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计算机断层扫描测量骨骼肌减少症预测老年烧伤患者的住院时间。

Computed Tomography Measurements of Sarcopenia Predict Length of Stay in Older Burn Patients.

机构信息

Department of Surgery, Division of Burn Surgery, University of California, Davis, Sacramento.

Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Ratchathewi, Bangko, Thailand.

出版信息

J Burn Care Res. 2021 Feb 3;42(1):3-8. doi: 10.1093/jbcr/iraa149.

Abstract

Sarcopenia and frailty are associated with aging. In older burn patients, frailty has been associated with mortality and discharge disposition, but sarcopenia has not been examined. This study aims to investigate the relationship between frailty and computed tomography (CT)-derived sarcopenia with length of stay and mortality in older burn patients. Burn patients ≥60 years old admitted between 2008 and 2017 who had chest or abdomen CT scans within 1 week of admission were evaluated. Frailty was assessed using the Canadian Study of Health and Aging Clinical Frailty Scale (CFS). Sarcopenia was assessed on CT exams by measuring skeletal muscle index (SMI) of paraspinal muscles at T12 and all skeletal muscles at L3. The relationship between frailty scores and SMI with length of stay (LOS) and mortality was determined using logistic regression. Eighty-three patients (59 men; mean age 70.2 ± 8.5 years) had chest (n = 50) or abdomen (n = 60) CT scans. Mean TBSA = 14.3 ± 14.0%, LOS = 25.8 ± 21.3 days, CFS = 4.36 ± 0.99. Sixteen patients (19.3%) died while in the hospital. CT-derived measurement of SMI at T12 was significantly associated with LOS (P < .05), but not with mortality (P = .561). CT-derived metrics at L3 were not significantly associated with outcomes. CFS was not associated with LOS (P = .836) or mortality (P = .554). In older burn patients, low SMI of the paraspinal muscles at T12 was associated with longer LOS.

摘要

肌肉减少症和衰弱与衰老有关。在老年烧伤患者中,衰弱与死亡率和出院去向有关,但尚未检查肌肉减少症。本研究旨在探讨衰弱与 CT 衍生的肌肉减少症与老年烧伤患者住院时间和死亡率的关系。评估了 2008 年至 2017 年间入院时年龄≥60 岁且入院后 1 周内接受过胸部或腹部 CT 扫描的烧伤患者。使用加拿大健康老龄化研究临床衰弱量表(CFS)评估衰弱。通过测量 T12 处脊柱旁肌肉和 L3 处所有骨骼肌的骨骼肌指数(SMI),在 CT 检查中评估肌肉减少症。使用逻辑回归确定衰弱评分和 SMI 与住院时间(LOS)和死亡率之间的关系。83 例患者(59 名男性;平均年龄 70.2±8.5 岁)进行了胸部(n=50)或腹部(n=60)CT 扫描。平均 TBSA=14.3±14.0%,LOS=25.8±21.3 天,CFS=4.36±0.99。16 例患者(19.3%)在住院期间死亡。T12 处的 CT 衍生 SMI 测量值与 LOS 显著相关(P<.05),但与死亡率无关(P=0.561)。L3 处的 CT 衍生指标与结果无显著相关性。CFS 与 LOS 无关(P=0.836)或死亡率无关(P=0.554)。在老年烧伤患者中,T12 处脊柱旁肌肉的低 SMI 与 LOS 延长相关。

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