Department of Internal Medicine, St. Luke's International Hospital, Tokyo, Japan.
Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, Japan.
Can Respir J. 2021 Dec 6;2021:3396950. doi: 10.1155/2021/3396950. eCollection 2021.
A retrospective cohort study was performed in patients aged 18 years or older with pneumonia who underwent chest CT within 24 hours of admission between April 2014 and March 2019. We measured the thickness, area, and volume of the pectoralis major and minor muscles at the level of the aortic arch. Factors associated with mortality were examined using logistic regression analysis.
A total of 483 patients (mean age 77 ± 14 years, 300 men (62%)) were included, and fifty-one patients (11%) died during admission. In univariate analysis, decreased thickness, area, and volume of the pectoralis major and minor muscles were associated with higher in-hospital mortality. Multivariate analysis with adjustment for age, gender, serum albumin, and A-DROP revealed that thinner pectoralis major and minor muscles were independent factors of poor prognosis (odds ratio: 0.878, 95% confidence interval (CI): 0.783-0.985, =0.026 and odds ratio: 0.842, 95% CI: 0.733-0.968, =0.016, respectively). Approximately 25% of the patients died when the pectoralis minor muscle thickness was 5 mm or less, and no patients died when it was 15 mm or more.
The pectoralis muscle mass may be an independent prognostic factor in hospitalized patients with pneumonia.
本回顾性队列研究纳入了 2014 年 4 月至 2019 年 3 月期间入院后 24 小时内行胸部 CT 检查的 18 岁及以上肺炎患者。我们测量了升主动脉水平胸大肌和胸小肌的厚度、面积和体积。使用逻辑回归分析检查与死亡率相关的因素。
共纳入 483 例患者（平均年龄 77±14 岁，300 例男性（62%）），51 例（11%）患者在住院期间死亡。单因素分析显示，胸大肌和胸小肌厚度、面积和体积减小与住院死亡率升高相关。多变量分析调整年龄、性别、血清白蛋白和 A-DROP 后显示，胸大肌和胸小肌较薄是预后不良的独立因素（比值比：0.878，95%置信区间（CI）：0.783-0.985，=0.026 和比值比：0.842，95% CI：0.733-0.968，=0.016，分别）。当胸小肌厚度≤5mm 时，约 25%的患者死亡，而当厚度≥15mm 时无患者死亡。
胸肌质量可能是肺炎住院患者的独立预后因素。
