CT-Determined Sarcopenia and Mortality in Critically Ill Cancer Patients

Hospital H+ Queretaro23 enrolled

Overview

The goal of this observational study is to evaluate the association between computed tomography-determined sarcopenia and muscle quality impairment with 28-day mortality in adult patients (aged 18 and older) with solid or hematologic malignancies admitted to the Intensive Care Unit (ICU). The main question it aims to answer is: Is lower psoas muscle quality, calculated using the Hounsfield Unit Average Calculation (HUAC), associated with increased 28-day mortality in critically ill cancer patients? Researchers will compare patients who survived at 28 days with those who died to evaluate whether tomographic muscle measurements (HUAC and total psoas area) and clinical nutritional scores (mNUTRIC) differ between groups and predict mortality. Participants' records will be evaluated through: * A retrospective review of electronic medical records to collect demographic, clinical, oncologic, laboratory, and disease severity scores (APACHE II, SOFA, mNUTRIC). * Quantitative tomographic assessment of the right and left psoas muscle area and radiation attenuation density (in Hounsfield Units) using existing computed tomography (CT) scans performed during routine clinical care. * Follow-up of 28-day vital status (alive or deceased) after ICU admission.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Sarcopenia Cancer Critical Illness Malnutrition

Interventions

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Adult patients aged 18 years or older. * Confirmed diagnosis of solid or hematological malignancy. * Admitted to the Intensive Care Unit (ICU) between January 1, 2022, and December 31, 2025. * Availability of an abdominal computed tomography (CT) scan performed during routine clinical care at the time of or prior to ICU admission. Exclusion Criteria: * Missing or incomplete clinical, laboratory, or outcome data in the electronic medical record. * Non-evaluable abdominal CT scans due to motion artifacts, metal artifacts, or lack of cross-sectional visibility of the bilateral psoas muscles.

Outcomes

Primary Outcomes

28-Day All-Cause Mortality

Vital status (alive or deceased) of critically ill cancer patients evaluated at 28 days following their admission to the Intensive Care Unit (ICU). The association with muscle quality metrics, specifically the Hounsfield Unit Average Calculation (HUAC) of the psoas muscles obtained via computed tomography (CT) scan, will be assessed.

Time frame: At 28 days post-ICU admission

Secondary Outcomes

Nutritional Risk Assessment via mNUTRIC Score

Evaluation of nutritional risk upon ICU admission using the modified Nutrition Risk in Critically Ill (mNUTRIC) score. The score ranges from 0 to 9 points, where 0 represents the lowest nutritional risk and 9 represents the highest nutritional risk (higher scores indicate a worse outcome/higher nutritional risk; a score \> 5 indicates high nutritional risk).

Time frame: Baseline (at ICU admission)

Total Psoas Muscle Cross-Sectional Area

Quantitative measurement of the total cross-sectional area of the right and left psoas muscles combined (mm\^2 or cm\^2) derived from abdominal computed tomography (CT) scans to assess muscle mass quantity.

Time frame: Baseline (CT scans performed within routine care prior to or at ICU admission)

Acute Physiology and Chronic Health Evaluation II (APACHE II) Score

Assessment of clinical disease severity at ICU admission using the Acute Physiology and Chronic Health Evaluation II (APACHE II) score. The score ranges from 0 to 71 points, where 0 indicates no physiological impairment and 71 represents the most severe degree of illness (higher scores indicate greater disease severity and a higher risk of mortality).

Time frame: At ICU admission (Baseline)

Sequential Organ Failure Assessment (SOFA) Score

Assessment of organ dysfunction at ICU admission using the Sequential Organ Failure Assessment (SOFA) score. The score ranges from 0 to 24 points, where 0 indicates normal organ function and 24 represents severe multi-organ failure (higher scores indicate greater organ dysfunction and worse prognosis).