Pectoral muscle area index is an independent protective factor for mortality in sepsis patients: a retrospective observational study
Background Sepsis is an infection-induced systemic inflammatory response involving multiple mediators. Identifying risk factors for mortality in patients with sepsis is important for determining treatment strategies. Sarcopenia is a systemic pathology of the skeletal muscles associated with poor out...
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2025-07-01
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| author | Xin Li Meijiao Li Yongchang Sun Qingtao Zhou |
| author_facet | Xin Li Meijiao Li Yongchang Sun Qingtao Zhou |
| author_sort | Xin Li |
| collection | DOAJ |
| description | Background Sepsis is an infection-induced systemic inflammatory response involving multiple mediators. Identifying risk factors for mortality in patients with sepsis is important for determining treatment strategies. Sarcopenia is a systemic pathology of the skeletal muscles associated with poor outcomes in patients with sepsis. However, there exists a gap in the literature regarding the thoracic muscle area and early outcomes of sepsis. Thus, this study investigated the relationship between 28-day survival and indicators of sarcopenia (pectoral muscle area and pectoral muscle density) from chest computed tomography images of patients with sepsis. Methods Patients (n = 134, median age = 75 years) who met the Sepsis-3 diagnosis criteria were included. Pectoral muscle area and density were measured in patients who underwent pulmonary computed tomography within ±3 days of admission. Univariate and multivariable factors associated with 28-day mortality were evaluated via Cox regression analysis. Factors with a single-factor p < 0.05 were included in the multivariate Cox regression analysis to evaluate the factors associated with 28-day mortality in sepsis. Results In this study, 88 patients survived, whereas 46 did not survive at the 28-day mark. Body mass index (BMI) (P = 0.044), pectoral muscle area (P = 0.005), pectoral muscle density (P = 0.008), and pectoral muscle area index (P = 0.003) significantly differed between patients who survived and those who did not survive. BMI was positively correlated with pectoral muscle area (r = 0.516, P < 0.001) and index (r = 0.560, P < 0.001). Acute Physiology and Chronic Health Evaluation II score (hazard ratio (HR) = 1.119, P < 0.001) constituted an independent risk factor for 28-day mortality, whereas the pectoral muscle area index (HR, 0.847; P = 0.027) was a protective factor for 28-day mortality in patients with sepsis. The pectoral muscle area index was associated with a reduced risk of early mortality in patients with sepsis. |
| format | Article |
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| institution | DOAJ |
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| language | English |
| publishDate | 2025-07-01 |
| publisher | PeerJ Inc. |
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| spelling | doaj-art-a364c9cdfe2f40489fe30650b6b18ae72025-08-20T02:50:05ZengPeerJ Inc.PeerJ2167-83592025-07-0113e1968910.7717/peerj.19689Pectoral muscle area index is an independent protective factor for mortality in sepsis patients: a retrospective observational studyXin Li0Meijiao Li1Yongchang Sun2Qingtao Zhou3Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, ChinaDepartment of Radiology, Peking University Third Hospital, Beijing, ChinaDepartment of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, ChinaDepartment of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, ChinaBackground Sepsis is an infection-induced systemic inflammatory response involving multiple mediators. Identifying risk factors for mortality in patients with sepsis is important for determining treatment strategies. Sarcopenia is a systemic pathology of the skeletal muscles associated with poor outcomes in patients with sepsis. However, there exists a gap in the literature regarding the thoracic muscle area and early outcomes of sepsis. Thus, this study investigated the relationship between 28-day survival and indicators of sarcopenia (pectoral muscle area and pectoral muscle density) from chest computed tomography images of patients with sepsis. Methods Patients (n = 134, median age = 75 years) who met the Sepsis-3 diagnosis criteria were included. Pectoral muscle area and density were measured in patients who underwent pulmonary computed tomography within ±3 days of admission. Univariate and multivariable factors associated with 28-day mortality were evaluated via Cox regression analysis. Factors with a single-factor p < 0.05 were included in the multivariate Cox regression analysis to evaluate the factors associated with 28-day mortality in sepsis. Results In this study, 88 patients survived, whereas 46 did not survive at the 28-day mark. Body mass index (BMI) (P = 0.044), pectoral muscle area (P = 0.005), pectoral muscle density (P = 0.008), and pectoral muscle area index (P = 0.003) significantly differed between patients who survived and those who did not survive. BMI was positively correlated with pectoral muscle area (r = 0.516, P < 0.001) and index (r = 0.560, P < 0.001). Acute Physiology and Chronic Health Evaluation II score (hazard ratio (HR) = 1.119, P < 0.001) constituted an independent risk factor for 28-day mortality, whereas the pectoral muscle area index (HR, 0.847; P = 0.027) was a protective factor for 28-day mortality in patients with sepsis. The pectoral muscle area index was associated with a reduced risk of early mortality in patients with sepsis.https://peerj.com/articles/19689.pdfIntensive care unitsPectoralis musclesPrognosisProtective factorsSepsis |
| spellingShingle | Xin Li Meijiao Li Yongchang Sun Qingtao Zhou Pectoral muscle area index is an independent protective factor for mortality in sepsis patients: a retrospective observational study PeerJ Intensive care units Pectoralis muscles Prognosis Protective factors Sepsis |
| title | Pectoral muscle area index is an independent protective factor for mortality in sepsis patients: a retrospective observational study |
| title_full | Pectoral muscle area index is an independent protective factor for mortality in sepsis patients: a retrospective observational study |
| title_fullStr | Pectoral muscle area index is an independent protective factor for mortality in sepsis patients: a retrospective observational study |
| title_full_unstemmed | Pectoral muscle area index is an independent protective factor for mortality in sepsis patients: a retrospective observational study |
| title_short | Pectoral muscle area index is an independent protective factor for mortality in sepsis patients: a retrospective observational study |
| title_sort | pectoral muscle area index is an independent protective factor for mortality in sepsis patients a retrospective observational study |
| topic | Intensive care units Pectoralis muscles Prognosis Protective factors Sepsis |
| url | https://peerj.com/articles/19689.pdf |
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