Sima Ghorabi1, Hossein Ardehali2, Zohreh Amiri3, Zahra Vahdat Shariatpanahi4. 1. National Nutrition and Food Technology Research Institute, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2. Department of Anesthesiology and Critical Care, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 3. Department of Biostatistics National Nutrition and Food Technology Research Institute, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 4. National Nutrition and Food Technology Research Institute, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran nutritiondata@yahoo.com.
Abstract
BACKGROUND: Different parameters may be used to evaluate the nutrition status of individuals. However, their use in the critically ill is problematic, since the interference of acute disease or therapeutic measures on their results can affect their interpretation. The aim of this study was to assess whether measuring the adductor pollicis muscle is useful in identifying malnutrition and clinical outcomes in the intensive care unit (ICU). MATERIALS AND METHODS: In total, 127 patients were enrolled in this prospective observational study. Serum albumin levels, anthropometrics, adductor pollicis muscle (APM) thickness, and Acute Physiology and Chronic Health Evaluation II (APACHE II) score were measured for each patient upon admission. APM thickness (APMT) was measured while the patient's elbow was flexed at a 90-degree angle and the forearm resting on the patient's torso. RESULTS: The dominant and nondominant APMT were significantly correlated with all anthropometric measurements (r = 0.41-0.68, P < .001 and r = 0.42-0.66, P < .001 respectively). Multivariate regression analysis adjusted by other risk factors, including APACHE II score, serum albumin, and age, showed that among all anthropometric variables, the APMT has the highest correlation with mortality (odds ratio [OR], 5.6; 95% confidence interval [CI], 0.02-0.12; P < .001), length of stay >10 days (OR, 11.3; 95% CI, 4.42-29.1; P < .001), and organ failure (OR, 14.5; 95% CI, 6.5-38.4; P < .001). CONCLUSIONS: The results showed that APMT is a low-cost, reliable, and easy method to assess nutrition status and to predict the patient's outcomes in the ICU.
BACKGROUND: Different parameters may be used to evaluate the nutrition status of individuals. However, their use in the critically ill is problematic, since the interference of acute disease or therapeutic measures on their results can affect their interpretation. The aim of this study was to assess whether measuring the adductor pollicis muscle is useful in identifying malnutrition and clinical outcomes in the intensive care unit (ICU). MATERIALS AND METHODS: In total, 127 patients were enrolled in this prospective observational study. Serum albumin levels, anthropometrics, adductor pollicis muscle (APM) thickness, and Acute Physiology and Chronic Health Evaluation II (APACHE II) score were measured for each patient upon admission. APM thickness (APMT) was measured while the patient's elbow was flexed at a 90-degree angle and the forearm resting on the patient's torso. RESULTS: The dominant and nondominant APMT were significantly correlated with all anthropometric measurements (r = 0.41-0.68, P < .001 and r = 0.42-0.66, P < .001 respectively). Multivariate regression analysis adjusted by other risk factors, including APACHE II score, serum albumin, and age, showed that among all anthropometric variables, the APMT has the highest correlation with mortality (odds ratio [OR], 5.6; 95% confidence interval [CI], 0.02-0.12; P < .001), length of stay >10 days (OR, 11.3; 95% CI, 4.42-29.1; P < .001), and organ failure (OR, 14.5; 95% CI, 6.5-38.4; P < .001). CONCLUSIONS: The results showed that APMT is a low-cost, reliable, and easy method to assess nutrition status and to predict the patient's outcomes in the ICU.
Authors: Aline Kirjner Poziomyck; Oly Campos Corleta; Leandro Totti Cavazzola; Antonio Carlos Weston; Edson Braga Lameu; Luisa Jussara Coelho; Luis Fernando Moreira Journal: Arq Bras Cir Dig Date: 2018-03-01
Authors: Mohammed I M Gubari; Abdolreza Norouzy; Mostafa Hosseini; Fadhil A Mohialdeen; Mohammad Javad Hosseinzadeh-Attar Journal: Medicina (Kaunas) Date: 2019-08-15 Impact factor: 2.430