Steihaug Ole Martin, Gjesdal Clara Gram, Bogen Bård, Kristoffersen Målfrid Holen, Lien Gunhild, Ranhoff Anette Hylen
Kavli Research Centre for Geriatrics and Dementia, Haraldsplass Deaconess Hospital, Bergen, Norway.
Department of Clinical Science, University of Bergen, Bergen, Norway.
PLoS One. 2017 Sep 13;12(9):e0184780. doi: 10.1371/journal.pone.0184780. eCollection 2017.
Sarcopenia is prevalent in older persons and is a risk factor for falls, fractures, and mortality. The aim of this study was to determine a) the feasibility of determining sarcopenia in patients with acute hip fracture, b) the prevalence of sarcopenia and c) associations of sarcopenia with nutritional status and comorbidities.
A multicenter cross-sectional study on sarcopenia in male and female patients with acute hip fracture. Participants were previously ambulatory and living in the community. Sarcopenia was assessed postoperatively with muscle mass estimated by anthropometry using triceps skinfold, arm circumference, height, weight and sex. Grip strength was measured by Jamar dynamometer and pre-fracture mobility was by self-report using the New Mobility Score.
Out of 282 patients, 202 were assessed for sarcopenia of whom 74 (37%) were diagnosed as sarcopenic. Sarcopenia was associated with age, odds ratio (OR) 1.4 per 5 years, 95% confidence interval (CI) [1.1, 1.8], ASA Physical Status Classification System score, OR 2.3 per point, 95% CI [1.3, 4.3] and number of medications at discharge, OR 1.2 per medication, 95% CI [1.0, 1.3] and inversely associated with BMI, OR 0.8, 95% CI [0.7, 0.9] and serum albumin, OR 0.9, 95% CI [0.8,1.0].
Thirty-seven percent of assessed subjects were diagnosed with sarcopenia. Our data demonstrates that the prevalence of sarcopenia is associated with older age, malnutrition and comorbidities. Determining sarcopenia at the bedside was feasible in postoperative hip fracture patients by using grip strength, estimation of muscle mass by anthropometry and self-reported mobility.
肌肉减少症在老年人中普遍存在,是跌倒、骨折和死亡的危险因素。本研究的目的是确定:a)在急性髋部骨折患者中确定肌肉减少症的可行性;b)肌肉减少症的患病率;c)肌肉减少症与营养状况和合并症的关联。
对急性髋部骨折的男性和女性患者进行关于肌肉减少症的多中心横断面研究。参与者之前能够行走且居住在社区。术后通过使用三头肌皮褶厚度、上臂围、身高、体重和性别进行人体测量来估计肌肉量,以此评估肌肉减少症。使用Jamar握力计测量握力,通过自我报告使用新的活动能力评分来评估骨折前的活动能力。
在282例患者中,对202例进行了肌肉减少症评估,其中74例(37%)被诊断为肌肉减少症。肌肉减少症与年龄相关,每5岁的比值比(OR)为1.4,95%置信区间(CI)[1.1, 1.8];美国麻醉医师协会(ASA)身体状况分类系统评分相关,每增加1分的OR为2.3,95% CI [1.3, 4.3];出院时用药数量相关,每增加一种药物的OR为1.2,95% CI [1.0, 1.3],并且与体重指数(BMI)呈负相关,OR为0.8,95% CI [0.7, 0.9],与血清白蛋白呈负相关,OR为0.9,95% CI [0.8, 1.0]。
37%的评估对象被诊断为肌肉减少症。我们的数据表明,肌肉减少症的患病率与年龄较大、营养不良和合并症相关。通过使用握力、人体测量估计肌肉量和自我报告的活动能力,在术后髋部骨折患者床边确定肌肉减少症是可行的。