Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Centre for Medical Research Building, 300 Grattan Street, Parkville, VIC, 3010, Australia.
Eur Geriatr Med. 2022 Jun;13(3):623-632. doi: 10.1007/s41999-022-00625-5. Epub 2022 Mar 2.
Albumin and C-reactive protein (CRP) are non-specific markers of inflammation, which could affect muscle tissue during acute hospitalization. We investigated the association between albumin and CRP during acute hospitalization with functional and body composition parameters in patients admitted to geriatric rehabilitation.
The REStORing Health of Acutely Unwell AdulTs (RESORT) cohort includes geriatric rehabilitation patients assessed for change in activities of daily living (ADL, using the Katz index) during acute hospitalization, and subsequently for Katz ADL, gait speed (GS), handgrip strength (HGS) and skeletal muscle mass index (SMI) at geriatric rehabilitation admission. Albumin and CRP average (median), variation (interquartile range), and maximum or minimum were collected from serum samples, and were examined for their association with functional and body composition parameters using multivariable linear regression analysis adjusted for age, sex and length of acute hospital stay.
1769 Inpatients were included for analyses (mean age 82.6 years ± 8.1, 56% female). Median length of acute hospitalization was 7 [IQR 4, 13] days and median number of albumin and CRP measurements was 5 [IQR 3, 12] times. ADL declined in 89% of patients (median - 3 points, IQR - 4, - 2). Lower average albumin, higher albumin variation and lower minimum albumin were associated with larger declines in ADL and with lower ADL, GS, HGS and SMI at geriatric rehabilitation admission. Higher average and maximum CRP were associated with lower GS.
Inflammation, especially lower albumin concentrations, during acute hospitalization is associated with lower physical function at geriatric rehabilitation admission.
白蛋白和 C 反应蛋白(CRP)是非特异性炎症标志物,在急性住院期间可能会影响肌肉组织。我们研究了老年康复住院患者急性住院期间白蛋白和 CRP 与功能和身体成分参数之间的关系。
REStORing Health of Acutely Unwell AdulTs(RESORT)队列包括接受评估的老年康复患者,评估他们在急性住院期间日常生活活动(ADL,使用 Katz 指数)的变化,随后在老年康复入院时评估 Katz ADL、步态速度(GS)、手握力(HGS)和骨骼肌质量指数(SMI)。从血清样本中收集白蛋白和 CRP 的平均值(中位数)、变异(四分位距)、最大值或最小值,并使用多变量线性回归分析调整年龄、性别和急性住院时间后,分析它们与功能和身体成分参数的关系。
共纳入 1769 例住院患者进行分析(平均年龄 82.6 ± 8.1 岁,56%为女性)。急性住院的中位数为 7 [IQR 4,13] 天,白蛋白和 CRP 测量的中位数为 5 [IQR 3,12] 次。89%的患者 ADL 下降(中位数 -3 分,IQR -4,-2)。平均白蛋白水平较低、白蛋白变异较大和最低白蛋白水平较低与 ADL 下降较大以及老年康复入院时 ADL、GS、HGS 和 SMI 较低相关。较高的平均和最大 CRP 与较低的 GS 相关。
急性住院期间的炎症,特别是较低的白蛋白浓度,与老年康复入院时较低的身体功能相关。