{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T11:03:32Z","timestamp":1793271812994,"version":"4.5.0"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T00:00:00Z","timestamp":1748217600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T00:00:00Z","timestamp":1748217600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100002839","name":"Charit\u00e9 - Universit\u00e4tsmedizin Berlin","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002839","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Anesthesiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>Muscle wasting in critically ill patients, particularly those with prolonged hospitalization, poses a significant challenge to recovery and long-term outcomes. The aim of this study was to characterize long-term muscle wasting trajectories in ICU patients with acute respiratory distress syndrome (ARDS) due to COVID-19 and acute pancreatitis (AP), to evaluate correlations between muscle wasting and patient outcomes, and to identify clinically feasible thresholds that have the potential to enhance patient care strategies.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Materials and methods<\/jats:title>\n            <jats:p>A collective of 154 ICU patients (100 AP and 54 COVID-19 ARDS) with a minimum ICU stay of 10 days and at least three abdominal CT scans were retrospectively analyzed. AI-driven segmentation of CT scans quantified changes in psoas muscle area (PMA). A mixed model analysis was used to assess the correlation between mortality and muscle wasting, Cox regression was applied to identify potential predictors of survival. Muscle loss rates, survival thresholds and outcome correlations were assessed using Kaplan-Meier and receiver operating characteristic (ROC) analyses.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Muscle loss in ICU patients was most pronounced in the first two weeks, peaking at -2.42% and \u2212\u20092.39% psoas muscle area (PMA) loss per day in weeks 1 and 2, respectively, followed by a progressive decline. The median total PMA loss was 48.3%, with significantly greater losses in non-survivors. Mixed model analysis confirmed correlation of muscle wasting with mortality. Cox regression identified visceral adipose tissue (VAT), sequential organ failure assessment (SOFA) score and muscle wasting as significant risk factors, while increased skeletal muscle area (SMA) was protective. ROC and Kaplan-Meier analyses showed strong correlations between PMA loss thresholds and survival, with daily loss\u2009&gt;\u20094% predicting the worst survival (39.7%).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>To our knowledge, This is the first study to highlight the substantial progression of muscle wasting in prolonged hospitalized ICU patients. The mortality-related thresholds for muscle wasting rates identified in this study may provide a basis for clinical risk stratification. Future research should validate these findings in larger cohorts and explore strategies to mitigate muscle loss.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Clinical trial number<\/jats:title>\n            <jats:p>Not applicable.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12871-025-03142-7","type":"journal-article","created":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T03:47:38Z","timestamp":1748231258000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The extent of Skeletal muscle wasting in prolonged critical illness and its association with survival: insights from a retrospective single-center study"],"prefix":"10.1186","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9843-2247","authenticated-orcid":false,"given":"Johannes","family":"Kolck","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clarissa","family":"Hosse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uli","family":"Fehrenbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick-Lasse","family":"Beetz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timo Alexander","family":"Auer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Pille","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominik","family":"Geisel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,26]]},"reference":[{"key":"3142_CR1","doi-asserted-by":"crossref","unstructured":"Vanhorebeek I, Latronico N, Van den Berghe G. ICU-acquired weakness. Intensive Care Med, 2020. 46(4): pp. 637\u2013653.","DOI":"10.1007\/s00134-020-05944-4"},{"issue":"14","key":"3142_CR2","doi-asserted-by":"publisher","first-page":"1293","DOI":"10.1056\/NEJMoa1011802","volume":"364","author":"MS Herridge","year":"2011","unstructured":"Herridge MS, et al. Functional disability 5 years after acute respiratory distress syndrome. N Engl J Med. 2011;364(14):1293\u2013304.","journal-title":"N Engl J Med"},{"issue":"1","key":"3142_CR3","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1186\/s12871-024-02687-3","volume":"24","author":"C Hosse","year":"2024","unstructured":"Hosse C, et al. Quantification of muscle recovery in post-ICU patients admitted for acute pancreatitis: a longitudinal single-center study. 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Low skeletal muscle area is a risk factor for mortality in mechanically ventilated critically ill patients. Crit Care. 2014;18(2):R12.","journal-title":"Crit Care"},{"issue":"1","key":"3142_CR7","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1186\/s13054-022-04253-0","volume":"27","author":"B Fazzini","year":"2023","unstructured":"Fazzini B, et al. The rate and assessment of muscle wasting during critical illness: a systematic review and meta-analysis. Crit Care. 2023;27(1):2.","journal-title":"Crit Care"},{"issue":"1","key":"3142_CR8","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1186\/s13613-023-01162-5","volume":"13","author":"J Kolck","year":"2023","unstructured":"Kolck J, et al. Intermittent body composition analysis as monitoring tool for muscle wasting in critically ill COVID-19 patients. 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Informed consent was waived by the Institutional Review Board of the Charit\u00e9 - Universit\u00e4tsmedizin Berlin.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"266"}}