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Table 2 Multivariate analysis determining the impact of day 3/LD serum cholesterol on the development of ICU-acquired muscle weakness in critically ill patients

From: Altered cholesterol homeostasis in critical illness-induced muscle weakness: effect of exogenous 3-hydroxybutyrate

Acquisition of ICU-acquired weaknessA

 

Odd ratio (95% CI)

p value

Role of serum cholesterol

  

 Serum cholesterol day 3/LD (per mg/l added)

0.94 (0.89–1.00)

0.05

 Randomization to late-PNB

0.69 (0.47–1.00)

0.05

 Baseline risk factors

  

  Age (per year added)

1.01 (1.00–1.03)

0.005

  Male gender

0.84 (0.57–1.24)

0.4

  BMI (25–40 kg/m2)

0.83 (0.55–1.23)

0.3

  NRS ≥ 5

1.41 (0.92–2.16)

0.1

  APACHE II (per unit added)

1.10 (1.07–1.13)

< 0.0001

  Presence of diabetes

0.72 (0.41–1.23)

0.2

  Presence of malignancy

0.90 (0.57–1.42)

0.6

  Pre-admission dialysis

2.15 (0.35–13.29)

0.3

  Sepsis upon admission

2.26 (1.42–3.59)

0.0005

  Admission categories (compared with medical ICU)

  

   Surgical ICU, emergency

0.68 (0.39–1.16)

0.1

   Surgical ICU, elective

1.83 (0.61–5.45)

0.2

   Cardiac surgery

1.84 (0.90–3.75)

0.09

Impact of statin therapy

  

 Statin therapy

0.66 (0.40–1.08)

0.1

 Serum cholesterol day 3/LD (per mg/l added)

0.94 (0.89–0.99)

0.03

 Randomization to late-PNB

0.68 (0.46–0.99)

0.04

 Baseline risk factors

  

  Age (per year added)

1.02 (1.00–1.03)

0.002

  Male gender

0.86 (0.58–1.27)

0.4

  BMI (25–40 kg/m2)

0.86 (0.58–1.29)

0.4

  NRS ≥ 5

1.45 (0.94–2.23)

0.08

  APACHE II (per unit added)

1.10 (1.07–1.13)

 < 0.0001

  Presence of diabetes

0.79 (0.45–1.37)

0.4

  Presence of malignancy

0.89 (0.57–1.41)

0.6

  Pre-admission dialysis

2.06 (0.33–12.58)

0.4

  Sepsis upon admission

0.44 (0.28–0.70)

0.0006

  Admission categories (compared with medical ICU)

  

   Surgical ICU, emergency

0.71 (0.41–1.23)

0.2

   Surgical ICU, elective

1.83 (0.61–5.46)

0.2

   Cardiac surgery

2.04 (1.00–4.20)

0.05

  1. AMuscle weakness was assessed by the Medical Research Center (MRC) sum score: a score of less than 48 is considered weak [24].
  2. BThe EPaNIC RCT showed that withholding parenteral nutrition until beyond the first week in intensive care unit (ICU) (late-PN) was clinically superior to early parenteral nutrition supplementing insufficient enteral nutrition (early-PN): it shortened ICU stay, quickened recovery and reduced the acquisition of ICU-acquired weakness [23, 24]. Study randomization did not affect day 3/LD cholesterol concentrations (72.7 ± 2.0 mg/dl in early-PN patients vs. 74.9 ± 2.0 mg/dl in late-PN patients; p = 0.2). See also Additional file 1: Table S2 for the independent association between the factors in this model and serum cholesterol day 3/LD. BMI is body mass index, or weight in kilograms divided by the square of the height in meters. APACHEII reflects scores on the Acute Physiology and Chronic Health Evaluation II (APACHE II) range from 0 to 71, with higher scores indicating a greater severity of illness. NRS reflects Nutritional Risk Screening (NRS) scores which range from 0 to 7, with higher scores indicating a higher risk of malnutrition
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Critical Care

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