1. Introduction
muscle mass, skeletal muscle, sarcopenia, malnutrition, Frailty, impaired muscle function
MALNOURISHED, SECONDARY, SARCOPENIA, MALNUTRITION
These authors contributed equally to this work.Background: Measurement of skeletal muscle index (SMI) in computed tomography has been suggested to improve the objective assessment of muscle mass. While most studies have focused on lumbar vertebrae, we examine the association of SMI at the thoracic level with nutritional and clinical outcomes and response to nutritional intervention. Methods: We conducted a secondary analysis of EFFORT, a Swiss-wide, multicenter, randomized trial. We investigated the association of low SMI at the 12th thoracic vertebra (T12) with adverse outcome within 30 days after hospital admission (primary endpoint). Results: 663 of 2028 patients from the EFFORT trial had available CT scans for T12, and 519 among them also had available L3 scans. Mean SMI at T12 was 22.4 ± 5.8 cmSarcopenia is defined as a reduction in either muscle mass or quality in the context of impaired muscle function and has been shown to predict adverse outcome in different patient populations, particularly in patients with malnutrition [Indeed, there is a need to better validate the different available tools to assess muscle mass and muscle function, including different imaging modalities as well as functional tests. Yet, computer tomography (CT)-based diagnosis of sarcopenia has emerged as a reliable and objective method to measure muscle mass. Herein, CT-based measures allow the assessment of both skeletal muscle and adipose tissue. For quantification of muscle mass, previous researchers have suggested the use of the skeletal muscle index (SMI), which estimates the area of total skeletal muscle (cmHerein, our aim was to examine the association of SMI at level T12 with clinical outcomes as well as nutritional outcomes and with the response to nutritional intervention in patients included in the Effect of early nutritional support on Frailty, Functional Outcomes, and Recovery of malnourished medical inpatients Trial (EFFORT) [