A Catabolic Index Adjusted for the Creatinine Height Index: Can It Help in Nutrition Assessment?

Bistrian, Bruce R.

doi:10.1002/jpen.1942

Cited by 1 publication

(9 citation statements)

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“…A future study in other types of surgical patients such as those scheduled to undergo thoracoabdominal surgery may wish to enroll preoperative patients without severe catabolism that are less likely to have undergone such aggressive fluid resuscitation, common after trauma, as we suspect in this setting sCHI may better correlate with uCHI and be more useful for nutrition assessment. 6 Following significant injury, trauma patients are subjected to an impressive catabolic pathway with complex changes in inflammatory mediators and metabolic cycles. 6,17 An increase in 24-h uCr excretion beyond the amount expected from lean tissue in a nonstressed state highlights the injury response as marked by an abnormally high uCHI.…”

Section: Resultsmentioning

confidence: 99%

“…6 Following significant injury, trauma patients are subjected to an impressive catabolic pathway with complex changes in inflammatory mediators and metabolic cycles. 6,17 An increase in 24-h uCr excretion beyond the amount expected from lean tissue in a nonstressed state highlights the injury response as marked by an abnormally high uCHI.…”

Section: Resultsmentioning

confidence: 99%

“…The serum-derived estimate of actual 24-h uCr was calculated by The CC of 80 ml/min is based on the assumption that the patient has normal renal function confirmed by a normal serum urea nitrogen level <20 mg/dl. 6 To determine the sCHI, the value of estimated uCr determined by sCr levels was divided by the ideal uCr based on IBW.…”

Section: Chimentioning

confidence: 99%

“…2 Clinically derived from a 24-h urine sample assessed for creatinine content, urine-based CHI (uCHI) is a standard nutrition assessment tool indicating the degree of malnutrition. [2][3][4][5][6] A modified CHI utilizing a measure of serum creatinine (sCr) has been hypothesized as being an adequate substitute for urinary-derived creatinine content (uCr).…”

Section: Introductionmentioning

confidence: 99%

“…The objective of this study was to evaluate whether this technique remains useful in the setting of significant traumatic injury when using initial sCr to estimate preinjury uCr. 6 Additionally, previous studies have shown a correlation between abdominal computed tomography (CT) images at specific lumbar vertebral levels and total body fat and muscle content which provide insight on overall nutrition status. [7][8][9][10][11][12][13][14] This was used for comparison as an independent measurement of nutrition status unlikely to be substantially altered by trauma.…”

Section: Introductionmentioning

confidence: 99%

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Application of creatinine height index in patients with trauma for the evaluation of psoas muscle mass: A clinical validation study

Stolarski

Wee

Young

et al. 2023

J Parenter Enteral Nutr

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BackgroundThe creatinine height index (CHI) is an estimate of lean body mass. We hypothesize that a modified CHI estimate using serum creatinine (sCr) levels in patients with normal renal function when performed soon after injury would reflect preinjury protein nutrition status.MethodsThe urine CHI (uCHI) was calculated using the 24‐h urine sample. The serum‐derived estimated CHI (sCHI) was calculated using the sCr on admission. Correlation between abdominal computed tomography images at specific lumbar vertebral levels and total body fat and muscle content was used for comparison as an independent measurement of nutrition status unlikely to be substantially altered by trauma.ResultsA total of 45 patients were enrolled, all with a significant injury burden (median injury severity score [ISS] = 25; interquartile range, 17–35). The calculated sCHI on admission was 71.0% (SD = 26.9%) and likely underestimates the CHI when compared with uCHI (mean = 112.5%, SD = 32.6%). Stratifying by degree of stress demonstrated that in a group of 23 moderately and severely stressed patients, uCHI (mean = 112.7%, SD = 5.7%) and sCHI (mean = 60.8%, SD = 1.9%) were significantly different and without correlation (r = −0.26, P = 0.91). In patients without stress, there was a significant negative correlation between sCHI and psoas muscle area (r = −0.869, P = 0.03), and in patients with severe stress there was a significant positive correlation between uCHI and psoas muscle area (r = 0.733, P = 0.016).ConclusionThe CHI calculated from the initial sCr is not an appropriate estimate of uCHI in critically ill trauma patients and is not a valid measure of psoas muscle mass in this setting.

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Section: Resultsmentioning

confidence: 99%