Yuenyongchaiwat Kornanong, Kulchanarat Chitima, Satdhabudha Opas
Physiotherapy Department, Faculty of Allied Health Sciences, Thammasat University, Thailand.
Thammasat University Research Unit in Physical Therapy in Respiratory and Cardiovascular Systems, Thailand.
Heliyon. 2020 Dec 17;6(12):e05759. doi: 10.1016/j.heliyon.2020.e05759. eCollection 2020 Dec.
Sarcopenia is a condition characterized by loss of muscle mass, muscle strength, or physical performance. It has been reported that cardiac surgery causes systemic inflammatory response, which leads to sarcopenia. In addition, open-heart surgery (OHS) has been associated with length of hospital stay, prolonged mechanical ventilation, and postoperative pulmonary complications. However, very few studies have explored the association of sarcopenia with OHS. Thus, this study explores the prevalence of sarcopenia in OHS patients as well as their relationship.
This cohort study included 160 patients; it was designed to assess sarcopenia during preoperative OHS and before patient discharge from the hospital. Sarcopenia was defined according to Asian Working Group for Sarcopenia (AWGS) criteria as low muscle mass plus low muscle strength and/or slow gait speed. Participants were requested to perform exercises to test their handgrip strength, gait speed, and bioelectrical impedance. In addition, their medical history (e.g., duration of hospitalization and mechanical ventilation) was recorded.
The prevalence of sarcopenia during preoperative OHS was 26.9%, with affected men comprising 11.9% and affected women comprising 15% of the total sample. Participants with sarcopenia had a significantly lower body mass index (BMI) than those without. Further, patients who had longer stays in the hospital and prolonged mechanical ventilation time showed significantly higher rates of developing sarcopenia. During postoperative OHS, the incidence of sarcopenia rose by 20.92%, increasing the total prevalence of sarcopenia to 46.41%. Moreover, advanced age emerged as one of the most significant risk factors of sarcopenia. Participants in the age group >55 years had an increased risk of sarcopenia (odds ratio [OR]: 3.90). It was also found that patients with a low BMI (<23 kg∗m) and a history of diabetes mellitus (DM) had an increased risk of sarcopenia (ORs: 2.11 and 1.47, respectively). Moreover, longer hospital stays and mechanical ventilation times were important risk factors (ORs: 1.58 and 2.07, respectively).
The prevalence of sarcopenia was observed to be high during postoperative OHS. Participants with sarcopenia who underwent OHS had a history of DM, longer length of hospital stays, and prolonged mechanical ventilation times, compared with patients without sarcopenia.
TCTR20190509003.
肌肉减少症是一种以肌肉量、肌肉力量或身体机能丧失为特征的病症。据报道，心脏手术会引发全身炎症反应，进而导致肌肉减少症。此外，心脏直视手术（OHS）与住院时间延长、机械通气时间延长及术后肺部并发症相关。然而，极少有研究探讨肌肉减少症与心脏直视手术之间的关联。因此，本研究旨在探究心脏直视手术患者中肌肉减少症的患病率及其关系。
本队列研究纳入了160例患者；旨在评估术前心脏直视手术期间及患者出院前的肌肉减少症情况。根据亚洲肌肉减少症工作组（AWGS）标准，肌肉减少症定义为低肌肉量加上低肌肉力量和/或慢步速。要求参与者进行锻炼以测试其握力、步速和生物电阻抗。此外，记录他们的病史（如住院时间和机械通气时间）。
术前心脏直视手术期间肌肉减少症的患病率为26.9%，其中受影响的男性占总样本的11.9%，受影响的女性占15%。肌肉减少症患者的体重指数（BMI）显著低于无肌肉减少症的患者。此外，住院时间较长和机械通气时间延长的患者发生肌肉减少症的比率显著更高。术后心脏直视手术期间，肌肉减少症的发生率上升了20.92%，使肌肉减少症的总患病率增至46.41%。此外，高龄是肌肉减少症最显著的危险因素之一。年龄>55岁组的参与者发生肌肉减少症的风险增加（优势比[OR]：3.90）。还发现BMI低（<23 kg∗m）和有糖尿病（DM）病史的患者发生肌肉减少症的风险增加（OR分别为：2.11和1.47）。此外，住院时间延长和机械通气时间是重要的危险因素（OR分别为：1.58和2.07）。
观察到术后心脏直视手术期间肌肉减少症的患病率较高。与无肌肉减少症的患者相比，接受心脏直视手术的肌肉减少症患者有糖尿病病史、住院时间更长且机械通气时间延长。
TCTR20190509003。
