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老年住院患者肌肉减少症和合并症的死亡决定因素

The mortality determinants of sarcopenia and comorbidities in hospitalized geriatric patients.

作者信息

Lamers Scott, Degerickx Robin, Vandewoude Maurits, Perkisas Stany

机构信息

School of Medicine, University of Antwerp, Antwerp 2610, Belgium.

University Centre for Geriatrics, ZNA (Ziekenhuis Netwerk Antwerp), Antwerp 2000, Belgium.

出版信息

J Frailty Sarcopenia Falls. 2017 Dec 1;2(4):65-72. doi: 10.22540/JFSF-02-065. eCollection 2017 Dec.

DOI:10.22540/JFSF-02-065
PMID:32300682
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7155369/
Abstract

OBJECTIVES

Determine the influence of muscle mass, muscle strength, physical performance, nutritional status and certain comorbidities on the four years mortality risk of hospitalized geriatric patients.

DESIGN

Retrospective cohort study.

SETTING

During hospitalization of the included geriatric patients, the determinants of sarcopenia and nutritional status were obtained.

PARTICIPANTS

A total of 302 patients hospitalized at the geriatric department of the Saint-Elisabeth hospital in Antwerp (Belgium) from 01/08/2012 until 31/01/2013.

MEASUREMENTS

Muscle mass was measured using a CT scan. The muscle strength was obtained by measuring the handgrip strength using a Jamar dynamometer. The physical performance was measured by performing the SPPB. The nutritional status was surveyed by using the MNA-SF. Comorbidities were obtained through medical records.

RESULTS

The variables gender (HR= 0.609; 95% CI 0.442-0.838), nutritional status (HR= 2.953; 95% CI 1.924-4.531), muscle mass (HR= 0.443; 95% CI 0.251-0.780), muscle strength (HR= 0.215; CI 95% 0.079-0.587), physical performance (HR= 0.407; 95% CI 0.237-0.702) and heart failure (HR= 1.440; 95% CI 1.022-2.029) have been shown to be significant.

CONCLUSION

The determinants gender, nutritional status and physical performance have the greatest prognostic value.

摘要

目的

确定肌肉质量、肌肉力量、身体机能、营养状况及某些合并症对老年住院患者四年死亡风险的影响。

设计

回顾性队列研究。

背景

在纳入的老年患者住院期间，获取肌少症和营养状况的决定因素。

参与者

2012年8月1日至2013年1月31日期间在比利时安特卫普圣伊丽莎白医院老年科住院的302例患者。

测量方法

使用CT扫描测量肌肉质量。通过使用Jamar测力计测量握力来获取肌肉力量。通过执行简易体能状况量表（SPPB）来测量身体机能。使用微型营养评定法简表（MNA-SF）调查营养状况。通过病历获取合并症情况。

结果

已证明性别（风险比[HR]=0.609；95%置信区间[CI]0.442 - 0.838）、营养状况（HR = 2.953；95% CI 1.924 - 4.531）、肌肉质量（HR = 0.443；95% CI 0.251 - 0.780）、肌肉力量（HR = 0.215；95% CI 0.079 - 0.587）、身体机能（HR = 0.407；95% CI 0.237 - 0.702）和心力衰竭（HR = 1.440；95% CI 1.022 - 2.029）这些变量具有显著性。

结论

性别、营养状况和身体机能这些决定因素具有最大的预后价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/102f/7155369/d017508781a8/JFSF-2-065-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/102f/7155369/d017508781a8/JFSF-2-065-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/102f/7155369/d017508781a8/JFSF-2-065-g001.jpg

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本文引用的文献

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Malnutrition-sarcopenia syndrome predicts mortality in hospitalized older patients.营养不良-肌少症综合征预测住院老年患者的死亡率。
Sci Rep. 2017 Jun 9;7(1):3171. doi: 10.1038/s41598-017-03388-3.
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Sarcopenic obesity, weight loss, and mortality: the English Longitudinal Study of Ageing.肌少症性肥胖、体重减轻与死亡率：英国老龄化纵向研究
简短体能表现电池作为老年人体能表现和死亡率预测指标的综合文献回顾。
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Am J Clin Nutr. 2017 Jul;106(1):125-129. doi: 10.3945/ajcn.117.152488. Epub 2017 May 24.
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Health Outcomes of Sarcopenia: A Systematic Review and Meta-Analysis.肌肉减少症的健康结局：一项系统评价与荟萃分析
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J Cachexia Sarcopenia Muscle. 2016 Jun;7(3):290-8. doi: 10.1002/jcsm.12073. Epub 2015 Oct 15.
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