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Association of the Adductor Pollicis Muscle Thickness With Clinical Outcomes in Intensive Care Unit Patients
Author(s) -
Ghorabi Sima,
Ardehali Hossein,
Amiri Zohreh,
Vahdat Shariatpanahi Zahra
Publication year - 2016
Publication title -
nutrition in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.725
H-Index - 71
eISSN - 1941-2452
pISSN - 0884-5336
DOI - 10.1177/0884533615621547
Subject(s) - medicine , anthropometry , intensive care unit , confidence interval , odds ratio , hazard ratio , prospective cohort study , adductor pollicis muscle , medical nutrition therapy , surgery , elbow , ulnar nerve
Background: Different parameters may be used to evaluate the nutrition status of individuals. However, their use in the critically ill is problematic, since the interference of acute disease or therapeutic measures on their results can affect their interpretation. The aim of this study was to assess whether measuring the adductor pollicis muscle is useful in identifying malnutrition and clinical outcomes in the intensive care unit (ICU). Materials and Methods: In total, 127 patients were enrolled in this prospective observational study. Serum albumin levels, anthropometrics, adductor pollicis muscle (APM) thickness, and Acute Physiology and Chronic Health Evaluation II (APACHE II) score were measured for each patient upon admission. APM thickness (APMT) was measured while the patient's elbow was flexed at a 90‐degree angle and the forearm resting on the patient's torso. Results: The dominant and nondominant APMT were significantly correlated with all anthropometric measurements ( r = 0.41–0.68, P < .001 and r = 0.42–0.66, P < .001 respectively). Multivariate regression analysis adjusted by other risk factors, including APACHE II score, serum albumin, and age, showed that among all anthropometric variables, the APMT has the highest correlation with mortality (odds ratio [OR], 5.6; 95% confidence interval [CI], 0.02–0.12; P < .001), length of stay >10 days (OR, 11.3; 95% CI, 4.42–29.1; P < .001), and organ failure (OR, 14.5; 95% CI, 6.5–38.4; P < .001). Conclusions: The results showed that APMT is a low‐cost, reliable, and easy method to assess nutrition status and to predict the patient's outcomes in the ICU.