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肌少症与老年人的医院相关结局:系统评价和荟萃分析。

Sarcopenia and hospital-related outcomes in the old people: a systematic review and meta-analysis.

机构信息

The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.

National Clinical Research Center for Geriatrics, Chengdu, 610041, Sichuan, China.

出版信息

Aging Clin Exp Res. 2019 Jan;31(1):5-14. doi: 10.1007/s40520-018-0931-z. Epub 2018 Mar 16.

Abstract

AIM

This systematic review was conducted to explore the associations between sarcopenia, hospitalization and length of stay in the old people.

METHODS

Pubmed, Embase, Medline and Cochrane Central Register of Controlled Trails from January 2009 to October 2017 were searched in this review. We included prospective studies, which had the clear definition of sarcopenia and reported the hospitalization or length of stay as one of outcomes. Adjusted Odd ratios (aORs), hazard ratios (aHRs) or relative risks (aRRs) extracted from the studies were combined to synthesize pooled effect measures. Heterogeneity, and methodological quality were assessed using I² statistic and Newcastle-Ottawa scale, respectively.

RESULTS

Nine studies were included in this review. Of these, 8 studies with 4174 individuals reported results for hospitalization, 3 studies involving 6276 old people in the community reported results for length of stay. Sarcopenia was significantly associated with future hospitalization (RR 1.40, 95% CI 1.04-1.89, p = 0.029; data from 8 studies). A subgroup analysis showed the associations between sarcopenia and readmission in hospitalized old patients that were statistically significant (RR 1.75, 95% CI 1.01-3.03, p = 0.044; data from 8 studies). However, this association were not found in the community-dwelling older subjects (RR 1.08, 95% CI 0.74-1.57, p = 0.688; data from 8 studies), uncertain in nursing home residents. The association of sarcopenia and length of stay was not statistically significant (OR 1.21, 95% CI 0.90-1.63, p = 0.20; data from 8 studies) in community-dwelling residents.

CONCLUSIONS

This systematic review demonstrates that sarcopenia is a significant predictor of readmission in old inpatients, but not associated with hospitalization or length of stay in community-dwelling old adults.

摘要

目的

本系统评价旨在探讨老年人肌少症与住院和住院时间之间的关系。

方法

本研究检索了 2009 年 1 月至 2017 年 10 月期间的 Pubmed、Embase、Medline 和 Cochrane 对照试验中心注册数据库。我们纳入了前瞻性研究,这些研究对肌少症有明确的定义,并将住院或住院时间作为结果之一进行报告。从研究中提取调整后的优势比(aORs)、风险比(aHRs)或相对风险(aRRs),以综合汇总效应量。使用 I² 统计量和纽卡斯尔-渥太华量表分别评估异质性和方法学质量。

结果

本研究共纳入 9 项研究。其中,8 项研究共纳入 4174 名个体报告了住院结果,3 项研究共纳入 6276 名社区老年人报告了住院时间结果。肌少症与未来住院显著相关(RR 1.40,95%CI 1.04-1.89,p=0.029;来自 8 项研究的数据)。亚组分析显示,肌少症与住院老年患者再入院之间的关联具有统计学意义(RR 1.75,95%CI 1.01-3.03,p=0.044;来自 8 项研究的数据)。然而,在社区居住的老年人中并未发现这种关联(RR 1.08,95%CI 0.74-1.57,p=0.688;来自 8 项研究的数据),在疗养院居民中这种关联不确定。肌少症与社区居住老年人住院时间的关联无统计学意义(OR 1.21,95%CI 0.90-1.63,p=0.20;来自 8 项研究的数据)。

结论

本系统评价表明,肌少症是老年住院患者再入院的一个显著预测因素,但与社区居住的老年成年人的住院或住院时间无关。

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