Cawthon Peggy M, Lui Li-Yung, Taylor Brent C, McCulloch Charles E, Cauley Jane A, Lapidus Jodi, Orwoll Eric, Ensrud Kristine E
California Pacific Medical Center Research Institute.
Department of Epidemiology and Biostatistics, University of California, San Francisco.
J Gerontol A Biol Sci Med Sci. 2017 Oct 1;72(10):1383-1389. doi: 10.1093/gerona/glw327.
The association between various definitions of sarcopenia and hospitalization has not been evaluated in community-dwelling older men.
We used data from 1,516 participants at Visit 3 of the Osteoporotic Fractures in Men (MrOS) study who also had linked Medicare Fee-For-Service Claims data available. We examined the association between several sarcopenia definitions (International Working Group, European Working Group for Sarcopenia in Older Persons, Foundation for the NIH Sarcopenia Project, Baumgartner, and Newman) and hospitalization, using two-part ("hurdle") models, adjusted for age, clinical center, functional limitations, self-reported health, comorbidity, and cognitive function. Predictors included sarcopenia status (the summary definitions and the components of slowness, weakness, and/or lean mass); outcomes included hospitalization and cumulative inpatient days/year in the 3 years following the Visit 3 exam.
After accounting for confounding factors, none of the summary definitions or the definition components (slowness, weakness, or low lean mass) were associated with likelihood of hospitalization, the rate ratio of inpatient days among those hospitalized, or the mean rate of inpatient days amongst all participants.
Sarcopenia was not associated hospitalization in community-dwelling older men. These results provide further evidence that current sarcopenia definitions are unlikely to identify those who are most likely to have greater hospitalization.
在社区居住的老年男性中,尚未评估肌肉减少症的各种定义与住院治疗之间的关联。
我们使用了来自男性骨质疏松性骨折(MrOS)研究第3次访视时的1516名参与者的数据,这些参与者还拥有与之关联的医疗保险按服务收费索赔数据。我们使用两部分(“障碍”)模型,在调整了年龄、临床中心、功能限制、自我报告的健康状况、合并症和认知功能后,研究了几种肌肉减少症定义(国际工作组、欧洲老年人肌肉减少症工作组、美国国立卫生研究院肌肉减少症项目基金会、鲍姆加特纳和纽曼)与住院治疗之间的关联。预测因素包括肌肉减少症状态(汇总定义以及行动迟缓、虚弱和/或瘦体重的组成部分);结局包括第3次检查后3年内的住院治疗情况以及每年的累积住院天数。
在考虑混杂因素后,汇总定义或定义组成部分(行动迟缓、虚弱或低瘦体重)均与住院可能性、住院患者的住院天数率比或所有参与者的平均住院天数率无关。
在社区居住的老年男性中,肌肉减少症与住院治疗无关。这些结果进一步证明,目前的肌肉减少症定义不太可能识别出最有可能住院的人群。