Biceps brachii muscle cross‐sectional area measured by ultrasonography is independently associated with one‐month mortality: A prospective observational study

Abstract

AbstractPurposeStudies examining mortality in palliative care units are limited. We aimed to investigate the mortality and associated factors including ultrasonographic muscle parameters in hospitalized palliative patients with a subgroup analysis of older patients.MethodsA prospective‐observational study. We recorded the demographics, number of diseases, diagnoses, and the Charlson comorbidity index (CCI), palliative performance scale (PPS), and nutritional risk screening‐2002 (NRS‐2002) scores. We noted the nutritional parameters and mortality. We measured the subcutaneous fat thickness (SFT), muscle thickness (MT), and cross‐sectional area (CSA) of the rectus femoris and biceps brachii using ultrasonography.ResultsWe enrolled 100 patients (mean age: 73.2 ± 16.4 years, 53%: female). One‐month mortality was 42%. The non‐survivors had significantly higher malignancy, increased CCI and NRS‐2002 scores, lower required energy intake, calorie sufficiency rate, and biceps brachii SFT, MT, and CSA than the survivors. The independent mortality predictors were malignancy and biceps brachii CSA while the PPS score and malignancy were significantly associated with mortality in the older subgroup.ConclusionThe malignancy and biceps brachii CSA might have prognostic value in predicting mortality in palliative patients. This was the first study investigating the mortality‐associated factors including ultrasonographic muscle measurements of both the lower and upper limbs in a palliative care center.