CT-scans in venous phase with a slice thickness of 5 mm that were performed during clinical routine upon ICU admission were used for this analysis. We manually assessed the adipose tissue distribution using the semi-automatical segmentation tool “3D slicer”, an open source software platform for medical image informatics [13]. Both the visceral adipose tissue (VAT) and the subcutaneous adipose tissue (SAT) were segmented at the center plane of the 3rd lumbar vertebra on axial CT-scans (Fig 1). This CT plane was chosen to gain the highest comparability with existing studies [14, 15]. Participants with missing data were omitted from the analysis.

The visceral and subcutaneous adipose tissue areas were segmented at the center plane of the 3rd lumbar vertebra on axial CT-scans using a semi-automatically segmentation tool (3D slicer) [13]. (A) An exemplary scan of a patient with excessive visceral (green area) and low subcutaneous (yellow area) adipose tissue is depicted. (B) An exemplary scan of a patient with low visceral (green area) and excessive subcutaneous (yellow area) adipose tissue is depicted.

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