Diaphragm thickness on computed tomography for nutritional assessment and hospital stay prediction in critical COVID-19.
Asia Pac J Clin Nutr
; 31(1): 33-40, 2022 Mar.
Article
in English
| MEDLINE | ID: covidwho-1771693
ABSTRACT
BACKGROUND AND OBJECTIVES:
To evaluate the significance of diaphragm thickness (DT) in assessing the nutritional status and predicting the length of hospital stay (LOS) of patients with COVID-19. METHODS AND STUDYDESIGN:
The data of 212 patients with severe and critical COVID-19 in Wuhan, China, were retrospectively analyzed. Computed tomography (CT)-obtained DT was measured in cross-sectional images of the mediastinal window at the level of the outlet of the celiac trunk at admission and at 2 weeks, then the rate of change in DT(RCDT) at 2 weeks was calculated. Nutritional risk and malnutrition were evaluated at admission.RESULTS:
A total of 91 patients were involved in the study. The mean DT was 3.06±0.58 mm (3.15±0.63 mm in male and 2.93±0.50 mm in female). DT was significantly negatively correlated with malnutrition based on Global Leadership Initiative on Malnutrition (GLIM) criteria (r=-0.324, p=0.002), Nutritional Risk Screening 2002 (NRS-2002) score (r=-0.364, p=0.000) and the Malnutrition Universal Screening Tool (MUST) score (r=-0.326, p=0.002) at admission. For the prediction of LOS ≥4 weeks in patients with COVID-19, the area under the ROC curve (AUC) of the RCDT at 2 weeks was 0.772, while the AUCs of DT, NRS-2002, MUST and Nutrition Risk in Critically Ill scores at admission were 0.751, 0.676, 0.638 and 0.699 respectively. According to the model of multiple linear regression analysis, the DT at admission (ß=-0.377, p=0.000), RCDT at 2 weeks (ß =-0.323, p=0.001), and mechanical ventilation (ß=0.192, p=0.031) were independent risk factors contributed to LOS.CONCLUSIONS:
CT-obtained DT can be used as a dynamic assessment tool for evaluating the nutritional status of patients in isolation wards for COVID-19.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Nutrition Assessment
/
COVID-19
Type of study:
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Limits:
Female
/
Humans
/
Male
Language:
English
Journal:
Asia Pac J Clin Nutr
Journal subject:
Nutritional Sciences
Year:
2022
Document Type:
Article
Affiliation country:
Apjcn.202203_31(1).0004
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