title: The prevalence of sarcopenia in patients with respiratory failure classified as normally nourished using computed tomography and subjective global assessment.
abstract: BACKGROUND
  Declines in nutrition status and adverse body composition changes frequently occur in the critically ill. The objective of this cross-sectional study was to examine the prevalence of sarcopenia and its occurrence in patients classified as normal nourished using subjective global assessment (SGA).
  
  
  METHODS
  Exploiting diagnostic CT images, skeletal muscle mass at the L3 region was quantified and used to determine sarcopenia and its association with normal nutrition status in 56 patients with respiratory failure. Sarcopenia was defined as an L3 skeletal muscle index of ≤38.5 cm(2)/m(2) for women and ≤52.4 cm(2)/m(2) for men. CT imaging and SGA classifications completed within 14, 10 and 7 days of each other were analyzed to assess sarcopenia and the influence of time between scans on misclassification (ie, normal nourished and sarcopenic). Descriptive statistics were conducted.
  
  
  RESULTS
  The average patient was 59.2 (± 15.6) years old, admitted with sepsis/infection, an APACHE II score of 26 (± 8.0), and BMI of 28.3 (± 5.8). Sarcopenia and sarcopenic obesity were prevalent in a minimum of 56% and 24% of patients, respectively, depending on the number of days between CT imaging and SGA assessment. Misclassified individuals were predominantly male, minority and overweight or obese. Controlling for age, no significant differences were noted for patients classified as normal nourished vs malnourished by SGA for lumbar muscle cross-sectional, whole-body lean mass, or skeletal muscle index.
  
  
  CONCLUSIONS
  Sarcopenia is highly prevalent among patients with respiratory failure requiring mechanical ventilation (MV) and not readily detected in patients classified as normal nourished using SGA.
authors: Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA psheea1@uic.edu.
authors: Patricia M
authors: PM
authors: Sheean
authors: Department of Food and Nutrition, Rush University Medical Center, Chicago, IL, USA.
authors: Sarah J
authors: SJ
authors: Peterson
authors: Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA.
authors: Sandra
authors: S
authors: Gomez Perez
authors: Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA.
authors: Karen L
authors: KL
authors: Troy
authors: Diagnostic Radiology & Nuclear Medicine Department, Rush University Medical Center, Chicago, IL, USA.
authors: Ankur
authors: A
authors: Patel
authors: Rush University Medical Center, Chicago, IL, USA.
authors: Joy S
authors: JS
authors: Sclamberg
authors: Howard University College of Medicine, Washington, DC, USA.
authors: Folabomi C
authors: FC
authors: Ajanaku
authors: Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA.
authors: Carol A
authors: CA
authors: Braunschweig
mesh_terms: D000328:Adult; D000368:Aged; D001823:Body Composition; D015992:Body Mass Index; D016638:Critical Illness; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008913:Minority Groups; D018482:Muscle, Skeletal; D015596:Nutrition Assessment; D009752:Nutritional Status; D009765:Obesity / Q000150:complications; D050177:Overweight; D015995:Prevalence; D012016:Reference Values; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000150:complications*; D055948:Sarcopenia / Q000150:complications / Q000453:epidemiology*; D018805:Sepsis; D012737:Sex Factors; D014054:Tomography
keywords: computed tomography; malnutrition; sarcopenia; sarcopenic obesity; subjective global assessment
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