Key patient characteristics by 90-day survival.

BackgroundThe incidence and mortality of sepsis in the intensive care unit (ICU) remain persistently high. This study primarily investigates the risk factors associated with the 90-day mortality in sepsis patients.MethodThis retrospective study included 123 sepsis patients admitted to a hospital in China from January 2015 to December 2018, clinical and abdominal CT data were compared between survivors and non-survivors, logistic regression and Cox regression analyses were performed on the abdominal CT data, Finally, survival curves for different skeletal muscle indices were analyzed using the Kaplan-Meier (K-M) method.ResultIn the abdominal CT scan data, significant differences were observed between survivors and non-survivors in skeletal muscle density (SMD), skeletal muscle area (SMA), skeletal muscle index (SMI), and subcutaneous adipose tissue area (SAT); Cox regression analysis revealed that higher skeletal muscle density (SMD) (HR = 0.953; 95% CI = 0.923–0.984; p = 0.003), skeletal muscle area (SMA) (HR = 0.986; 95% CI = 0.976–0.997; p = 0.011), and skeletal muscle index (SMI) (HR = 0.951; 95% CI = 0.917–0.985; p = 0.005) were significantly associated with lower 90-day mortality compared to non-survivors. Finally, the Kaplan-Meier (K-M) curves demonstrated differences in survival based on the median skeletal muscle index (SMI).ConclusionBody composition parameters assessed by abdominal CT scans are highly associated with 90-day mortality in ICU patients with sepsis. Among them, SMD, SMA, and SMI are valuable prognostic factors.

背景：重症监护病房（Intensive Care Unit，ICU）内脓毒症的发病率与死亡率仍持续居高不下。本研究旨在探究脓毒症患者90天死亡率的相关危险因素。
方法：本研究为回顾性研究，纳入2015年1月至2018年12月期间国内某医院收治的123例脓毒症患者。对存活者与非存活者的临床资料及腹部CT影像数据进行对比分析；针对腹部CT数据开展logistic回归与Cox回归分析；最终采用Kaplan-Meier（K-M）法对不同骨骼肌指标的生存曲线进行分析。
结果：腹部CT影像数据显示，存活者与非存活者在骨骼肌密度（Skeletal Muscle Density，SMD）、骨骼肌面积（Skeletal Muscle Area，SMA）、骨骼肌指数（Skeletal Muscle Index，SMI）及皮下脂肪组织面积（Subcutaneous Adipose Tissue Area，SAT）方面均存在显著差异。Cox回归分析结果表明，相较于非存活者，较高的骨骼肌密度（SMD）（风险比Hazard Ratio，HR=0.953；95%置信区间Confidence Interval，CI=0.923~0.984；p=0.003）、骨骼肌面积（SMA）（HR=0.986；95%CI=0.976~0.997；p=0.011）及骨骼肌指数（SMI）（HR=0.951；95%CI=0.917~0.985；p=0.005）均与更低的90天死亡率显著相关。最终，Kaplan-Meier（K-M）曲线显示，基于骨骼肌指数（SMI）中位数分组的患者生存情况存在显著差异。
结论：腹部CT扫描评估的身体成分参数与ICU脓毒症患者的90天死亡率高度相关；其中，SMD、SMA及SMI均为具有临床价值的预后因素。