Association between Neurologic Outcomes and Changes of Muscle Mass Measured by Brain Computed Tomography in Neurocritically Ill Patients.
Yun Im LeeRyoung-Eun KoJoonghyun AhnKeumhee C CarriereJeong-Am RyuPublished in: Journal of clinical medicine (2021)
This study aimed to investigate whether skeletal muscle mass estimated via brain computed tomography (CT) could predict neurological outcomes in neurocritically ill patients. This is a retrospective, single-center study. Adult patients admitted to the neurosurgical intensive care unit (ICU) from January 2010 to September 2019 were eligible. Cross-sectional areas of paravertebral muscles at the first cervical vertebra level (C1-CSA) and temporalis muscle thickness (TMT) on brain CT were measured to evaluate skeletal muscle mass. The primary outcome was the Glasgow Outcome Scale score at 3 months. Among 189 patients, 81 (42.9%) patients had favorable neurologic outcomes. Initial and follow-up TMT values were higher in patients with favorable neurologic outcomes compared to those with poor outcomes ( p = 0.003 and p = 0.001, respectively). The initial C1-CSA/body surface area was greater in patients with poor neurological outcomes than in those with favorable outcomes ( p = 0.029). In multivariable analysis, changes of C1-CSA and TMT were significantly associated with poor neurological outcomes. The risk of poor neurologic outcome was especially proportional to changes of C1-CSA and TMT. The follow-up skeletal muscle mass measured via brain CT at the first week from ICU admission may help predict poor neurological outcomes in neurocritically ill patients.
Keyphrases
- computed tomography
- intensive care unit
- end stage renal disease
- newly diagnosed
- ejection fraction
- prognostic factors
- cross sectional
- positron emission tomography
- emergency department
- type diabetes
- resting state
- white matter
- patient reported outcomes
- randomized controlled trial
- adipose tissue
- young adults
- multiple sclerosis
- brain injury
- pet ct
- functional connectivity