Use of adductor pollicis muscle thickness in hospitalized or ambulatory patients: a systematic review.
Brunna Gabrielly Ferreira da Silva Soares, Andréa Pereira Vicentini
PMID 29947718WHAT IT FOUND
Adductor pollicis muscle thickness helped screen muscle loss in some hospitalized or ambulatory patients, but it missed many cases and did not consistently predict outcomes.
Use it with other assessments, not alone.
Key findings
01APMT was considered a good anthropometric parameter in most clinical groups, except liver disease, but it had low sensitivity and high specificity.
02In critical patients, abnormal APMT was associated with higher mortality and severe malnutrition by the Global Subjective Assessment, but not with days of mechanical ventilation.
03Edema and lack of condition-specific cutoffs made APMT results difficult to apply.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only one author searched and selected the articles, so missed studies or selection bias cannot be ruled out. APMT accuracy was affected by edema, and edema led to exclusion of many patients. There were no condition-specific reference standards for many groups; cutoffs often came from healthy populations or single values. Different adipometers, evaluators and measurement standardization may have changed APMT values. APMT had low sensitivity, so normal thickness does not rule out malnutrition.
The easy way to misread this
Do not use APMT alone to diagnose malnutrition or predict outcomes. It had low sensitivity, inconsistent prognostic associations, and no standardized cutoffs for many patient groups.