scholarly journals Acute Skeletal Muscle Wasting and Dysfunction Predict Physical Disability at Hospital Discharge in Patients With Critical Illness

2020 ◽  
Author(s):  
Kirby P. Mayer ◽  
Melissa L. Thompson Bastin ◽  
Ashley A. Montgomery-Yates ◽  
Amy M. Pastva ◽  
Esther E. Dupont-Versteegden ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Critical Illness ◽  
Physical Function ◽  
Hospital Discharge ◽  
Physical Disability ◽  
Muscle Power ◽  
Muscle Dysfunction ◽  
Icu Admission ◽  
Percent Change ◽  
Icu Discharge

Abstract Background: Patients surviving critical illness develop muscle weakness and impairments in physical function, however, the relationship between early skeletal muscle dysfunction and physical function at hospital discharge remains unclear. The primary purpose of this study was to determine if changes in muscle size, strength and power assessed in the intensive care unit (ICU) predict physical function at hospital discharge. Methods: Study design is a single-center, prospective, observational study in patients admitted to the medicine or cardiothoracic ICU with diagnosis of sepsis or acute respiratory failure. Rectus femoris (RF) and tibialis anterior (TA) muscle ultrasound images were obtained day one of ICU admission, repeated serially and assessed for muscle cross-sectional area (CSA), layer thickness (mT), and echointensity (EI). Muscle strength, as measured by Medical Research Council-sum score, and muscle power (lower-extremity leg-press) were assessed prior to ICU discharge. Physical function was assessed with performance on 5-times sit-to-stand (5STS) at hospital discharge.Results: Forty-one patients with median age of 61 years (IQR 55-68), 56% male, and sequential organ failure assessment score of 8.1 ± 4.8 were enrolled. RF muscle CSA decreased significantly a median percent change of 18.5% from day 1 to 7 (F = 26.6, p = 0.0253). RF EI increased at a mean percent change of 10.5 ± 21% in the first 7 days (F = 3.28, p = 0.081). At hospital discharge 25.7% of patients (9/35) met criteria for ICU-acquired weakness. Change in RF EI in first 7 days of ICU admission and muscle power measured prior to ICU were strong predictors of ICU-AW at hospital discharge (AUC = 0.912). Muscle power at ICU discharge, age and ICU length of stay were predictive of performance on 5STS at hospital discharge.Conclusion: ICU-assessed muscle dysfunction is a predictor of physical disability at hospital discharge in patients surviving critical illness.

scholarly journals Acute skeletal muscle wasting and dysfunction predict physical disability at hospital discharge in patients with critical illness

2020 ◽  
Author(s):  
Kirby P. Mayer ◽  
Melissa L. Thompson Bastin ◽  
Ashley A. Montgomery-Yates ◽  
Amy M. Pastva ◽  
Esther E. Dupont-Versteegden ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Critical Illness ◽  
Physical Function ◽  
Hospital Discharge ◽  
Physical Disability ◽  
Muscle Power ◽  
Muscle Dysfunction ◽  
Icu Admission ◽  
Percent Change ◽  
Icu Discharge

Abstract Background: Patients surviving critical illness develop muscle weakness and impairments in physical function, however, the relationship between early skeletal muscle dysfunction and physical function at hospital discharge remains unclear. The primary purpose of this study was to determine if changes in muscle size, strength and power assessed in the intensive care unit (ICU) predict physical function at hospital discharge. Methods: Study design is a single-center, prospective, observational study in patients admitted to the medicine or cardiothoracic ICU with diagnosis of sepsis or acute respiratory failure. Rectus femoris (RF) and tibialis anterior (TA) muscle ultrasound images were obtained day one of ICU admission, repeated serially and assessed for muscle cross-sectional area (CSA), layer thickness (mT), and echointensity (EI). Muscle strength, as measured by Medical Research Council-sum score, and muscle power (lower-extremity leg-press) were assessed prior to ICU discharge. Physical function was assessed with performance on 5-times sit-to-stand (5STS) at hospital discharge.Results: Forty-one patients with median age of 61 years (IQR 55-68), 56% male, and sequential organ failure assessment score of 8.1 ± 4.8 were enrolled. RF muscle CSA decreased significantly a median percent change of 18.5% from day 1 to 7 (F = 26.6, p = 0.0253). RF EI increased at a mean percent change of 10.5 ± 21% in the first 7 days (F = 3.28, p = 0.081). At hospital discharge 25.7% of patients (9/35) met criteria for ICU-acquired weakness. Change in RF EI in first 7 days of ICU admission and muscle power measured prior to ICU were strong predictors of ICU-AW at hospital discharge (AUC = 0.912). Muscle power at ICU discharge, age and ICU length of stay were predictive of performance on 5STS at hospital discharge.Conclusion: ICU-assessed muscle dysfunction is a predictor of physical disability at hospital discharge in patients surviving critical illness.

