Department of Physical Therapy, School of Rehabilitation, Hyogo Medical University, Kobe, Japan.
Department of Physical Therapy, School of Rehabilitation, Kansai Medical University, Hirakata, Japan.
Geriatr Gerontol Int. 2024 Apr;24(4):359-363. doi: 10.1111/ggi.14840. Epub 2024 Feb 26.
How possible sarcopenia affects functional prognosis in patients with premorbid disability remains unclear. This study aimed to compare and investigate the impact of possible sarcopenia at admission on functional outcomes at discharge in patients with acute stroke with and without premorbid disability.
This cohort study enrolled patients who were consecutively admitted to a single center for acute stroke. Calf circumference and grip strength were measured within 7 days of admission, and possible sarcopenia was determined using the Asian Working Group for Sarcopenia 2019 criteria. The Functional Independence Measure (FIM) score at discharge during the acute phase was the primary outcome. To examine the impact of possible sarcopenia on FIM scores at discharge, patients were divided into two groups according to being with or without premorbid disability according to the modified Rankin Scale, and multiple linear regression analysis was performed in each group.
This study included 456 patients with acute stroke (median age, 80 years). In the premorbid-disability group (n = 166), possible sarcopenia was present in 140 patients (84%). Patients without possible sarcopenia had significantly higher FIM scores at discharge compared with those with possible sarcopenia (P < 0.001). However, multiple linear regression analysis showed that possible sarcopenia was not associated with FIM scores at discharge in the premorbid-disability group (β = -0.054, P = 0.346).
The results of this study demonstrated that a high rate of possible sarcopenia was observed in patients with stroke with premorbid disability; however, this did not affect functional prognosis. Geriatr Gerontol Int 2024; 24: 359-363.
目前尚不清楚轻度肌肉减少症对伴有预存残疾的患者功能预后的影响。本研究旨在比较和探讨入院时存在轻度肌肉减少症对伴有和不伴有预存残疾的急性脑卒中患者出院时功能结局的影响。
这项队列研究纳入了连续入住一家中心的急性脑卒中患者。在入院后 7 天内测量小腿围和握力，并使用 2019 年亚洲肌肉减少症工作组标准确定可能存在的肌肉减少症。急性期出院时的功能独立性测量（FIM）评分是主要结局。为了研究可能存在的肌肉减少症对出院时 FIM 评分的影响，根据改良 Rankin 量表将患者分为伴有和不伴有预存残疾两组，并在每组中进行多元线性回归分析。
本研究纳入了 456 例急性脑卒中患者（中位年龄 80 岁）。在伴有预存残疾组（n=166）中，140 例患者（84%）存在可能存在的肌肉减少症。与存在可能存在的肌肉减少症的患者相比，不存在可能存在的肌肉减少症的患者出院时的 FIM 评分显著更高（P<0.001）。然而，多元线性回归分析显示，在伴有预存残疾组中，可能存在的肌肉减少症与出院时的 FIM 评分无关（β=-0.054，P=0.346）。
本研究结果表明，伴有预存残疾的脑卒中患者中存在较高比例的可能存在的肌肉减少症；然而，这并未影响功能预后。
