Bhurchandi Shreerang, Kumar Sunil, Agrawal Sachin, Acharya Sourya, Jain Shraddha, Talwar Dhruv, Lomte Sunayana
Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND.
Department of Otorhinolaryngology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND.
Cureus. 2021 Oct 26;13(10):e19065. doi: 10.7759/cureus.19065. eCollection 2021 Oct.
Frailty phenotype represents weight loss, decreased functional and physical capacity and activity, falls, slow gait, and memory impairment. Sarcopenia is a generalized and progressive loss of skeletal muscle mass, strength, and function, which occurs due to primary effects of aging and secondary effects of other causes including diseases, malnutrition, and inactivity.
This prospective cross-sectional study was performed on 70 critically ill geriatric patients (of age > 60 years) admitted in Medicine ICU (MICU) from December 2020 to May 2021 at a rural medical school at Wardha in central rural India. We assessed sarcopenia in all the patients by the European Working Group on Sarcopenia in Older People (EWGSOP) criteria and compared it with the modified frailty index. All the patients were divided in sarcopenic and non-sarcopenic groups; frailty index was applied, and outcomes were measured in terms of mortality, the need for ventilation, and length of ICU stay.
In this study, the mean age of the patients was 68.61 ± 5.88 years in the sarcopenic group and 69.10 ± 6.31 years in the non-sarcopenic group. Eighteen (42.86%) patients in the sarcopenic group were severely frail, whereas eight (28.57%) patients in the non-sarcopenic group (p = 0.532) were not. In the sarcopenic severely frail group, mortality was six (14.29%), and eight (19.05%) required ventilation (p = 0.001), whereas in the non-sarcopenic severely frail group, mortality as well as the need for ventilation were four (14.29%) (p = 0.0001). Total duration of ICU stays was 4.30 ± 1.07 days in the sarcopenic group (n = 42), whereas it was 3.85 ± 1.23 days in the non-sarcopenic group (n = 28) (p = 0.10).
Our study found that critically ill patients with sarcopenia had more tendency to become frail, thereby increased risk of mortality. A timely routine assessment for sarcopenia upon ICU admission may provide an important prognostic factor in patient outcomes.
衰弱表型表现为体重减轻、功能和身体能力及活动下降、跌倒、步态缓慢和记忆障碍。肌肉减少症是骨骼肌质量、力量和功能的全身性和进行性丧失，这是由于衰老的主要影响以及包括疾病、营养不良和缺乏运动在内的其他原因的次要影响所致。
本前瞻性横断面研究于2020年12月至2021年5月在印度中部农村瓦尔达的一所农村医学院的医学重症监护病房（MICU）对70名年龄>60岁的危重症老年患者进行。我们根据欧洲老年人肌肉减少症工作组（EWGSOP）标准评估了所有患者的肌肉减少症，并将其与改良衰弱指数进行比较。所有患者分为肌肉减少症组和非肌肉减少症组；应用衰弱指数，并根据死亡率、通气需求和ICU住院时间来衡量结果。
在本研究中，肌肉减少症组患者的平均年龄为68.61±5.88岁，非肌肉减少症组为69.10±6.31岁。肌肉减少症组中有18名（42.86%）患者严重衰弱，而非肌肉减少症组中有8名（28.57%）患者不严重衰弱（p = 0.532）。在肌肉减少症严重衰弱组中，死亡率为6名（14.29%），8名（19.05%）需要通气（p = 0.001），而非肌肉减少症严重衰弱组中，死亡率和通气需求均为4名（14.29%）（p = 0.0001）。肌肉减少症组（n = 42）的ICU总住院时间为4.30±1.07天，而非肌肉减少症组（n = 28）为3.85±1.23天（p = 0.10）。
我们的研究发现，患有肌肉减少症的危重症患者更易变得衰弱，从而增加死亡风险。在ICU入院时及时对肌肉减少症进行常规评估可能为患者预后提供一个重要的预后因素。
