Wakabayashi Hidetaka, Takahashi Rimiko, Watanabe Naoko, Oritsu Hideyuki, Shimizu Yoshitaka
Department of Rehabilitation Medicine, Yokohama City University Medical Center , Yokohama City, 232-0024, Japan.
J Rehabil Med. 2017 Aug 31;49(8):682-685. doi: 10.2340/16501977-2253.
To assess the prevalence of sarcopaenia and the association between sarcopaenia, activities of daily living, and dysphagia in cancer patients who require rehabilitation.
A cross-sectional study was performed in 83 consecutive cancer patients referred to the Department of Rehabilitation Medicine. Skeletal muscle index was calculated as total psoas muscle area assessed via abdominal computed tomography divided by height squared. Sarcopaenia was diagnosed using the Asian Working Group for Sarcopenia criteria. Activities of daily living were evaluated with the Barthel Index. Dysphagia was assessed with the 10-item Eating Assessment Tool (EAT-10).
Study participants were 50 males and 33 females (mean age 71, standard deviation 12 years). Sarcopaenia was observed in 66 (80%) patients. The median Barthel Index score was 55 (interquartile range: 25-75). Thirty-five (42%) patients were diagnosed as having dysphagia. Logistic regression analysis of dysphagia adjusted for sarcopaenia, Barthel Index score, age, and reason for hospitalization showed that sarcopaenia (odds ratio (OR) 3.616; 95% confidence interval (95% CI) 0.926-14.114; p = 0.064) and Barthel Index score (OR 0.984; 95% CI 0.966-1.002; p = 0.073) did not reach statistical significance.
The prevalence of sarcopaenia in cancer patients who require rehabilitation is very high. The power of this study was too low to observe a significant association between sarcopaenia and dysphagia.
评估需要康复治疗的癌症患者中肌肉减少症的患病率，以及肌肉减少症、日常生活活动能力和吞咽困难之间的关联。
对连续转诊至康复医学科的83例癌症患者进行了横断面研究。骨骼肌指数的计算方法为通过腹部计算机断层扫描评估的腰大肌总面积除以身高的平方。采用亚洲肌少症工作组的标准诊断肌肉减少症。用巴氏指数评估日常生活活动能力。用10项饮食评估工具（EAT-10）评估吞咽困难。
研究参与者包括50名男性和33名女性（平均年龄71岁，标准差12岁）。66例（80%）患者存在肌肉减少症。巴氏指数评分中位数为55（四分位间距：25-75）。35例（42%）患者被诊断为吞咽困难。对吞咽困难进行逻辑回归分析，校正了肌肉减少症、巴氏指数评分、年龄和住院原因，结果显示肌肉减少症（比值比（OR）3.616；95%置信区间（95%CI）0.926-14.114；p = 0.064）和巴氏指数评分（OR 0.984；95%CI 0.966-1.002；p = 0.073）未达到统计学显著性。
需要康复治疗的癌症患者中肌肉减少症的患病率非常高。本研究的检验效能过低，无法观察到肌肉减少症与吞咽困难之间的显著关联。
