危重症患者低骨骼肌量的患病率及死亡风险：一项更新的系统评价与荟萃分析
Prevalence and mortality risk of low skeletal muscle mass in critically ill patients: an updated systematic review and meta-analysis.
作者信息
Yang Hui, Wan Xi-Xi, Ma Hui, Li Zhen, Weng Li, Xia Ying, Zhang Xiao-Ming
机构信息
Department of Nursing, Chinese Academy of Medical Sciences-Peking Union Medical College Hospital, Beijing, China.
Department of Medical Intensive Care Unit, Chinese Academy of Medical Sciences-Peking Union Medical College Hospital, Beijing, China.
出版信息
Front Nutr. 2023 May 12;10:1117558. doi: 10.3389/fnut.2023.1117558. eCollection 2023.
BACKGROUND
Patients with critical illness often develop low skeletal muscle mass (LSMM) for multiple reasons. Numerous studies have explored the association between LSMM and mortality. The prevalence of LSMM and its association with mortality are unclear. This systematic review and meta-analysis was performed to examine the prevalence and mortality risk of LSMM among critically ill patients.
METHODS
Three internet databases (Embase, PubMed, and Web of Science) were searched by two independent investigators to identify relevant studies. A random-effects model was used to pool the prevalence of LSMM and its association with mortality. The GRADE assessment tool was used to assess the overall quality of evidence.
RESULTS
In total, 1,582 records were initially identified in our search, and 38 studies involving 6,891 patients were included in the final quantitative analysis. The pooled prevalence of LSMM was 51.0% [95% confidence interval (CI), 44.5-57.5%]. The subgroup analysis showed that the prevalence of LSMM in patients with and without mechanical ventilation was 53.4% (95% CI, 43.2-63.6%) and 48.9% (95% CI, 39.7-58.1%), respectively (-value for difference = 0.44). The pooled results showed that critically ill patients with LSMM had a higher risk of mortality than those without LSMM, with a pooled odds ratio of 2.35 (95% CI, 1.91-2.89). The subgroup analysis based on the muscle mass assessment tool showed that critically ill patients with LSMM had a higher risk of mortality than those with normal skeletal muscle mass regardless of the different assessment tools used. In addition, the association between LSMM and mortality was statistically significant, independent of the different types of mortality.
CONCLUSION
Our study revealed that critically ill patients had a high prevalence of LSMM and that critically ill patients with LSMM had a higher risk of mortality than those without LSMM. However, large-scale and high-quality prospective cohort studies, especially those based on muscle ultrasound, are required to validate these findings.
SYSTEMATIC REVIEW REGISTRATION
http://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022379200.
背景
危重症患者常因多种原因出现低骨骼肌质量（LSMM）。众多研究探讨了LSMM与死亡率之间的关联。LSMM的患病率及其与死亡率的关联尚不清楚。本系统评价和荟萃分析旨在研究危重症患者中LSMM的患病率及死亡风险。
方法
两名独立研究人员检索了三个互联网数据库（Embase、PubMed和Web of Science）以识别相关研究。采用随机效应模型汇总LSMM的患病率及其与死亡率的关联。使用GRADE评估工具评估证据的总体质量。
结果
我们的检索最初共识别出1582条记录，最终定量分析纳入了38项研究，涉及6891例患者。LSMM的合并患病率为51.0%[95%置信区间（CI），44.5 - 57.5%]。亚组分析显示，有创机械通气患者和无创机械通气患者中LSMM的患病率分别为53.4%（95%CI，43.2 - 63.6%）和48.9%（95%CI，39.7 - 58.
Zotero 插件