Correlation between rectus femoris cross-sectional area,nutritional status changes,and caloric intake with ICU mortality

WANG Ming; BIAN Weishuai; LIU Ping; YAN Chengyue; TU dahong

doi:10.3969∕j.issn.1674-3245.2026.01.017

Abstract：Objective To investigate the correlation between rectus femoris cross-sectional area(RFCSA),nutritional status dynamics,caloric intake,and in-hospital mortality in the intensive care unit(ICU).Methods This prospective study enrolled 190 ICU patients from June 2022 to June 2024 as the derivation cohort.Participants were stratified into survival and non-survival groups based on in-hospital mortality.RFCSA was measured by ultrasonography;nutritional status was assessed using the NUTRIC score;caloric intake was quantified from medical records.An additional 82 patients(July-December 2024)constituted the validation cohort at a 7∶3 ratio.Univariate and binary logistic regression identified independent predictors,with ROC curves evaluating model performance.Results Univariate analysis revealed significant differences in age,BMI,RFCSA,rectus femoris atrophy rate,NUTRIC score,caloric intake,plasma albumin,PaCO2,and oxygenation index between groups(P<0.05).Binary logistic regression identified higher RFCSA and greater caloric intake as independent protective factors,while advanced age,elevated muscle atrophy rate,and higher NUTRIC score were independent risk factors.The predictive model achieved an AUC of 0.989(95%CI:0.979～0.999)a sensitivity of 98.1%and a specificity of 93.5%.Validation cohort results showed an AUC of 0.983(95%CI:0.960～1.000),sensitivity of 95.0%,and specificity of 95.2%.Conclusion Age,RFCSA,rectus femoris atrophy rate,NUTRIC score,and caloric intake are critical determinants of ICU mortality.The developed model demonstrates excellent predictive accuracy for clinical prognosis assessment.