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肌肉超声作为衰弱的影像学领域。

Muscle Ultrasound as Imaging Domain of Frailty.

作者信息

Bencivenga Leonardo, Picaro Francesco, Ferrante Lorenzo, Komici Klara, Ruggiero Federico, Sepe Immacolata, Gambino Giuseppina, Femminella Grazia Daniela, Vitale Dino Franco, Ferrara Nicola, Rengo Carlo, Rengo Giuseppe

机构信息

Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy.

Gérontopôle de Toulouse, Institut du Vieillissement, CHU de Toulouse, Toulouse, France.

出版信息

Front Med (Lausanne). 2022 Jul 11;9:922345. doi: 10.3389/fmed.2022.922345. eCollection 2022.

Abstract

INTRODUCTION

Frailty is a geriatric syndrome, a clinical state of vulnerability for developing dependency and/or death. Due to its multidimensional nature, Comprehensive Geriatric Assessment (CGA) constitutes the best strategy to evaluate frailty in older patients. Accumulation of deficits model synthesizes the global assessment of geriatric domains in the Frailty Index (FI) score. Muscle Ultrasound (MUS) has been employed to evaluate muscle mass wasting as tool to assess sarcopenia in late life. The present study aims to evaluate the association between CGA-based FI and MUS measures in a population of hospitalized older adults.

METHODS

Patients aged ≥65 years underwent CGA for the evaluation of the domains of health and functional status, psycho-cognition, nutritional status, socio-environmental condition. Following standard procedure, a CGA-based FI was elaborated, taking into account 38 multidimensional items. Muscle thicknesses (MT) of rectus femoris plus vastus intermedius were measured through MUS axial cross-section. Multivariable regression analysis was employed to determine factors associated with FI.

RESULTS

The study population consisted of 136 older patients, 87 men (63.9%), with median age of 74 (70-81) years, FI of 0.3 (0.21-0.46), and MT of rectus femoris plus vastus intermedius 29.27 (23.08-35.7) mm. At multivariable regression analysis, FI resulted significantly and independently associated with age and MT.

CONCLUSION

Muscle thicknesses of rectus femoris plus vastus intermedius, measured through MUS, resulted to be significantly related to FI in a population of hospitalized older patients. In the CGA-based assessment of frailty, MUS may constitute an additional imaging domain.

摘要

引言

衰弱是一种老年综合征,是一种易发展为失能和/或死亡的临床脆弱状态。由于其多维度性质,综合老年评估(CGA)是评估老年患者衰弱的最佳策略。缺陷累积模型在衰弱指数(FI)评分中综合了对老年领域的整体评估。肌肉超声(MUS)已被用作评估肌肉质量消耗的工具,以评估晚年的肌肉减少症。本研究旨在评估住院老年人群中基于CGA的FI与MUS测量值之间的关联。

方法

年龄≥65岁的患者接受CGA,以评估健康和功能状态、心理认知、营养状况、社会环境状况等领域。按照标准程序,制定了基于CGA的FI,考虑了38个多维度项目。通过MUS轴向横截面测量股直肌加股中间肌的肌肉厚度(MT)。采用多变量回归分析来确定与FI相关的因素。

结果

研究人群包括136名老年患者,其中87名男性(63.9%),中位年龄为74(70 - 81)岁,FI为0.3(0.21 - 0.46),股直肌加股中间肌的MT为29.27(23.08 - 35.7)mm。在多变量回归分析中,FI与年龄和MT显著且独立相关。

结论

通过MUS测量的股直肌加股中间肌的肌肉厚度,在住院老年患者人群中与FI显著相关。在基于CGA的衰弱评估中,MUS可能构成一个额外的影像学领域。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f21/9309884/33b658d4fc01/fmed-09-922345-g0001.jpg

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