Department of Geriatric Medicine, Zuyderland Medical Centre, Sittard-Geleen, The Netherlands.
Department of Health Services Research, CAPHRI, Maastricht University, Maastricht, The Netherlands.
Eur Geriatr Med. 2020 Feb;11(1):155-162. doi: 10.1007/s41999-019-00253-6. Epub 2019 Nov 2.
Geriatric patients with low skeletal muscle mass (SMM) and strength have a poor clinical outcome following acute illness. Consequently, it is recommended to assess SMM and strength in patients admitted to the acute care geriatric ward. Bio-impedance analysis (BIA) is a practical tool to assess SMM in hospitalized patients. However, the reproducibility of this assessment may be compromised due to changing clinical conditions. The objective was to study the reproducibility of SMM assessment using multifrequency BIA (mf-BIA) in acutely ill geriatric patients.
A total of 47 geriatric patients (age: 83 ± 7 years; n = 31 female) admitted to the acute geriatric ward participated in this pilot study. SMM was assessed on three occasions within the first week of hospital admission using the Maltron Bioscan-920-II.
Total skeletal SMM averaged 21.4 ± 5.7, 20.7 ± 5.4, and 20.8 ± 5.1 kg assessed at 2 ± 1, 3 ± 1 and 5 ± 2 days after hospital admission, respectively. Coefficient of variation (COV) of the three SMM measurements was 4.9 ± 4.5% with an intraclass correlation coefficient (ICC) of 0.976 (CI 95%: 0.961-0.986; P < 0.001). Hydration status affected the reproducibility of the measurement, with non-euvolemic patients (n = 16) showing a significantly higher COV (7.6 ± 5.9% vs 3.5 ± 2.9%; P < 0.01) and a lower ICC (0.983 vs 0.913; P < 0.001) when compared to the euvolemic patients (n = 31).
Mf-BIA seems a highly reproducible and reliable method to assess SMM throughout the first week of hospitalization in geriatric patients. However, since abnormal hydration status may compromise reliability of the measurement, assessment of SMM using mf-BIA may better be performed when euvolemic status has been established.
患有低骨骼肌量(SMM)和肌肉力量的老年患者在急性疾病后临床预后较差。因此,建议在入住急性老年病房的患者中评估 SMM 和肌肉力量。生物阻抗分析(BIA)是评估住院患者 SMM 的实用工具。然而,由于临床状况的变化,这种评估的可重复性可能会受到影响。目的是研究在急性老年患者中使用多频 BIA(mf-BIA)评估 SMM 的可重复性。
本研究共纳入 47 名入住急性老年病房的老年患者(年龄:83±7 岁;n=31 名女性)。在入院后第一周内,使用 Maltron Bioscan-920-II 三次评估 SMM。
入院后 2±1、3±1 和 5±2 天,总骨骼肌 SMM 分别平均为 21.4±5.7、20.7±5.4 和 20.8±5.1kg。三次 SMM 测量的变异系数(CV)为 4.9±4.5%,组内相关系数(ICC)为 0.976(95%CI:0.961-0.986;P<0.001)。水合状态影响测量的可重复性,非等容患者(n=16)的 CV 明显更高(7.6±5.9%比 3.5±2.9%;P<0.01),ICC 更低(0.983 比 0.913;P<0.001),与等容患者(n=31)相比。
在老年患者住院的第一周内,mf-BIA 似乎是一种高度可重复和可靠的评估 SMM 的方法。然而,由于异常水合状态可能会影响测量的可靠性,因此最好在建立等容状态后使用 mf-BIA 评估 SMM。