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肌肉减少症预测急性护理病房老年患者的再入院率和死亡率:一项前瞻性研究。

Sarcopenia predicts readmission and mortality in elderly patients in acute care wards: a prospective study.

作者信息

Yang Ming, Hu Xiaoyi, Wang Haozhong, Zhang Lei, Hao Qiukui, Dong Birong

机构信息

The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No.37 Guoxue Lane, Chengdu, Sichuan, China.

The Department of Orthopedic Surgery, West China Hospital, Sichuan University, No.37 Guoxue Lane, Chengdu, Sichuan, China.

出版信息

J Cachexia Sarcopenia Muscle. 2017 Apr;8(2):251-258. doi: 10.1002/jcsm.12163. Epub 2016 Nov 28.

DOI:10.1002/jcsm.12163
PMID:27896949
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5377397/
Abstract

BACKGROUND

The aim of this study is to assess the prevalence of sarcopenia and investigate the associations between sarcopenia and long-term mortality and readmission in a population of elderly inpatients in acute care wards.

METHODS

We conducted a prospective observational study in the acute care wards of a teaching hospital in western China. The muscle mass was estimated according to a previously validated anthropometric equation. Handgrip strength was measured with a handheld dynamometer, and physical performance was measured via a 4 m walking test. Sarcopenia was defined according to the recommended diagnostic algorithm of the Asia Working Group for Sarcopenia. The survival status and readmission information were obtained via telephone interviews at 12, 24, and 36 months during the 3 year follow-up period following the baseline investigation.

RESULTS

Two hundred and eighty-eight participants (mean age: 81.1 ± 6.6 years) were included. Forty-nine participants (17.0%) were identified as having sarcopenia. This condition was similar in men and women (16.9% vs. 17.5%, respectively, P = 0.915). During the 3 year follow-up period, 49 men (22.7%) and 9 women (16.4%) died (P = 0.307). The mortality of sarcopenic participants was significantly increased compared with non-sarcopenic participants (40.8% vs. 17.1%, respectively, P < 0.001). After adjusting for age, sex and other confounders, sarcopenia was an independent predictor of 3 year mortality (adjusted hazard ratio: 2.49; 95% confidential interval: 1.25-4.95) and readmission (adjusted hazard ratio: 1.81; 95% confidential interval: 1.17-2.80).

CONCLUSIONS

Sarcopenia, which is evaluated by a combination of anthropometric measures, gait speed, and handgrip strength, is valuable to predict hospital readmission and long-term mortality in elderly patients in acute care wards.

摘要

背景

本研究旨在评估肌少症的患病率,并调查急性护理病房老年住院患者中肌少症与长期死亡率和再入院之间的关联。

方法

我们在中国西部一家教学医院的急性护理病房进行了一项前瞻性观察研究。根据先前验证的人体测量方程估计肌肉量。用手持测力计测量握力,通过4米步行试验测量身体性能。根据亚洲肌少症工作组推荐的诊断算法定义肌少症。在基线调查后的3年随访期内,通过12、24和36个月的电话访谈获得生存状态和再入院信息。

结果

纳入288名参与者(平均年龄:81.1±6.6岁)。49名参与者(17.0%)被确定患有肌少症。男性和女性的这种情况相似(分别为16.9%和17.5%,P = 0.915)。在3年随访期内,49名男性(22.7%)和9名女性(16.4%)死亡(P = 0.307)。与非肌少症参与者相比,肌少症参与者的死亡率显著增加(分别为40.8%和17.1%,P < 0.001)。在调整年龄、性别和其他混杂因素后,肌少症是3年死亡率(调整后风险比:2.49;95%置信区间:1.25 - 4.95)和再入院(调整后风险比:1.81;95%置信区间:1.17 - 2.80)的独立预测因素。

结论

通过人体测量指标、步态速度和握力相结合评估的肌少症,对于预测急性护理病房老年患者的医院再入院和长期死亡率具有重要价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2a0/5377397/3b9918678af3/JCSM-8-251-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2a0/5377397/102f93dcc54c/JCSM-8-251-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2a0/5377397/24ce5ec5b0ad/JCSM-8-251-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2a0/5377397/3b9918678af3/JCSM-8-251-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2a0/5377397/102f93dcc54c/JCSM-8-251-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2a0/5377397/24ce5ec5b0ad/JCSM-8-251-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2a0/5377397/3b9918678af3/JCSM-8-251-g003.jpg

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