Department of Pulmonary Medicine, Cleveland Clinic, Cleveland, Ohio, USA.
Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, USA.
J Am Geriatr Soc. 2021 Jul;69(7):1815-1825. doi: 10.1111/jgs.17108. Epub 2021 Mar 18.
Skeletal muscle loss or sarcopenia is a frequent complication in heart failure (HF) and contributes to adverse clinical outcomes. We evaluated if age (primary) and chronic disease (secondary) related sarcopenia, that we refer to as compound sarcopenia, impacts clinical outcomes in hospitalized patients with HF.
Cross-sectional study using hospitalized patient data.
Data from the Agency for Healthcare Research and Quality through the Healthcare Cost and Utilization Project (HCUP).
Hospitalized adult patients with a primary or secondary diagnosis of HF (n = 64,476) and a concurrent random 2% sample of general medical population (GMP; n = 322,217) stratified by age (<50 years of age [y], 51-65y, >65y) from the Nationwide Inpatient Sample (NIS) database (years 2010-2014).
In-hospital mortality, length of stay (LoS), cost of hospitalization per admission (CoH), comorbidities and discharge disposition, with and without muscle loss phenotype, were analyzed. Muscle loss phenotype was defined using a comprehensive code set from international classification of diseases-9 (ICD-9).
Muscle loss phenotype was observed in 8673 (13.5%) patients with HF compared to 5213 (1.6%) GMP across all age strata. In patients with HF, muscle loss phenotype was associated with higher mortality, LoS, and CoH. Patients with HF (>65y) and muscle loss phenotype had higher mortality (adjusted OR: 1.81; 95% CI 1.56-2.10), CoH (adjusted OR 1.48; 95% CI 1.44-1.1.52), and LoS (adjusted OR 1.40; 95% CI 1.37-1.43) compared to >65y GMP with muscle loss phenotype.
Muscle loss phenotype is more commonly associated with increasing age in hospitalized patients with HF. Clinical outcomes were significantly worse in patients with HF aged >65y compared to younger patients with HF and all age strata in GMP with and without a muscle loss phenotype.
骨骼肌减少或肌肉减少症是心力衰竭（HF）的常见并发症，并导致不良的临床结局。我们评估了年龄（主要因素）和慢性疾病（次要因素）相关的肌肉减少症，即我们所说的复合性肌肉减少症，是否会影响住院 HF 患者的临床结局。
使用住院患者数据的横断面研究。
通过医疗保健成本和利用项目（HCUP）从医疗保健研究和质量机构获取的数据。
从全国住院患者样本（NIS）数据库（2010-2014 年）中按年龄分层（<50 岁[y]、51-65y、>65y），对患有原发性或继发性 HF 诊断的成年住院患者（n=64476）和一般医疗人群（GMP；n=322217）进行了同期随机 2%样本选择。
分析了住院死亡率、住院时间（LoS）、每次入院的住院费用（CoH）、合并症和出院去向，同时分析了有和没有肌肉减少症表型的情况。肌肉减少症表型使用来自国际疾病分类-9（ICD-9）的综合代码集定义。
在所有年龄组中，与一般医疗人群相比，HF 患者中有 8673（13.5%）例患者存在肌肉减少症表型，而 GMP 中有 5213（1.6%）例患者存在肌肉减少症表型。在 HF 患者中，肌肉减少症表型与更高的死亡率、LoS 和 CoH 相关。HF 患者（>65 岁）和肌肉减少症表型患者的死亡率更高（调整后的 OR：1.81；95%CI 1.56-2.10），CoH（调整后的 OR：1.48；95%CI 1.44-1.52）和 LoS（调整后的 OR：1.40；95%CI 1.37-1.43）高于肌肉减少症表型的 GMP（>65 岁）。
在住院 HF 患者中，肌肉减少症表型更常见于年龄增加。与年轻的 HF 患者相比，年龄>65 岁的 HF 患者和 GMP 中所有年龄组的肌肉减少症表型患者的临床结局明显更差。
