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Long-Term Outcomes After In-Hospital Cardiac Arrest: Does Pre-arrest Skeletal Muscle Depletion Matter?

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Abstract
Background: Skeletal muscle depletion is prevalent in elderly patients and is associated with unfavorable outcomes in patients with chronic diseases. However, the relationship between skeletal muscle mass and neurological outcomes following in-hospital cardiac arrest (IHCA) has not been evaluated. The aim of this study was to investigate whether skeletal muscle status before cardiac arrest is an independent factor affecting neurological outcomes in patients with IHCA.

Methods: We reviewed a prospectively enrolled registry of IHCA patients. Consecutive adult patients (> 18 years) admitted to a tertiary care hospital from 2013 to 2019 were included in the study. Of these, 421 patients who underwent abdominopelvic computed tomography within 3 months of cardiac arrest were included. Skeletal muscle index (SMI) was measured at the third lumbar vertebra, and skeletal muscle depletion was defined using sex- and body mass index-specific cutoffs of SMI. The primary outcome was a Cerebral Performance Category score of 1 or 2 at 6 months after cardiac arrest, which was considered a good neurological outcome.

Results: Of the 421 patients, 248 (58.9%) had skeletal muscle depletion before IHCA. The patients without skeletal muscle depletion showed significantly better neurological outcomes at 6 months after cardiac arrest than those with pre-arrest muscle depletion (20.8 vs. 10.9%, p = 0.004). The absence of skeletal muscle depletion was significantly associated with good neurological outcomes in a multivariable logistic analysis (OR = 3.49, 95% confidence intervals: 1.83-6.65, p < 0.001), along with the absence of diabetes, presence of active cancer, shockable rhythm, and short resuscitation duration.

Conclusion: Pre-arrest skeletal muscle depletion was associated with long-term mortality and poor neurological outcomes after IHCA. Skeletal muscle depletion may be used as a tool to identify at-risk patients who may benefit from aggressive treatments.
Author(s)
김경원김원영김윤정허진원홍상범Seok-In HongYousun Ko
Issued Date
2021
Type
Article
Keyword
in-hospital cardiac arrestlong-term outcomeneurologic outcomesarcopeniaskeletal muscle depletion
DOI
10.3389/fphys.2021.692757
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7131
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_doaj_primary_oai_doaj_org_article_a23f6dece8bb486a99060bb45b68455c&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Long-Term%20Outcomes%20After%20In-Hospital%20Cardiac%20Arrest:%20Does%20Pre-arrest%20Skeletal%20Muscle%20Depletion%20Matter%3F&amp;offset=0&amp;pcAvailability=true
Publisher
FRONTIERS IN PHYSIOLOGY
Location
스위스
Language
영어
ISSN
1664-042X
Citation Volume
12
Citation Number
0
Citation Start Page
0
Citation End Page
0
Appears in Collections:
Medicine > Medicine
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