ArticleJournal of intensive care2020
Upper limb muscle atrophy associated with in-hospital mortality and physical function impairments in mechanically ventilated critically ill adults: a two-center prospective observational study.
Article in Journal of intensive care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 4 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.
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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.
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Who cites it
27 citing papers in PubMed, 4 syntheses or guidelines pooled it, 68 citations in OpenAlex.
- Disuse-Induced Muscle Atrophy and Muscle Weakness From Hospitalization to Spaceflight: Exercise Succeeds in Prevention and Treatment-A Meta-Analysis.Journal of cachexia, sarcopenia and muscle · 2026Pooled it
- Acute Sarcopenia: Systematic Review and Meta-Analysis on Its Incidence and Muscle Parameter Shifts During Hospitalisation.Journal of cachexia, sarcopenia and muscle · 2025Pooled it
- Impact of Muscle Changes Assessed by Ultrasonography on Muscle Strength and Functioning after ICU Discharge: A Systematic Review with Meta-Analysis.International journal of environmental research and public health · 2024Pooled it
- The rate and assessment of muscle wasting during critical illness: a systematic review and meta-analysis.Critical care (London, England) · 2023Pooled it
- Methodological Approaches for Ultrasound Assessment of Peripheral and Abdominal Muscle Thickness in Intensive Care: A Scoping Review and Proposed Reporting Framework.Physiotherapy research international : the journal for researchers and clinicians in physical therapy · 2026Article
- Ultrasound assessment of muscle atrophy and its association with functional outcomes in critically ill patients: a systematic review and meta-analysis.Critical care (London, England) · 2026Review
- Longitudinal Ultrasound Monitoring of Peripheral Muscle Loss in Neurocritical Patients.Journal of imaging · 2025Article
- Myostatin antisense administration prevents sepsis-induced muscle atrophy and weakness in male mice.Physiological reports · 2025Article
- Intensive care unit-acquired muscle atrophy and weakness in critical illness: a review of long-term recovery strategies.Acute and critical care · 2025Article
- Novel Strategies to Promote Intensive Care Unit Recovery via Personalized Exercise, Nutrition, and Anabolic Interventions.Critical care clinics · 2025Review
- Point-of-Care Ultrasound as a Prognostic Tool in Critically Ill Patients: Insights Beyond Core Muscle Mass.medRxiv : the preprint server for health sciences · 2025Article
- Ultrasonographic assessment of the muscle mass of the rectus femoris in mechanically ventilated patients at intensive care unit discharge is associated with deterioration of functional status at hospital discharge: a prospective cohort study.Critical care science · 2025Article
- Ferroptosis and Its Potential Role in the Physiopathology of Skeletal Muscle Atrophy.International journal of molecular sciences · 2024Review
- Evaluating Muscle Mass Changes in Critically Ill Patients: Rehabilitation Outcomes Measured by Ultrasound and Bioelectrical Impedance.Healthcare (Basel, Switzerland) · 2024Article
- Acute muscle loss assessed using panoramic ultrasound in critically ill adults: a prospective observational study.Journal of medical ultrasonics (2001) · 2024Observational
- Achievement of adequate nutrition contributes to maintaining the skeletal muscle area in patients with sepsis undergoing early mobilization: a retrospective observational study.BMC nutrition · 2024Article
- Prolonged intensive care: muscular functional, and nutritional insights from the COVID-19 pandemic.Acute and critical care · 2024Article
- Post-intensive care syndrome follow-up system after hospital discharge: a narrative review.Journal of intensive care · 2024Review
- Effects of early exercise training following severe burn injury: a randomized controlled trial.Burns & trauma · 2024Article
- A randomized controlled clinical trial of the effects of range of motion exercises and massage on muscle strength in critically ill patients.BMC sports science, medicine & rehabilitation · 2022Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLower limb muscle atrophy is often observed in critically ill patients. Although upper limb muscles can undergo atrophy, it remains unclear how this atrophy is associated with clinical outcomes. We hypothesized that this atrophy is associated with mortality and impairments in physical function.
methodsIn this two-center prospective observational study, we included adult patients who were expected to require mechanical ventilation for > 48 h and remain in the intensive care unit (ICU) for > 5 days. We used ultrasound to evaluate the cross-sectional area of the biceps brachii on days 1, 3, 5, and 7 and upon ICU discharge along with assessment of physical functions. The primary outcome was the relationship between muscle atrophy ratio and in-hospital mortality on each measurement day, which was assessed using multivariate analysis. The secondary outcomes were the relationships between upper limb muscle atrophy and Medical Research Council (MRC) score, handgrip strength, ICU Mobility Scale (IMS) score, and Functional Status Score for the ICU (FSS-ICU).
resultsSixty-four patients (43 males; aged 70 ± 13 years) were enrolled. The Acute Physiology and Chronic Health Evaluation (APACHE) II score was 27 (22-30), and in-hospital mortality occurred in 21 (33%) patients. The decreased cross-sectional area of the biceps brachii was not associated with in-hospital mortality on day 3 (p = 0.43) but was associated on days 5 (p = 0.01) and 7 (p < 0.01), which was confirmed after adjusting for sex, age, and APACHE II score. In 27 patients in whom physical functions were assessed, the decrease of the cross-sectional area of the biceps brachii was associated with MRC score (r = 0.47, p = 0.01), handgrip strength (r = 0.50, p = 0.01), and FSS-ICU (r = 0.56, p < 0.01), but not with IMS score (r = 0.35, p = 0.07) upon ICU discharge.
conclusionsUpper limb muscle atrophy was associated with in-hospital mortality and physical function impairments; thus, it is prudent to monitor it. (321 words)
trial registrationUMIN 000031316 . Retrospectively registered on 15 February 2018.
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