scholarly journals Acute skeletal muscle wasting and dysfunction predict physical disability at hospital discharge in patients with critical illness

Critical Care ◽  
2020 ◽  
Vol 24 (1) ◽  
Author(s):  
Kirby P. Mayer ◽  
Melissa L. Thompson Bastin ◽  
Ashley A. Montgomery-Yates ◽  
Amy M. Pastva ◽  
Esther E. Dupont-Versteegden ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Critical Illness ◽  
Physical Function ◽  
Hospital Discharge ◽  
Muscle Power ◽  
Muscle Size ◽  
Ultrasound Images ◽  
Icu Admission ◽  
Percent Change ◽  
Icu Discharge

Abstract Background Patients surviving critical illness develop muscle weakness and impairments in physical function; however, the relationship between early skeletal muscle alterations and physical function at hospital discharge remains unclear. The primary purpose of this study was to determine whether changes in muscle size, strength and power assessed in the intensive care unit (ICU) predict physical function at hospital discharge. Methods Study design is a single-center, prospective, observational study in patients admitted to the medicine or cardiothoracic ICU with diagnosis of sepsis or acute respiratory failure. Rectus femoris (RF) and tibialis anterior (TA) muscle ultrasound images were obtained day one of ICU admission, repeated serially and assessed for muscle cross-sectional area (CSA), layer thickness (mT) and echointensity (EI). Muscle strength, as measured by Medical Research Council-sum score, and muscle power (lower-extremity leg press) were assessed prior to ICU discharge. Physical function was assessed with performance on 5-times sit-to-stand (5STS) at hospital discharge. Results Forty-one patients with median age of 61 years (IQR 55–68), 56% male and sequential organ failure assessment score of 8.1 ± 4.8 were enrolled. RF muscle CSA decreased significantly a median percent change of 18.5% from day 1 to 7 (F = 26.6, p = 0.0253). RF EI increased at a mean percent change of 10.5 ± 21% in the first 7 days (F = 3.28, p = 0.081). At hospital discharge 25.7% of patients (9/35) met criteria for ICU-acquired weakness. Change in RF EI in first 7 days of ICU admission and muscle power measured prior to ICU were strong predictors of ICU-AW at hospital discharge (AUC = 0.912). Muscle power at ICU discharge, age and ICU length of stay were predictive of performance on 5STS at hospital discharge. Conclusion ICU-assessed muscle alterations, specifically RF EI and muscle power, are predictors of diagnosis of ICU-AW and physical function assessed by 5x-STS at hospital discharge in patients surviving critical illness.

scholarly journals Acute skeletal muscle wasting and dysfunction predict physical disability at hospital discharge in patients with critical illness

2020 ◽  
Author(s):  
Kirby P. Mayer ◽  
Melissa L. Thompson Bastin ◽  
Ashley A. Montgomery-Yates ◽  
Amy M. Pastva ◽  
Esther E. Dupont-Versteegden ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Critical Illness ◽  
Physical Function ◽  
Hospital Discharge ◽  
Muscle Power ◽  
Muscle Size ◽  
Ultrasound Images ◽  
Icu Admission ◽  
Percent Change ◽  
Icu Discharge

