Ultrasound Assessment of Quadriceps Muscle Layer Thickness as a Predictor of Outcome in Critically ill Patients

Aim: Muscle weakness in critically ill patients is associated with complications, but its accurate quantification at the bedside remains challenging.Our aim was to assess whether loss of quadriceps muscle layer thickness (QMLT) predicts mortality, and to examine its correlation with duration of mechanical ventilation and other severity indices. Materials and Methods:A total of 100 intensive care unit (ICU) patients were prospectively assessed with QMLT measurements on the dominant side on days 1, 3, and 7 of the ICU stay, or on the day of discharge, whichever occurred earlier.Results: Percentage decline in QMLT on days 3 and 7 (or discharge) was a significant predictor of mortality [for day 3: hazard ratio (HR): 1.06, 95% confidence interval (CI): 1.03-1.1,p=0.001; for day 7 or discharge: HR: 1.05, 95% CI: 1.02-1.07,p=0.0002].The decline in QMLT correlated well with mortality (p=0.50, p