Nozoe Masafumi, Kanai Masashi, Kubo Hiroki, Yamamoto Miho, Shimada Shinichi, Mase Kyoshi
Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University, Kobe, Japan.
Department of Rehabilitation, Itami Kousei Neurosurgical Hospital, Itami, Japan.
J Stroke Cerebrovasc Dis. 2019 Aug;28(8):2228-2231. doi: 10.1016/j.jstrokecerebrovasdis.2019.05.001. Epub 2019 May 22.
The association between prestroke sarcopenia and stroke severity has not been evaluated previously. The purpose of this study was to determine whether prestroke sarcopenia is associated with stroke severity in elderly patients with acute stroke.
We assessed prestroke sarcopenia of elderly patients with acute stroke by using a questionnaire for sarcopenia (SARC-F). Patients were divided into groups according to their SARC-F score: SARC-F score less than 4 (nonsarcopenia) and SARC-F score ≥4 (prestroke sarcopenia). Stroke severity was assessed according to the National Institute of Health Stroke Scale. Logistic regression was used to derive crude and adjusted odds ratio for the presence of prestroke sarcopenia and stroke severity.
Among the 183 patients enrolled (age, median [interquartile range]: 75 [11] years; 103 men), the prevalence of prestroke sarcopenia was 15% (n = 27). Crude odds ratio for the presence of prestroke sarcopenia and moderate-to-severe stroke (National Institute of Health Stroke Scale score > 5) was 4.00 (95% confidence interval, 1.68-9.53; P = .002). After adjusting for confounding variables (age, sex, and stroke risk factors), the presence of prestroke sarcopenia remained an independent predictor of severe stroke, with an odds ratio of 3.54 (95% confidence interval, 1.32-9.49; P= .01).
Prestroke sarcopenia can predict moderate to severe stroke in elderly patients with acute stroke.
卒中前肌肉减少症与卒中严重程度之间的关联此前尚未得到评估。本研究的目的是确定卒中前肌肉减少症是否与老年急性卒中患者的卒中严重程度相关。
我们通过使用肌肉减少症问卷（SARC-F）评估老年急性卒中患者的卒中前肌肉减少症。根据SARC-F评分将患者分为两组：SARC-F评分小于4（非肌肉减少症）和SARC-F评分≥4（卒中前肌肉减少症）。根据美国国立卫生研究院卒中量表评估卒中严重程度。采用逻辑回归分析得出卒中前肌肉减少症与卒中严重程度的粗比值比和调整后比值比。
在纳入的183例患者中（年龄，中位数[四分位间距]：75[11]岁；103例男性），卒中前肌肉减少症的患病率为15%（n = 27）。卒中前肌肉减少症与中重度卒中（美国国立卫生研究院卒中量表评分>5）的粗比值比为4.00（95%置信区间，1.68 - 9.53；P = .002）。在对混杂变量（年龄、性别和卒中危险因素）进行调整后，卒中前肌肉减少症仍然是重度卒中的独立预测因素，比值比为3.54（95%置信区间，1.32 - 9.49；P = .01）。
卒中前肌肉减少症可预测老年急性卒中患者的中重度卒中。
