ArticleCritical care (London, England)2014
Low skeletal muscle area is a risk factor for mortality in mechanically ventilated critically ill patients.
Article in Critical care (London, England), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 7 registered trials, which are not on this map. Cited by 167 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Relation Between Bioelectrical Impedance-derived Muscle Mass and CT-derived Muscle Area in Critically Ill Patients
Strategies to Reduce Organic Muscle Atrophy in the Intensive Care Unit (STROMA-ICU)
A Retrospective Investigator Initiated Trial Evaluating Protein Intake and CT Assessments of Muscle Mass of Critically Ill Patients in Relation to Outcome Parameters: the PROMUS-study
Validation of Bedside Ultrasound to Predict Body Composition in Non- and Critically Ill Patients: The USVALID Prospective Study
Efficacy of Testosterone Gel to Restore Normal Serum Values of Testosterone During the Acute Phase of Critical Illness in Adult ICU Patients
Ultrasound Measurements of Accessory Respiratory Muscles in the Intensive Care Unit
Relationship Between Protein Intake and ICU Skeletal Muscle Weakness
Who cites it
167 citing papers in PubMed, 7 syntheses or guidelines pooled it, 452 citations in OpenAlex.
- Exploring the association between computed tomography (CT)-derived skeletal muscle mass and short- and long-term mortality in critically ill patients: a systematic review and meta-analysis.Critical care (London, England) · 2025Pooled it
- Phase angle as a marker of outcome in hospitalized pediatric patients. A systematic review of the evidence (GRADE) with meta-analysis.Reviews in endocrine & metabolic disorders · 2023Pooled it
- Prevalence and mortality risk of low skeletal muscle mass in critically ill patients: an updated systematic review and meta-analysis.Frontiers in nutrition · 2023Pooled it
- Prevalence and prognostic value of preexisting sarcopenia in patients with mechanical ventilation: a systematic review and meta-analysis.Critical care (London, England) · 2022Pooled it
- Prevalence of Sarcopenia in Patients With COVID-19: A Systematic Review and Meta-Analysis.Frontiers in nutrition · 2022Pooled it
- Sarcopenia as a predictor of mortality among the critically ill in an intensive care unit: a systematic review and meta-analysis.BMC geriatrics · 2021Pooled it
- Sarcopenia as a predictor of mortality in women with breast cancer: a meta-analysis and systematic review.BMC cancer · 2020Pooled it
- Trial
- Impact of Very Early Physical Therapy During Septic Shock on Skeletal Muscle: A Randomized Controlled Trial.Critical care medicine · 2018Trial
- Mortality, Renal Replacement Therapy and Renal Impairment Markers in Critically Ill Patients in a Multinational Point-Prevalence ICU Cohort over 2007 to 2024: A nutritionDay Descriptive Multivariable Analysis.Journal of clinical medicine · 2026Article
- Early mechanical changes of limb muscle in septic shock assessed by dual-plane shear-wave elastography.Intensive care medicine experimental · 2026Article
- Strategies to mitigate muscle mass loss in individuals with spinal cord injury.The journal of spinal cord medicine · 2026Review
- Low CT-Derived Thoracic Muscle Area and Composite Weaning Failure in Mechanically Ventilated ICU Patients with Pneumonia: An Exploratory Analysis by Age Group.Journal of clinical medicine · 2026Article
- CT-based muscle mass cutoff values for Caucasians according to the European Working Group on Sarcopenia recommendations.European radiology · 2026Article
- Intramuscular fat content and the risk of peritonitis in peritoneal dialysis patients.Clinical kidney journal · 2026Article
- Observational
- Mitochondrial Impairment in Unloaded Postural Muscle: Mechanisms Driving Loss of Muscle Function and Mass.Antioxidants (Basel, Switzerland) · 2026Review
- Ginsenoside Rg1 Attenuates Muscle Atrophy in Hyperglycemic Conditions, Inactivity and Protein Deprivation Models via AKT/mTOR Pathway Activation.Current molecular medicine · 2026Article
- Ultrasound- and circumference-based quadriceps mass is an independent predictor of 28-day mortality in critically ill patients.Frontiers in nutrition · 2026Article
- Estimating vastus lateralis muscle volume from a single ultrasound image.Scientific reports · 2025Article
107 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionHigher body mass index (BMI) is associated with lower mortality in mechanically ventilated critically ill patients. However, it is yet unclear which body component is responsible for this relationship.
methodsThis retrospective analysis in 240 mechanically ventilated critically ill patients included adult patients in whom a computed tomography (CT) scan of the abdomen was made on clinical indication between 1 day before and 4 days after admission to the intensive care unit. CT scans were analyzed at the L3 level for skeletal muscle area, expressed as square centimeters. Cutoff values were defined by receiver operating characteristic (ROC) curve analysis: 110 cm2 for females and 170 cm2 for males. Backward stepwise regression analysis was used to evaluate low-muscle area in relation to hospital mortality, with low-muscle area, sex, BMI, Acute Physiologic and Chronic Health Evaluation (APACHE) II score, and diagnosis category as independent variables.
resultsThis study included 240 patients, 94 female and 146 male patients. Mean age was 57 years; mean BMI, 25.6 kg/m2. Muscle area for females was significantly lower than that for males (102 ± 23 cm2 versus 158 ± 33 cm2; P < 0.001). Low-muscle area was observed in 63% of patients for both females and males. Mortality was 29%, significantly higher in females than in males (37% versus 23%; P = 0.028). Low-muscle area was associated with higher mortality compared with normal-muscle area in females (47.5% versus 20%; P = 0.008) and in males (32.3% versus 7.5%; P < 0.001). Independent predictive factors for mortality were low-muscle area, sex, and APACHE II score, whereas BMI and admission diagnosis were not. Odds ratio for low-muscle area was 4.3 (95% confidence interval, 2.0 to 9.0, P < 0.001). When applying sex-specific cutoffs to all patients, muscle mass appeared as primary predictor, not sex.
conclusionsLow skeletal muscle area, as assessed by CT scan during the early stage of critical illness, is a risk factor for mortality in mechanically ventilated critically ill patients, independent of sex and APACHE II score. Further analysis suggests muscle mass as primary predictor, not sex. BMI is not an independent predictor of mortality when muscle area is accounted for.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.