ICU Muscle Loss Rate Predicts Survival, Berlin Study Finds

A study published in BMC Anesthesiology found that the rate of muscle wasting in ICU patients is a strong predictor of survival, with daily losses above 4% of psoas muscle area linked to survival rates below 40%. Researchers at a Berlin center analyzed 154 patients, including severe COVID-19 and acute pancreatitis cases, each with extended ICU stays and multiple abdominal CT scans. Artificial intelligence tracked changes in psoas muscle area across scans, enabling precise longitudinal measurement without additional clinical burden. The most severe losses occurred within the first two weeks of admission, with rates sometimes exceeding 4% per day and a median total loss of 48.3% across the full hospitalization. Non-survivors lost more than 56% of psoas muscle area on average, compared to lower losses among survivors. Patients losing muscle at under 2% per day showed survival probability near 85%. Higher baseline muscle mass had a protective effect, while elevated visceral fat and organ failure scores compounded risk. The findings suggest AI-assisted CT analysis of existing scans could be integrated into clinical monitoring to trigger earlier interventions in nutrition, physiotherapy, or sedation management.