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SARC-F 问卷和 Ishii 评分在老年住院患者肌少症筛查中的准确性和预后能力。

Accuracy and prognostic ability of the SARC-F questionnaire and Ishii's score in the screening of sarcopenia in geriatric inpatients.

机构信息

School of Humanities and Social Science, University of Science and Technology of China, Hefei, Anhui, China.

The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.

出版信息

Braz J Med Biol Res. 2019;52(9):e8204. doi: 10.1590/1414-431X20198204. Epub 2019 Aug 29.

Abstract

Sarcopenia remains poorly managed in clinical practice due to the lack of simple and accurate screening tools. This study aimed to identify the cutoff values of the SARC-F questionnaire and Ishii's score using the variables age, grip strength, and calf circumference in older inpatients in China to compare the accuracy of the two methods and to explore their predictive ability for adverse outcomes (rehospitalization, falls, fracture, and death). Hospitalized patients (n=138) aged ≥60 years were included. The accuracy of the two tools was evaluated using the reference diagnosis recommended by the Asian Working Group on Sarcopenia (assessing patients with measurements of muscle mass, handgrip strength, and usual gait speed). Follow-up data were obtained by telephone and clinical visits combined with the inpatient medical record system after discharge for at least one year. The results showed that the SARC-F score reached the highest Youden's index when a score of 3 was set as the cutoff value. Ishii's score presented a higher accuracy than SARC-F (area under the receiver operating curve: 0.78 vs 0.64, P=0.01). The Kaplan-Meier survival analysis demonstrated a higher cumulative incidence of rehospitalization in sarcopenic individuals compared to non-sarcopenic individuals according to SARC-F (log-rank test, P<0.001). Cox analysis revealed that SARC-F was an independent risk factor for rehospitalization (adjusted hazard ratio: 4.23, 95%CI: 2.12-9.79, P<0.001). The SARC-F and Ishii's scores might facilitate the early detection of sarcopenia and help identify older adults at risk for adverse outcomes in clinical practice.

摘要

肌肉减少症在临床实践中管理不善,主要是因为缺乏简单而准确的筛查工具。本研究旨在确定中国老年住院患者使用 SARC-F 问卷和 Ishii 评分的变量(年龄、握力和小腿围)的截断值,以比较两种方法的准确性,并探讨其对不良结局(再住院、跌倒、骨折和死亡)的预测能力。纳入年龄≥60 岁的住院患者。使用亚洲肌肉减少症工作组推荐的参考诊断(评估肌肉质量、握力和通常步态速度的患者)来评估两种工具的准确性。通过电话和临床随访以及出院后的住院病历系统进行至少一年的随访。结果表明,当 SARC-F 评分为 3 分时,达到了 Youden 指数的最高值。Ishii 评分的准确性高于 SARC-F(受试者工作特征曲线下面积:0.78 比 0.64,P=0.01)。Kaplan-Meier 生存分析显示,根据 SARC-F,肌肉减少症患者的再住院累积发生率高于非肌肉减少症患者(对数秩检验,P<0.001)。Cox 分析表明,SARC-F 是再住院的独立危险因素(调整后的危险比:4.23,95%CI:2.12-9.79,P<0.001)。SARC-F 和 Ishii 评分可能有助于早期发现肌肉减少症,并有助于在临床实践中识别有不良结局风险的老年人。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e1b/6719342/5ceb1a30b9ad/1414-431X-bjmbr-52-9-e8204-gf001.jpg

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