significantly increased 1-year mortality (72.7% versus 55.8%, P = 0.036) on Kaplan–Meier analysis. A multivariable logistic regression model was built to test the impact of FMF on outcome. FMF was identified as a significant predictor of 1-year mortality (hazard ratio per percent FMF, 1.017 [95% confidence interval, 1.002–1.033]; P = 0.031), independent of anthropometric characteristics, Charlson Comorbidity Index, Simplified Acute Physiology Score, Respiratory Extracorporeal Membrane Oxygenation Survival Prediction Score, and duration of ECMO support. To conclude, FMF predicted 1-year mortality independently of established clinical prognosticators in ECMO patients and may have the potential to become a new muscle quality imaging biomarker, which is available from clinical CT.
format article
author Anton Faron
Stefan Kreyer
Alois M. Sprinkart
Thomas Muders
Stefan F. Ehrentraut
Alexander Isaak
Rolf Fimmers
Claus C. Pieper
Daniel Kuetting
Jens-Christian Schewe
Ulrike Attenberger
Christian Putensen
Julian A. Luetkens
author_facet Anton Faron
Stefan Kreyer
Alois M. Sprinkart
Thomas Muders
Stefan F. Ehrentraut
Alexander Isaak
Rolf Fimmers
Claus C. Pieper
Daniel Kuetting
Jens-Christian Schewe
Ulrike Attenberger
Christian Putensen
Julian A. Luetkens
author_sort Anton Faron
title CT fatty muscle fraction as a new parameter for muscle quality assessment predicts outcome in venovenous extracorporeal membrane oxygenation
title_short CT fatty muscle fraction as a new parameter for muscle quality assessment predicts outcome in venovenous extracorporeal membrane oxygenation
title_full CT fatty muscle fraction as a new parameter for muscle quality assessment predicts outcome in venovenous extracorporeal membrane oxygenation
title_fullStr CT fatty muscle fraction as a new parameter for muscle quality assessment predicts outcome in venovenous extracorporeal membrane oxygenation
title_full_unstemmed CT fatty muscle fraction as a new parameter for muscle quality assessment predicts outcome in venovenous extracorporeal membrane oxygenation
title_sort ct fatty muscle fraction as a new parameter for muscle quality assessment predicts outcome in venovenous extracorporeal membrane oxygenation
publisher Nature Portfolio
publishDate 2020
url https://doaj.org/article/fc0f42dd466b4653ae9802bd2914a5f7
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