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ISSN 2007-1752 (Print)
Archivos de Medicina de Urgencia de México

2025, Number 1

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Arch Med Urg Mex 2025; 17 (1)

Quadriceps ultrasound diagnostic performance in nutritional assessment of critically ill patients

Vargas-Miranda CE, Dector-Lira DM, Enríquez-Santos D, Mercado-Cruz E

Language: Spanish
References: 31
Page: 25-31
PDF size: 215.56 Kb.


ABSTRACT

Anthropometry, determination of basal energy expenditure, and measurement of prealbumin and transferrin are key in nutritional assessment. Muscle estimation, the loss of which is associated with worse outcomes, is another component. Ultrasound is an innovative tool for assessing muscle volume.
Objective: explore the diagnostic performance of quadriceps measurement during nutritional assessment five days after staying in intensive care.
Material and methods: longitudinal, prospective, observational study. It included patients ›18 years of age in intensive care. It excluded patients with kidney or liver disease, palliative care, pregnancy, puerperium, and those unable to perform measurements. Prealbumin, transferrin, and quadriceps thickness were measured by ultrasound upon admission and five days later. ROC curves were performed and sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. p ≤ 0.05 was considered significant.
Results: eighty patients were included. Age was 58.5 (51-68) years. Decreased quadriceps thickness (›3 mm) had a sensitivity of 30.8%, specificity of 73.3%, PPV of 83.3%, and NPV of 19.6%. The area under the curve was 0.52 (p=0.08).
Conclusion: ultrasound has a low diagnostic yield and should not be used alone to diagnose malnutrition in critically ill patients. It may be useful as a complement to other assessments.


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