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肌肉减少症对老年疗养院居民死亡率的预测作用:SARC-F与SARC-CalF对比

Sarcopenia for predicting mortality among elderly nursing home residents: SARC-F versus SARC-CalF.

作者信息

Yang Ming, Jiang Jiaojiao, Zeng Yanli, Tang Huairong

机构信息

The Center of Gerontology and Geriatrics, West China Hospital.

Precision Medicine Research Center, West China Hospital.

出版信息

Medicine (Baltimore). 2019 Feb;98(7):e14546. doi: 10.1097/MD.0000000000014546.

Abstract

Little is known about the prognostic value of the strength, assistance walking, rise from a chair, climb stairs, and falls questionnaire (SARC-F) and SARC-F combined with calf circumference (SARC-CalF) among elderly nursing home residents.To compare the prognostic value of SARC-F and SARC-CalF for mortality in this population.We conducted a prospective study in four nursing homes in western China. Sarcopenia was estimated using SARC-F and SARC-CalF, respectively. Nutrition status, activities of daily living, and other covariates were evaluated. The survival status was collected via medical records and telephone interviews at the 12th month after the baseline investigation. We used multivariate Cox proportional-hazard models to calculate the hazard ratio (HR) and 95% confidence interval (CI) for 1-year all-cause mortality by SARC-F-defined sarcopenia and SARC-CalF-defined sarcopenia, separately.We included 329 participants (median age: 85 years). The prevalences of SARC-F-defined sarcopenia and SARC-CalF-defined sarcopenia were 39.8% and 46.8%, respectively. During the 1-year follow-up period, 73 participants (22.7%) died. The mortality was 29.0% and 18.3% in the participants with or without SARC-F-defined sarcopenia, respectively (P = .025). The mortality was 26.6% and 19.0% in the participants with or without SARC-CalF-defined sarcopenia, respectively (P = .105). After adjusted for the relevant confounders including malnutrition, SARC-F-defined sarcopenia was independently associated with an increased risk of 1-year mortality (adjusted HR: 2.08; 95% CI: 1.27-3.42). However, SARC-CalF-defined sarcopenia was not an independent predictor of 1-year mortality (adjusted HR: 1.54; 95% CI: 0.95-2.47).Sarcopenia is highly prevalent in Chinese elderly nursing home residents according to SARC-F or SARC-CalF. SARC-F-defined sarcopenia appears to be better for predicting the 1-year mortality of Chinese nursing home residents than SARC-CalF-defined sarcopenia.

摘要

关于力量、辅助行走、从椅子上起身、爬楼梯及跌倒问卷(SARC - F)以及SARC - F联合小腿围度(SARC - CalF)对老年疗养院居民的预后价值,目前所知甚少。为比较SARC - F和SARC - CalF对该人群死亡率的预后价值。我们在中国西部的四家疗养院进行了一项前瞻性研究。分别使用SARC - F和SARC - CalF评估肌肉减少症。评估营养状况、日常生活活动及其他协变量。在基线调查后第12个月,通过病历和电话访谈收集生存状况。我们使用多变量Cox比例风险模型分别计算由SARC - F定义的肌肉减少症和由SARC - CalF定义的肌肉减少症导致的1年全因死亡率的风险比(HR)和95%置信区间(CI)。我们纳入了329名参与者(中位年龄:85岁)。由SARC - F定义的肌肉减少症和由SARC - CalF定义的肌肉减少症的患病率分别为39.8%和46.8%。在1年随访期内,73名参与者(22.7%)死亡。有或没有SARC - F定义的肌肉减少症的参与者的死亡率分别为29.0%和18.3%(P = 0.025)。有或没有SARC - CalF定义的肌肉减少症的参与者的死亡率分别为26.6%和19.0%(P = 0.105)。在对包括营养不良在内的相关混杂因素进行调整后,SARC - F定义的肌肉减少症与1年死亡率风险增加独立相关(调整后HR:2.08;95%CI:1.27 - 3.42)。然而,SARC - CalF定义的肌肉减少症不是1年死亡率的独立预测因素(调整后HR:1.54;95%CI:0.95 - 2.47)。根据SARC - F或SARC - CalF,肌肉减少症在中国老年疗养院居民中非常普遍。SARC - F定义的肌肉减少症似乎比SARC - CalF定义的肌肉减少症更能预测中国疗养院居民的1年死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4fc1/6407983/543320cdf985/medi-98-e14546-g001.jpg

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