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老年住院患者的肌肉力量和肌肉质量:EMPOWER 研究。

Muscle Strength and Muscle Mass in Older Patients during Hospitalization: The EMPOWER Study.

机构信息

Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.

出版信息

Gerontology. 2017;63(6):507-514. doi: 10.1159/000478777. Epub 2017 Aug 18.

Abstract

BACKGROUND

Low muscle strength and muscle mass are associated with an increased length of hospital stay and higher mortality rate in inpatients. To what extent hospitalization affects muscle strength and muscle mass is unclear.

OBJECTIVE

We aimed to assess muscle strength and muscle mass at admission and during hospitalization in older patients and its relation with being at risk of geriatric conditions.

METHODS

The EMPOWER study included patients aged 70 years and older, admitted to 4 wards of the VU University Medical Center in the Netherlands between April and December 2015. At admission, patients were screened for being at risk of 4 geriatric conditions: delirium, falls, malnutrition, and functional disability. At admission and at discharge, muscle strength and muscle mass were assessed.

RESULTS

A total of 373 patients (mean age, standard deviation [SD]: 79.6, 6.38 years) were included at admission, and 224 patients (mean age, SD: 80.1, 6.32 years) at discharge. At admission, lower muscle strength in both female and male patients and low muscle mass in male patients were associated with being at risk of a higher cumulative number of geriatric conditions. Muscle strength increased during hospitalization, but no change in muscle mass was observed. Changes in muscle measures were not associated with being at risk of geriatric conditions.

DISCUSSION

Older patients with lower muscle strength and muscle mass at admission were at risk of a higher cumulative number of geriatric conditions. However, being at risk of geriatric conditions did not forecast further decrease in muscle strength and muscle mass during hospitalization.

摘要

背景

肌肉力量和肌肉质量低与住院时间延长和住院患者死亡率升高有关。住院对肌肉力量和肌肉质量的影响程度尚不清楚。

目的

我们旨在评估老年患者入院时和住院期间的肌肉力量和肌肉质量及其与老年病风险的关系。

方法

EMPOWER 研究纳入了 2015 年 4 月至 12 月期间在荷兰 VU 大学医学中心的 4 个病房住院的 70 岁及以上的患者。入院时,患者接受了 4 种老年病风险(谵妄、跌倒、营养不良和功能障碍)的筛查。在入院时和出院时,评估了肌肉力量和肌肉质量。

结果

共纳入 373 名患者(平均年龄,标准差[SD]:79.6,6.38 岁)入院,224 名患者(平均年龄,SD:80.1,6.32 岁)出院。入院时,女性和男性患者的肌肉力量较低,男性患者的肌肉质量较低,与较高的累积老年病风险相关。住院期间肌肉力量增加,但肌肉质量没有变化。肌肉测量值的变化与老年病风险无关。

讨论

入院时肌肉力量和肌肉质量较低的老年患者有较高的累积老年病风险。然而,老年病风险并不能预测住院期间肌肉力量和肌肉质量的进一步下降。

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