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This study aimed to evaluate the diagnostic performance of muscular ultrasound (MUS) measurements in predicting ICU-AW and identify potential predictors.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Forty-three surgical and medical ICU patients underwent serial MUS measurements of the femoral cross-sectional area (Fcsa) and femoral\u2009+\u2009vastus intermedius thickness (F\u2009+\u2009VIth) on days 1, 3 and 5 post-ICU admission. Patients were categorized as having ICU-AW (Medical Research Council (MRC) sum score\u2009&lt;\u200948 at discharge) or not. Univariate and multivariate logistic regression analyses were performed to identify predictors of ICU-AW. The diagnostic performance of MUS measurements was assessed via receiver operating characteristic (ROC) curves. Clinical outcomes (ICU length of stay, ventilator days, extubation failure) were compared between the groups.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Patients with ICU-AW (<jats:italic>n<\/jats:italic>\u2009=\u200912, 28%) showed a significant reduction in the Fcsa from Day 1 to Day 5 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Univariate analysis revealed significant associations between ICU-AW and the Apache II score (OR 1.12, <jats:italic>p<\/jats:italic>\u2009=\u20090.03), SOFA score (OR 1.32, <jats:italic>p<\/jats:italic>\u2009=\u20090.008), and Day 1 F\u2009+\u2009VIth score (OR 0.23, <jats:italic>p<\/jats:italic>\u2009=\u20090.05). Multivariate analysis confirmed a significant association with the SOFA score (OR 1.35, <jats:italic>p<\/jats:italic>\u2009=\u20090.04) and a trend toward an F\u2009+\u2009VIth score of Day 1 (OR 0.12, <jats:italic>p<\/jats:italic>\u2009=\u20090.09). The day 1 Fcsa and F\u2009+\u2009VIth demonstrated moderate predictive capabilities for ICU-AW (ROC-AUC values of 0.72 and 0.82, respectively). ICU-AW patients experienced longer ICU stays, more ventilator days, and higher extubation failure rates.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Preexisting low muscle mass, combined with a high SOFA score, may be a stronger predictor of ICU-acquired weakness than the degree of subsequent muscle loss.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s40477-025-01013-y","type":"journal-article","created":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T13:01:40Z","timestamp":1745326900000},"page":"447-454","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Prospective ultrasonographic evaluation of femoral and vastus intermedius muscles as predictors of ICU-acquired weakness in critically ill patients"],"prefix":"10.1007","volume":"28","author":[{"given":"A. 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The Institutional Review Board approved the study (CCEI-13851\u20132022). Given that the study was observational following current clinical practices, the requirement for written consent to participate was waived by the ethics committee.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The authors affirm that the human research participants provided informed consent for the publication of the images in Fig.\u00a0a and 1b.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}]}}