Abstract Background: Patients surviving critical illness develop muscle weakness and impairments in physical function, however, the relationship between early skeletal muscle dysfunction and physical function at hospital discharge remains unclear. The primary purpose of this study was to determine if changes in muscle size, strength and power assessed in the intensive care unit (ICU) predict physical function at hospital discharge. Methods: Study design is a single-center, prospective, observational study in patients admitted to the medicine or cardiothoracic ICU with diagnosis of sepsis or acute respiratory failure. Rectus femoris (RF) and tibialis anterior (TA) muscle ultrasound images were obtained day one of ICU admission, repeated serially and assessed for muscle cross-sectional area (CSA), layer thickness (mT), and echointensity (EI). Muscle strength, as measured by Medical Research Council-sum score, and muscle power (lower-extremity leg-press) were assessed prior to ICU discharge. Physical function was assessed with performance on 5-times sit-to-stand (5STS) at hospital discharge. Results: Forty-one patients with median age of 61 years (IQR 55-68), 56% male, and sequential organ failure assessment score of 8.1 ± 4.8 were enrolled. RF muscle CSA decreased significantly a median percent change of 18.5% from day 1 to 7 (F = 26.6, p = 0.0253). RF EI increased at a mean percent change of 10.5 ± 21% in the first 7 days (F = 3.28, p = 0.081). At hospital discharge 25.7% of patients (9/35) met criteria for ICU-acquired weakness. Change in RF EI in first 7 days of ICU admission and muscle power measured prior to ICU were strong predictors of ICU-AW at hospital discharge(AUC = 0.912). Muscle power at ICU discharge, age and ICU length of stay were predictive of performance on 5STS at hospital discharge. Conclusion: ICU-assessed muscle alterations, specifically RF EI and muscle power are predictors of diagnosis of ICU-AW and physical function assessed by 5x-STS at hospital discharge in patients surviving critical illness.

scholarly journals Acute skeletal muscle wasting and dysfunction predict physical disability at hospital discharge in patients with critical illness

2020 ◽  
Author(s):  
Kirby P. Mayer ◽  
Melissa L. Thompson Bastin ◽  
Ashley A. Montgomery-Yates ◽  
Amy M. Pastva ◽  
Esther E. Dupont-Versteegden ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Critical Illness ◽  
Physical Function ◽  
Hospital Discharge ◽  
Muscle Power ◽  
Muscle Size ◽  
Ultrasound Images ◽  
Icu Admission ◽  
Percent Change ◽  
Icu Discharge

Abstract Background: Patients surviving critical illness develop muscle weakness and impairments in physical function, however, the relationship between early skeletal muscle alterations and physical function at hospital discharge remains unclear. The primary purpose of this study was to determine if changes in muscle size, strength and power assessed in the intensive care unit (ICU) predict physical function at hospital discharge. Methods: Study design is a single-center, prospective, observational study in patients admitted to the medicine or cardiothoracic ICU with diagnosis of sepsis or acute respiratory failure. Rectus femoris (RF) and tibialis anterior (TA) muscle ultrasound images were obtained day one of ICU admission, repeated serially and assessed for muscle cross-sectional area (CSA), layer thickness (mT), and echointensity (EI). Muscle strength, as measured by Medical Research Council-sum score, and muscle power (lower-extremity leg-press) were assessed prior to ICU discharge. Physical function was assessed with performance on 5-times sit-to-stand (5STS) at hospital discharge.Results: Forty-one patients with median age of 61 years (IQR 55-68), 56% male, and sequential organ failure assessment score of 8.1 ± 4.8 were enrolled. RF muscle CSA decreased significantly a median percent change of 18.5% from day 1 to 7 (F = 26.6, p = 0.0253). RF EI increased at a mean percent change of 10.5 ± 21% in the first 7 days (F = 3.28, p = 0.081). At hospital discharge 25.7% of patients (9/35) met criteria for ICU-acquired weakness. Change in RF EI in first 7 days of ICU admission and muscle power measured prior to ICU were strong predictors of ICU-AW at hospital discharge (AUC = 0.912). Muscle power at ICU discharge, age and ICU length of stay were predictive of performance on 5STS at hospital discharge.Conclusion: ICU-assessed muscle alterations, specifically RF EI and muscle power are predictors of diagnosis of ICU-AW and physical function assessed by 5x-STS at hospital discharge in patients surviving critical illness.

scholarly journals Multicentre pilot randomised clinical trial of early in-bed cycle ergometry with ventilated patients

2019 ◽  
Vol 6 (1) ◽  
pp. e000383 ◽  
Author(s):  
Michelle E Kho ◽  
Alexander J Molloy ◽  
France J Clarke ◽  
Julie C Reid ◽  
Margaret S Herridge ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Physical Function ◽  
Hospital Discharge ◽  
Randomised Clinical Trial ◽  
Consent Rate ◽  
Main Trial ◽  
Intervention Delivery ◽  
Icu Admission ◽  
Icu Discharge ◽  
Pilot Rct

