Matsumoto Ayaka, Yoshimura Yoshihiro, Wakabayashi Hidetaka, Kose Eiji, Nagano Fumihiko, Bise Takahiro, Kido Yoshifumi, Shimazu Sayuri, Shiraishi Ai
Department of Pharmacy, Kumamoto Rehabilitation Hospital, Kumamoto 869-1106, Japan.
Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto 869-1106, Japan.
Nutrients. 2022 Jan 19;14(3):443. doi: 10.3390/nu14030443.
Evidence is scarce regarding the polypharmacy in patients with sarcopenia. The aim of this study was to investigate the effect of deprescribing for polypharmacy on the improvement of nutritional intake and sarcopenia in older patients with sarcopenia. A retrospective cohort study was conducted with hospitalized older patients with sarcopenia undergoing rehabilitation after stroke. Study outcomes included energy intake, protein intake, handgrip strength (HG) and skeletal muscle mass index (SMI) at hospital discharge. To consider the effects of deprescribing for polypharmacy, we used multivariate analyses to examine whether the change in the number of medications during hospitalization was associated with outcomes. Of 361 patients after enrollment, 91 (mean age 81.0 years, 48.4% male) presented with sarcopenia and polypharmacy and were eligible for analysis. The change in the number of medications was independently associated with energy intake (β = -0.237, = 0.009) and protein intake (β = -0.242, = 0.047) at discharge, and was not statistically significantly associated with HG (β = -0.018, = 0.768) and SMI (β = 0.083, = 0.265) at discharge, respectively. Deprescribing was associated with improved nutritional intake in older sarcopenic patients with polypharmacy undergoing stroke rehabilitation.
关于肌肉减少症患者多重用药的证据很少。本研究的目的是调查减少多重用药对老年肌肉减少症患者营养摄入改善和肌肉减少症的影响。对住院的老年中风后肌肉减少症康复患者进行了一项回顾性队列研究。研究结果包括出院时的能量摄入、蛋白质摄入、握力（HG）和骨骼肌质量指数（SMI）。为了考虑减少多重用药的影响，我们使用多变量分析来检查住院期间用药数量的变化是否与结果相关。在纳入的361例患者中，91例（平均年龄81.0岁，男性占48.4%）出现肌肉减少症和多重用药，符合分析条件。出院时用药数量的变化与能量摄入（β = -0.237，P = 0.009）和蛋白质摄入（β = -0.242，P = 0.047）独立相关，分别与出院时的握力（β = -0.018，P = 0.768）和骨骼肌质量指数（β = 0.083，P = 0.265）无统计学显著相关性。减少多重用药与接受中风康复的老年肌肉减少症多重用药患者营养摄入的改善有关。
