Bernabeu-Wittel Máximo, González-Molina Álvaro, Fernández-Ojeda Rocío, Díez-Manglano Jesús, Salgado Fernando, Soto-Martín María, Muniesa Marta, Ollero-Baturone Manuel, Gómez-Salgado Juan
Internal Medicine Departments, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain.
Hospital San Juan de Dios del Aljarafe, 41930 Sevilla, Spain.
J Clin Med. 2019 Apr 18;8(4):535. doi: 10.3390/jcm8040535.
The prevalence, relationships and outcomes of sarcopenia and frailty in polypathological patients remain unknown. We performed a multicenter prospective observational study in six hospitals in order to assess prevalence, clinical features, outcome and associated risk factors of sarcopenia and frailty in a hospital-based population of polypathological patients. The cohort was recruited by performing prevalence surveys every 14 days during the inclusion period (March 2012-June 2016). Sarcopenia was assessed by means of EWGSOP criteria and frailty by means of Fried's criteria. Skeletal muscle mass was measured by tetrapolar bioimpedanciometry. All patients were followed for 12 months. Factors associated with sarcopenia, frailty and mortality were analyzed by multivariate logistic regression, and Kaplan-Meier curves. A total of 444 patients (77.3 ± 8.4 years, 55% males) were included. Sarcopenia was present in 97 patients (21.8%), this being moderate in 54 (12.2%), and severe in 43 (9.6%); frailty was present in 278 patients (62.6%), and 140 (31.6%) were pre-frail; combined sarcopenia and frailty were present in the same patient in 80 (18%) patients. Factors independently associated to the presence of both, sarcopenia and frailty were female gender, older age, different chronic conditions, poor functional status, low body mass index, asthenia and depressive disorders, and low leucocytes and lymphocytes count. Mortality in the 12-months follow-up period was 40%. Patients with sarcopenia, frailty or both survived significantly less than those without these conditions. Sarcopenia and frailty are frequent and interrelated conditions in polypathological patients, shadowing their survival. Their early recognition and management could improve health-related outcomes in this population.
多病共存患者中肌肉减少症和衰弱的患病率、关系及后果尚不清楚。我们在六家医院开展了一项多中心前瞻性观察性研究，以评估在以医院为基础的多病共存患者群体中肌肉减少症和衰弱的患病率、临床特征、后果及相关危险因素。在纳入期（2012年3月至2016年6月），每14天进行一次患病率调查以招募队列。采用欧洲老年人肌肉减少症工作组（EWGSOP）标准评估肌肉减少症，采用弗里德（Fried）标准评估衰弱。通过四极生物电阻抗分析法测量骨骼肌质量。对所有患者随访12个月。通过多因素逻辑回归分析及卡普兰-迈耶曲线分析与肌肉减少症、衰弱和死亡率相关的因素。共纳入444例患者（77.3±8.4岁，55%为男性）。97例患者存在肌肉减少症（21.8%），其中54例为中度（12.2%），43例为重度（9.6%）；278例患者存在衰弱（62.6%），140例（31.6%）为衰弱前期；80例（18%）患者同时存在肌肉减少症和衰弱。与肌肉减少症和衰弱同时存在独立相关的因素为女性性别、年龄较大、不同的慢性疾病、功能状态差、低体重指数、乏力和抑郁障碍，以及白细胞和淋巴细胞计数低。12个月随访期内的死亡率为40%。存在肌肉减少症、衰弱或两者皆有的患者的生存期明显短于无这些情况的患者。在多病共存患者中，肌肉减少症和衰弱是常见且相互关联的情况，影响着他们的生存。对其早期识别和管理可改善该人群与健康相关的结局。