IntroductionAcute rehabilitation in critically ill patients can improve post-intensive care unit (post-ICU) physical function. In-bed cycling early in a patient’s ICU stay is a promising intervention. The objective of this study was to determine the feasibility of recruitment, intervention delivery and retention in a multi centre randomised clinical trial (RCT) of early in-bed cycling with mechanically ventilated (MV) patients.MethodsWe conducted a pilot RCT conducted in seven Canadian medical-surgical ICUs. We enrolled adults who could ambulate independently before ICU admission, within the first 4 days of invasive MV and first 7 days of ICU admission. Following informed consent, patients underwent concealed randomisation to either 30 min/day of in-bed cycling and routine physiotherapy (Cycling) or routine physiotherapy alone (Routine) for 5 days/week, until ICU discharge. Our feasibility outcome targets included: accrual of 1–2 patients/month/site; >80% cycling protocol delivery; >80% outcomes measured and >80% blinded outcome measures at hospital discharge. We report ascertainment rates for our primary outcome for the main trial (Physical Function ICU Test-scored (PFIT-s) at hospital discharge).ResultsBetween 3/2015 and 6/2016, we randomised 66 patients (36 Cycling, 30 Routine). Our consent rate was 84.6 % (66/78). Patient accrual was (mean (SD)) 1.1 (0.3) patients/month/site. Cycling occurred in 79.3% (146/184) of eligible sessions, with a median (IQR) session duration of 30.5 (30.0, 30.7) min. We recorded 43 (97.7%) PFIT-s scores at hospital discharge and 37 (86.0%) of these assessments were blinded.DiscussionOur pilot RCT suggests that a future multicentre RCT of early in-bed cycling for MV patients in the ICU is feasible.Trial registration numberNCT02377830.

scholarly journals Healthcare trajectories before and after critical illness: population-based insight on diverse patients clusters

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Youenn Jouan ◽  
Leslie Grammatico-Guillon ◽  
Noémie Teixera ◽  
Claire Hassen-Khodja ◽  
Christophe Gaborit ◽  
...  
Keyword(s):  
Septic Shock ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Critical Illness ◽  
Length Of Stay ◽  
Population Based ◽  
Hospital Length Of Stay ◽  
Healthcare Use ◽  
Icu Admission ◽  
Icu Discharge

Abstract Background The post intensive care syndrome (PICS) gathers various disabilities, associated with a substantial healthcare use. However, patients’ comorbidities and active medical conditions prior to intensive care unit (ICU) admission may partly drive healthcare use after ICU discharge. To better understand retative contribution of critical illness and PICS—compared to pre-existing comorbidities—as potential determinant of post-critical illness healthcare use, we conducted a population-based evaluation of patients’ healthcare use trajectories. Results Using discharge databases in a 2.5-million-people region in France, we retrieved, over 3 years, all adult patients admitted in ICU for septic shock or acute respiratory distress syndrome (ARDS), intubated at least 5 days and discharged alive from hospital: 882 patients were included. Median duration of mechanical ventilation was 11 days (interquartile ranges [IQR] 8;20), mean SAPS2 was 49, and median hospital length of stay was 42 days (IQR 29;64). Healthcare use (days spent in healthcare facilities) was analyzed 2 years before and 2 years after ICU admission. Prior to ICU admission, we observed, at the scale of the whole study population, a progressive increase in healthcare use. Healthcare trajectories were then explored at individual level, and patients were assembled according to their individual pre-ICU healthcare use trajectory by clusterization with the K-Means method. Interestingly, this revealed diverse trajectories, identifying patients with elevated and increasing healthcare use (n = 126), and two main groups with low (n = 476) or no (n = 251) pre-ICU healthcare use. In ICU, however, SAPS2, duration of mechanical ventilation and length of stay were not different across the groups. Analysis of post-ICU healthcare trajectories for each group revealed that patients with low or no pre-ICU healthcare (which represented 83% of the population) switched to a persistent and elevated healthcare use during the 2 years post-ICU. Conclusion For 83% of ARDS/septic shock survivors, critical illness appears to have a pivotal role in healthcare trajectories, with a switch from a low and stable healthcare use prior to ICU to a sustained higher healthcare recourse 2 years after ICU discharge. This underpins the hypothesis of long-term critical illness and PICS-related quantifiable consequences in healthcare use, measurable at a population level.

