This study uncovered pivotal indicators for predicting the occurrence of ICUAW in septic patients. Despite no significant difference in age, gender, BMI, BSA, or SOFA scores between the two groups, the significant differences in APACHE II scores underlined that critically ill patients were at a higher risk of developing ICUAW.

Statistically significant differences were observed in key ultrasound indicators, including RF-MT, VITH, and RF-CSA, underscoring their value in assessing muscle integrity in ICUs.

Additionally, significant differences in laboratory markers, such as IL-6 and CRP, supported the role of inflammation in the progression of muscle atrophy in critically ill patients.

The logistic regression analysis demonstrated RF-CSA as a robust predictor of ICUAW.

The nomogram model constructed based on VITH, RF-CSA, IL-6, and CRP exhibited high sensitivity and specificity, with an AUC of 0.966, indicating excellent discriminatory ability and providing a promising tool to assess the risk of ICUAW.

Furthermore, the calibration curve and Hosmer-Lemeshow test also validated the reliability of the model, suggesting that the model can accurately reflect clinical reality.

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