ArticleFrontiers in nutrition2026
Ultrasound- and circumference-based quadriceps mass is an independent predictor of 28-day mortality in critically ill patients.
Article in Frontiers in nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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4 authors.
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Abstract
Background: Skeletal muscle mass is a key indicator of physiological reserve in critical illness. Objective: This study aimed to evaluate whether quadriceps mass assessed by bedside methods predicts 28-day mortality in critically ill patients. Methods: In this prospective study of 603 critically ill adults, we measured quadriceps thickness by ultrasonography under minimal transducer pressure (QT-min) and maximal transducer pressure (QT-max), quadriceps circumference (QC), and mid-upper arm circumference (MUAC) at admission. Cox regression was used to analyze the association between quadriceps thickness and 28-day mortality. Interaction and subgroup analyses were conducted for age, sex, BMI, mechanical ventilation, number of organ supports and vasopressor use. Results: The 28-day mortality rate was 21.06% (127/603). After adjustment in Model 3, QC (HR 0.95 per 1-cm increase, 95% CI 0.91-1.00), QT-min (HR 0.63 per 1-cm increase, 95% CI 0.42-0.92), and QT-max (HR 0.42 per 1-cm increase, 95% CI 0.20-0.85) remained independent protective factors for mortality, while MUAC do not. Significant interactions were found for QT-min with vasopressor use and organ support ( Conclusion: Bedside quadriceps mass assessment independently predicts 28-day mortality in critically ill patients, supporting its use for early risk stratification. In patients requiring vasopressors or organ support, the prognostic value of QT-min was attenuated, suggesting it may be susceptible to illness severity. However, given the small size of these subgroups, this finding warrants a cautious interpretation.
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