Anemia in Critically Ill Patients With Acute Respiratory Distress Syndrome and Posthospitalization Physical Outcomes

2020 ◽  
pp. 088506662091326
Author(s):  
Matthew A. Warner ◽  
Daryl J. Kor ◽  
Ryan D. Frank ◽  
Victor D. Dinglas ◽  
Pedro Mendez-Tellez ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Critical Illness ◽  
Muscle Strength ◽  
Respiratory Distress Syndrome ◽  
Hospital Discharge ◽  
Distress Syndrome ◽  
Physical Status ◽  
Icu Discharge ◽  
Multivariable Regression ◽  
Physical Outcomes

Objective: Anemia is common during critical illness and often persists after hospital discharge; however, its potential association with physical outcomes after critical illness is unclear. Our objective was to assess the associations between hemoglobin at intensive care unit (ICU) and hospital discharge with physical status at 3-month follow-up in acute respiratory distress syndrome (ARDS) survivors. Methods: This is a secondary analysis of a multisite prospective cohort study of 195 mechanically ventilated ARDS survivors from 13 ICUs at 4 teaching hospitals in Baltimore, Maryland. Multivariable regression was utilized to assess the relationships between ICU and hospital discharge hemoglobin concentrations with measures of physical status at 3 months, including muscle strength (Medical Research Council sumscore), exercise capacity (6-minute walk distance [6MWD]), and self-reported physical functioning (36-Item Short-Form Health Survey [SF-36v2] Physical Function score and Activities of Daily Living [ADL] dependencies). Results: Median (interquartile range) hemoglobin concentrations at ICU and hospital discharge were 9.5 (8.5-10.7) and 10.0 (9.0-11.2) g/dL, respectively. In multivariable regression analyses, higher ICU discharge hemoglobin concentrations (per 1 g/dL) were associated with greater 3-month 6MWD mean percent of predicted (3.7% [95% confidence interval 0.8%-6.5%]; P = .01) and fewer ADL dependencies (−0.2 [−0.4 to −0.1]; P = .02), but not with percentage of maximal muscle strength (0.7% [−0.9 to 2.3]; P = .37) or SF-36v2 normalized Physical Function scores (0.8 [−0.3 to 1.9]; P = .15). The associations of physical outcomes and hospital discharge hemoglobin concentrations were qualitatively similar, but none were statistically significant. Conclusions: In ARDS survivors, higher hemoglobin concentrations at ICU discharge, but not hospital discharge, were significantly associated with improved exercise capacity and fewer ADL dependencies. Future studies are warranted to further assess these relationships.

scholarly journals Employment status and its associated factor for patients 12 months after intensive care: Secondary analysis of the SMAP-HoPe-study

2021 ◽  
Author(s):  
Takeshi Unoki ◽  
Mio Kitayama ◽  
Hideaki Sakuramoto ◽  
Akira Ouchi ◽  
Tomoki Kuribara ◽  
...  
Keyword(s):  
Intensive Care ◽  
Depressive Symptoms ◽  
Physical Function ◽  
Employment Status ◽  
Depression Scale ◽  
Community Support ◽  
Financial Status ◽  
Icu Admission ◽  
Number Of Patients ◽  
Icu Discharge

