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石井评分对肌肉减少症的预测价值及老年心力衰竭住院患者的预后

Predictive value of the Ishii score for sarcopenia and the prognosis of older patients hospitalized with heart failure.

作者信息

Maeda Daichi, Matsue Yuya, Kagiyama Nobuyuki, Fujimoto Yudai, Sunayama Tsutomu, Dotare Taishi, Nakade Taisuke, Jujo Kentaro, Saito Kazuya, Noda Takumi, Yamashita Masashi, Kamiya Kentaro, Saito Hiroshi, Ogasahara Yuki, Maekawa Emi, Konishi Masaaki, Kitai Takeshi, Iwata Kentaro, Wada Hiroshi, Hiki Masaru, Kasai Takatoshi, Nagamatsu Hirofumi, Ozawa Tetsuya, Izawa Katsuya, Yamamoto Shuhei, Aizawa Naoki, Wakaume Kazuki, Oka Kazuhiro, Momomura Shin-Ichi, Minamino Tohru

机构信息

Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Department of Cardiology, The Sakakibara Heart Institute of Okayama, Okayama, Japan.

出版信息

Geriatr Gerontol Int. 2024 Jan;24(1):147-153. doi: 10.1111/ggi.14736. Epub 2023 Nov 21.

Abstract

AIMS

Although sarcopenia is common and associated with poor outcomes in patients with heart failure, its simple screening methods remain unclear. We aimed to investigate the predictive value of the Ishii score, which includes age, grip strength, and calf circumference, for sarcopenia and its prognostic predictability in patients with heart failure.

METHODS

This was a subanalysis of the FRAGILE-HF study. Receiver operating characteristic curves were used to evaluate the predictive value for sarcopenia. Patients were stratified into the high and low Ishii score groups based on the cutoff values of the Ishii score determined by the Youden index for sarcopenia, and the 1-year mortality rates were compared.

RESULTS

Of the 1262 study participants, 936 were evaluated with sarcopenia, and 184 (55 women, 129 men) were diagnosed with sarcopenia. The areas under the receiver operating characteristic curves for sarcopenia were 0.73 and 0.87 for women and men, respectively. The optimal cutoff values for predicting sarcopenia were 165 and 141 for women and men, respectively. Using these cutoff values, the sensitivity and specificity for sarcopenia were 70.9% and 68.5% for women and 88.4% and 69.7% for men, respectively. At 1 year, 151 (low Ishii score group, 98; high Ishii score group, 53) deaths were observed. Adjusted Cox proportional hazards analysis showed that the high Ishii score group was significantly associated with 1-year mortality.

CONCLUSION

Among older patients hospitalized for heart failure, the Ishii score is useful for predicting sarcopenia and 1-year mortality. Geriatr Gerontol Int 2024; 24: 147-153.

摘要

目的

尽管肌肉减少症在心力衰竭患者中很常见且与不良预后相关,但其简单的筛查方法仍不明确。我们旨在研究包含年龄、握力和小腿围度的石井评分对肌肉减少症的预测价值及其在心力衰竭患者中的预后预测能力。

方法

这是对FRAGILE-HF研究的一项亚分析。采用受试者工作特征曲线评估对肌肉减少症的预测价值。根据由约登指数确定的肌肉减少症石井评分临界值,将患者分为石井评分高分组和低分组,并比较两组的1年死亡率。

结果

在1262名研究参与者中,936人接受了肌肉减少症评估,184人(55名女性,129名男性)被诊断为肌肉减少症。女性和男性肌肉减少症受试者工作特征曲线下面积分别为0.73和0.87。预测肌肉减少症的最佳临界值女性为165,男性为141。使用这些临界值,女性肌肉减少症的敏感性和特异性分别为70.9%和68.5%,男性分别为88.4%和69.7%。1年时,观察到151例死亡(低石井评分组98例,高石井评分组53例)。校正后的Cox比例风险分析显示,高石井评分组与1年死亡率显著相关。

结论

在因心力衰竭住院的老年患者中,石井评分有助于预测肌肉减少症和1年死亡率。《老年医学与老年病学国际杂志》2024年;24: 147 - 153。

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