Department of Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita, 879-5593, Japan.
Department of Internal Medicine, Tenshindo Hetsugi Hospital, 5956 Nihongi, Nakahetsugi, Oita, Oita, 879-7761, Japan.
Sci Rep. 2021 Feb 22;11(1):4319. doi: 10.1038/s41598-021-83995-3.
Erector spinae muscle (ESM) size has been reported as a predictor of prognosis in patients with some respiratory diseases. This study aimed to assess the association of ESM size on all-cause in-hospital mortality among elderly patients with pneumonia. We retrospectively included patients (age: ≥ 65 years) admitted to hospital from January 2015 to December 2017 for community-acquired pneumonia who underwent chest computed tomography (CT) on admission. The cross-sectional area of the ESM (ESMcsa) was measured on a single-slice CT image at the end of the 12th thoracic vertebra and adjusted by body surface area (BSA). Cox proportional hazards regression models were used to assess the influence of ESMcsa/BSA on in-hospital mortality. Among 736 patients who were admitted for pneumonia, 702 patients (95%) underwent chest CT. Of those, 689 patients (98%) for whom height and weight were measured to calculate BSA were included in this study. Patients in the non-survivor group were significantly older, had a greater frequency of respiratory failure, loss of consciousness, lower body mass index, hemoglobin, albumin, and ESMcsa/BSA. Multivariate analysis showed that a lower ESMcsa/BSA independently predicted in-hospital mortality after adjusting for these variables. In elderly patients with pneumonia, quantification of ESMcsa/BSA may be associated with in-hospital mortality.
竖脊肌（ESM）大小已被报道可预测某些呼吸系统疾病患者的预后。本研究旨在评估 ESM 大小与老年社区获得性肺炎患者全因住院死亡率的相关性。我们回顾性纳入了 2015 年 1 月至 2017 年 12 月期间因社区获得性肺炎住院的年龄（≥65 岁）患者，这些患者在入院时接受了胸部 CT（CT）检查。在第 12 胸椎末端的单张 CT 图像上测量 ESM 的横截面积（ESMcsa），并通过体表面积（BSA）进行校正。使用 Cox 比例风险回归模型评估 ESMcsa/BSA 对住院死亡率的影响。在 736 名因肺炎住院的患者中，有 702 名（95%）患者接受了胸部 CT 检查。在这些患者中，有 689 名（98%）患者测量了身高和体重以计算 BSA，他们被纳入本研究。非幸存者组的患者年龄明显更大，呼吸衰竭、意识丧失、较低的 BMI、血红蛋白、白蛋白和 ESMcsa/BSA 的发生率更高。多变量分析显示，在校正这些变量后，较低的 ESMcsa/BSA 独立预测住院死亡率。在老年肺炎患者中，ESM CSA/BSA 的定量可能与住院死亡率相关。