AbstractReturning to work is a serious issue that affects patients who are being discharged from the intensive care unit (ICU). This study aimed to clarify the employment status and the perceived household financial status of ICU patients 12 months following discharge from the ICU. Additionally, a hypothesis of whether depressive symptoms were associated with subsequent unemployment status was tested. This study was a subgroup analysis using data from the published Survey of Multicenter Assessment with Postal questionnaire for Post-Intensive Care Syndrome (PICS) for Home Living Patients (the SMAP-HoPe study) in Japan. The patients included those who had a history of staying in the ICU for at least three nights and had been living at home for one year following discharge, between October 2019 and July 2020. We assessed employment status, subjective cognitive functions, household financial status, Hospital Anxiety and Depression Scale scores, and EuroQOL-5 dimensions of physical function at 12 months following intensive care. This study included 328 patients who were known to be employed prior to ICU admission. The median age was 64 (Interquartile Range [IQR] 52-72), and males were predominant (86%). Seventy-nine (24%) of those evaluated were unemployed. The number of patients who reported worsened financial status was significantly higher in the unemployed group. (p<.01) Multivariate analysis showed that higher age (Odds Ratio [OR]: 1.06, 95% Confidence Interval [CI]: 1.03-1.08]) and severity of depressive symptoms (OR: 1.13 [95% CI: 1.05-1.23]) were independent factors for employment status after 12 months from being discharged from the ICU. These factors were determined to be significant even after adjusting for sex, physical function, and cognitive function. We found that one-fourth of our patients who had been employed prior to ICU admission were subsequently unemployed 12 months following ICU discharge. Additionally, depressive symptoms were associated with unemployment status. The government and the local municipalities should provide medical and financial support to such patients. Additionally, community support for such patients is warranted.

scholarly journals Ultrasonic Elastography of the Rectus Femoris, a Potential Tool to Predict Sarcopenia in Patients With Chronic Obstructive Pulmonary Disease

2022 ◽  
Vol 12 ◽  
Author(s):  
Mingming Deng ◽  
Xiaoming Zhou ◽  
Yanxia Li ◽  
Yan Yin ◽  
Chaonan Liang ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Physical Function ◽  
Muscle Function ◽  
Rectus Femoris ◽  
Chronic Obstructive ◽  
Muscle Dysfunction ◽  
Obstructive Pulmonary Disease ◽  
Skeletal Muscle Dysfunction ◽  
Tnf Α ◽  
Potential Tool

Purpose: Skeletal muscle dysfunction is common in patients with chronic obstructive pulmonary disease (COPD) and is associated with a poor prognosis. Abnormal muscle quantity of the lower limbs is a manifestation of skeletal muscle dysfunction in patients with COPD. Shear wave ultrasound elastography (SWE) is a novel and possible tool to evaluate qualitative muscle parameters. This study explores the feasibility of SWE to measure the stiffness of the rectus femoris and evaluates its value in predicting sarcopenia in patients with COPD.Methods: Ultrasound examination of the rectus femoris was performed to determine the mean elasticity index (SWEmean), cross-sectional area (RFcsa), and thickness (RFthick) using grayscale ultrasonography (US) and SWE in 53 patients with COPD and 23 age-matched non-COPD healthy controls. The serum levels of circulating biomarkers (GDF15, resistin, and TNF-α) were measured using ELISA. The definition of sarcopenia followed the guidelines from the Asian Working Group for Sarcopenia. Receiver operating characteristic (ROC) curve analysis of the SWEmean, RFthick, and RFcsa was used to evaluate their predictive ability for sarcopenia.Results: The intraobserver and interobserver repeatability of SWE performance was excellent (all correlation coefficients &gt; 0.95; p &lt; 0.05). The SWEmean of the rectus femoris in patients with COPD (8.98 ± 3.12 kPa) was decreased compared with that in healthy controls (17.00 ± 5.14 kPa) and decreased with advanced global initiative for chronic obstructive lung disease (GOLD) stage. Furthermore, SWEmean was found to be independent of sex, height, and body mass, and a lower SWEmean in patients with COPD was positively associated with reduced pulmonary function, worse physical function, poor exercise tolerance, decreased muscle strength, and worse dyspnea index score. The correlation between physical function [five-repetition sit-to-stand test (5STST)], muscle function, and SWEmean was higher than those of RFthick and RFcsa. In addition, SWEmean was negatively correlated with serum GDF15 levels (r = −0.472, p &lt; 0.001), serum resistin levels (r = −0.291, p = 0.035), and serum TNF-α levels (r = −0.433, p = 0.001). Finally, the predictive power of SWEmean [area under the curve (AUC): 0.863] in the diagnosis of sarcopenia was higher than that of RFthick (AUC: 0.802) and RFcsa (AUC: 0.816).Conclusion: Compared with grayscale US, SWE was not affected by the patient’s height, weight, or BMI and better represented skeletal muscle function and physical function. Furthermore, SWE is a promising potential tool to predict sarcopenia in patients with COPD.

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