Ceolin C, Acunto V, Simonato C, Cazzavillan S, Vergadoro M, Papa M V, Trapella G S, Sermasi R, Noale M, De Rui M, Zanforlini B M, Curreri C, Bertocco A, Devita M, Coin A, Sergi G
Chiara Ceolin, Department of Medicine (DIMED), Geriatrics Division, University of Padua, Via Giustiniani 2, 35128 Padua, Italy, Fax: +39 049 8211218; Phone: +39 049 8218949, E-mail:
J Frailty Aging. 2024;13(2):108-115. doi: 10.14283/jfa.2024.4.
Considering the impact of sarcopenia on mortality, and the difficulty to assessment of body composition, the hypothesis of the study is that calf circumference (CC) is closely related to mortality in older patients. The aim of the study was to analyze the potential role of CC to predict mortality in old individuals at 3, 6 and 12 months after discharge from hospital.
Patients aged >65 years were recruited for this retrospective study from September 2021 to March 2022. Their physical and body composition characteristics (including Body Mass Index-BMI and Mini Nutritional Assessment-MNA) were measured; data on mortality at 3 (T3), 6 (T6) and 12 (T12) months after discharge were recorded. Sarcopenia was diagnosed according to the 2019 European Consensus criteria.
Participants were 192 older adults (92 women), with a mean age of 82.8±7.0 years. Sarcopenic people were 41. The mortality rate was higher in sarcopenic people only at T3 and T6. CC had comparable validity in predicting mortality to that of MNA and ASMMI (Appendicular Skeletal Muscle Mass), and was better than BMI and serum albumin at each time point. Youden's index showed that the best cut-off for CC for predicting mortality was 30.6 cm both at T3 (sensitivity: 74%; specificity: 75%) and T6 (sensitivity: 75%; specificity: 67%). At the Cox regression model for mortality, high values of CC (HR 0.73, CI95% 0.60-0.89/p<0.001) and ADL scores (HR 0.72, CI95% 0.54-0.96/p=0.04) were protective factors at T6 and T12 respectively; at T12 high comorbidity rate was a risk factor (HR 1.28, IC95% 1.02-1.62/p=0.04).
CC has a validity comparable to MNA and ASMMI in predicting mortality at 3, 6 and 12 months after hospital discharge. Moreover, it can be considered an independent predictor of medium-term mortality in the hospitalized older population. CC can be an effective method for the prognostic stratification of these patients, due to its simplicity and immediacy.
考虑到肌肉减少症对死亡率的影响以及身体成分评估的困难，本研究的假设是小腿围（CC）与老年患者的死亡率密切相关。本研究的目的是分析CC在预测老年患者出院后3个月、6个月和12个月死亡率方面的潜在作用。
2021年9月至2022年3月招募年龄>65岁的患者进行这项回顾性研究。测量他们的身体和身体成分特征（包括体重指数-BMI和微型营养评定-MNA）；记录出院后3个月（T3）、6个月（T6）和12个月（T12）的死亡率数据。根据2019年欧洲共识标准诊断肌肉减少症。
参与者为192名老年人（92名女性），平均年龄82.8±7.0岁。肌肉减少症患者有41名。仅在T3和T6时，肌肉减少症患者的死亡率较高。CC在预测死亡率方面的有效性与MNA和ASMMI（四肢骨骼肌质量）相当，并且在每个时间点都优于BMI和血清白蛋白。约登指数显示，预测死亡率的CC最佳截断值在T3时为30.6 cm（敏感性：74%；特异性：75%），在T6时为30.6 cm（敏感性：75%；特异性：67%）。在死亡率的Cox回归模型中，CC的高值（HR 0.73，CI95% 0.60-0.89/p<0.001）和ADL评分（HR 0.72，CI95% 0.54-0.96/p=0.04）分别在T6和T12时是保护因素；在T12时，高合并症发生率是一个危险因素（HR 1.28，IC95% 1.02-1.62/p=0.04）。
CC在预测出院后3个月、6个月和12个月的死亡率方面具有与MNA和ASMMI相当的有效性。此外，它可以被认为是住院老年人群中期死亡率的独立预测指标。由于其简单性和即时性，CC可以成为这些患者预后分层的有效方法。
