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肌肉减少症:住院患者的患病率和预后意义。

Sarcopenia: prevalence and prognostic significance in hospitalized patients.

机构信息

Internal Medicine, Faculty of Medicine & Health Sciences, United Arab Emirates University (UAEU), UAE; University of Sheffield, UK.

出版信息

Clin Nutr. 2013 Oct;32(5):772-6. doi: 10.1016/j.clnu.2013.01.010. Epub 2013 Jan 30.

Abstract

BACKGROUND

Sarcopenia is prevalent in older populations with many causes and varying outcomes however information for use in clinical practice is still lacking.

AIMS

The aim of this report is to identify the clinical determinants and prognostic significance of sarcopenia in a cohort of hospitalized acutely ill older patients.

METHODS

Four hundred and thirty two randomly selected patients had their baseline clinical characteristic data assessed within 72 h of admission, at 6 weeks and at 6 months. Nutritional status was assessed from anthropometric and biochemical data. Sarcopenia was diagnosed from low muscle mass and low muscle strength-hand grip using anthropometric measures based on the European Working Group criteria.

RESULTS

Compared with patients without sarcopenia, those diagnosed with sarcopenia 44 (10%) were more likely to be older, have more depression symptoms and lower serum albumin concentration. The length of hospital stay (LOS) was significantly longer in patients diagnosed with sarcopenia compared with patients without sarcopenia [mean (SD) LOS 13.4 (8.8) versus 9.4 (7) days respectively, p = 0.003]. The risk of non-elective readmission in the 6 months follow up period was significantly lower in patients without sarcopenia compared with those diagnosed with sarcopenia (adjusted hazard ratio .53 (95% CI: .32 to .87, p = 0.013). The death rate was also lower in patients without sarcopenia 38/388 (10%), compared with those with sarcopenia 12/44 (27%), p-value = .001.

CONCLUSION

Older people with sarcopenia have poor clinical outcome following acute illness compared with those without sarcopenia.

摘要

背景

肌少症在老年人群中较为普遍,其病因众多,结局各异,但用于临床实践的信息仍十分有限。

目的

本报告旨在确定住院急性老年患者队列中肌少症的临床决定因素和预后意义。

方法

432 名随机患者在入院后 72 小时内、6 周和 6 个月时评估其基线临床特征数据。营养状况通过人体测量和生化数据进行评估。肌少症采用基于欧洲工作组标准的人体测量学指标诊断,即低肌肉量和低握力。

结果

与无肌少症的患者相比,诊断为肌少症的 44 例(10%)患者年龄更大,抑郁症状更多,血清白蛋白浓度更低。与无肌少症的患者相比,诊断为肌少症的患者住院时间(LOS)明显更长[平均(SD)LOS 分别为 13.4(8.8)天和 9.4(7)天,p=0.003]。在 6 个月的随访期间,非择期再入院的风险在无肌少症患者中明显低于肌少症患者(调整后的危险比为 0.53(95%CI:0.32 至 0.87,p=0.013)。无肌少症患者的死亡率也较低(38/388(10%)),而肌少症患者的死亡率较高(12/44(27%),p 值=0.001)。

结论

与无肌少症的患者相比,急性疾病后老年肌少症患者的临床结局较差。

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