Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Internal Medicine, Section of Gerontology and Geriatrics, Amsterdam, the Netherlands; Amsterdam Movement Sciences, Amsterdam, the Netherlands.
Amsterdam Movement Sciences, Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Rehabilitation Medicine, Amsterdam, the Netherlands.
J Am Med Dir Assoc. 2021 Apr;22(4):816-820.e2. doi: 10.1016/j.jamda.2020.12.016. Epub 2021 Jan 13.
Sarcopenia is highly prevalent in hospitalized older patients and associated with short-term mortality. This study aimed to investigate whether sarcopenia and its measures handgrip strength (HGS) and muscle mass at hospital admission were associated with long-term mortality in a cohort of hospitalized older patients.
Observational, prospective, longitudinal inception cohort study.
Academic teaching hospital; patients age ≥70 years admitted to the internal medicine, acute admission, trauma, or orthopedic wards.
HGS and muscle mass were measured at admission using a hand dynamometer and bioelectrical impedance analysis. Sarcopenia was determined based on the European Working Group on Sarcopenia in Older People definition. HGS and muscle mass (skeletal muscle mass index, appendicular lean mass, relative skeletal muscle mass) were expressed as sex-specific tertiles. The associations of sarcopenia, HGS, and muscle mass with mortality (during a follow-up of 3.4-4.1 years) were analyzed using Cox regression, adjusted for age, sex, comorbidity, and weight or height. Associations of HGS and muscle mass were stratified by sex.
Out of 363 patients [mean age: 79.6 years (standard deviation: 6.4), 49.9% female] 49% died. Probable sarcopenia (prevalence of 53.7%) and sarcopenia (prevalence of 20.8%) were significantly associated with long-term mortality [hazard ratio (HR) 1.53, 95% confidence interval (CI) 1.08‒2.17 and 1.71 95% CI 1.12‒2.61, respectively]. Low HGS, skeletal muscle mass index, and appendicular lean mass were associated with a higher mortality risk (lowest tertile vs highest tertile: HR 2.660, 95% CI 1.40‒5.05; HR 1.95, 95% CI 1.06‒3.58 and HR 1.99 (95% CI 1.12‒3.53) in male patients. No statistically significant associations of relative muscle mass with mortality were found.
Sarcopenia and its measures (low HGS and low absolute muscle mass at admission) predict long-term mortality in older hospitalized patients.
肌少症在住院老年患者中高度普遍，并与短期死亡率相关。本研究旨在调查肌少症及其测量指标——握力（HGS）和入院时肌肉量是否与住院老年患者队列的长期死亡率相关。
观察性、前瞻性、纵向起始队列研究。
学术教学医院；年龄≥70 岁、入住内科、急性入院、创伤或矫形病房的患者。
使用手持测力计和生物电阻抗分析在入院时测量 HGS 和肌肉量。肌少症根据欧洲老年人肌少症工作组的定义确定。HGS 和肌肉量（骨骼肌指数、四肢瘦体重、相对骨骼肌量）表示为性别特异性三分位数。使用 Cox 回归分析肌少症、HGS 和肌肉量与死亡率（随访 3.4-4.1 年）之间的关联，调整了年龄、性别、合并症和体重或身高。按性别对 HGS 和肌肉量的相关性进行分层。
在 363 名患者中[平均年龄：79.6 岁（标准差：6.4），49.9%为女性]，有 49%死亡。可能的肌少症（患病率为 53.7%）和肌少症（患病率为 20.8%）与长期死亡率显著相关[危险比（HR）分别为 1.53、95%置信区间（CI）为 1.08-2.17 和 1.71、95% CI 为 1.12-2.61]。低 HGS、骨骼肌指数和四肢瘦体重与更高的死亡率风险相关（最低三分位与最高三分位相比：HR 2.660、95% CI 1.40-5.05；HR 1.95、95% CI 1.06-3.58 和 HR 1.99、95% CI 1.12-3.53）在男性患者中。相对肌肉量与死亡率无统计学显著相关性。
肌少症及其测量指标（入院时低 HGS 和绝对肌肉量低）可预测住院老年患者的长期死亡率。
