Introduction and Hypothesis: Sarcopenia is the degenerative loss of skeletal muscle and reported as a predictor of the unfavorable outcome in patients with chronic disease. We hypothesize that the prognosis in patients with cardiac arrest have an association with skeletal muscle amount.
Methods: Fifty-five consecutive patients over 15 years old with non-traumatic cardiac arrest that underwent abdominal CT during January 2014 to December 2015 were the subjects. Cross-sectional area of abdominal skeletal muscle in CT image was employed to determine the existence of sarcopenia. Clinical information regarding cardiac arrest and resuscitation was collected and those relationships to sarcopenia were evaluated.
Results: Skeletal muscle area was greater in patients with return of spontaneous circulation (ROSC; 116 +/- 30 cm2) than in non-ROSC patients (100 +/- 29 cm2; P = 0.06). Eighteen patients (33 %) were diagnosed with sarcopenia based on the percentage of skeletal muscle area to ideal area. Percentages of skeletal muscle area to ideal area were similar between patients with and without ventricular fibrillation (VF) as initial rhythm (87 +/- 9 % and 84 +/- 15 % in 16 VF and 39 no-VF cases, respectively; P = 0.43). Twenty-four-hour survival rate after hospital arrival in patients with sarcopenia (39 % in 33 cases) was significantly lower than that in patients without sarcopenia (70 % in 22 cases; P = 0.013). In non-VF patients, the proportion of the favorable neurological outcome (cerebral performance category (CPC) 1 or 2) in patients with sarcopenia (0 % in 14 cases) was significantly lower than that in patients without sarcopenia (32 % in 25 cases; P = 0.034).
Conclusion: Patients with non-traumatic cardiac arrest accompanied with sarcopenia have a poor prognosis. The association of sarcopenia with the unfavorable outcome is particularly evident in cardiac arrest with non-VF cause.