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老年住院患者肌肉减少症的预后特征:一项为期6个月的随访研究。

Prognostic Features of Sarcopenia in Older Hospitalized Patients: A 6-Month Follow-Up Study.

作者信息

Ferring Anne, Mück Luisa, Stegemann Jill, Wiebe Laura, Becker Ingrid, Benzing Thomas, Meyer Anna Maria, Polidori Maria Cristina

机构信息

Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany.

Institute of Medical Statistics and Computational Biology, University Hospital of Cologne, 50937 Cologne, Germany.

出版信息

J Clin Med. 2024 May 26;13(11):3116. doi: 10.3390/jcm13113116.

Abstract

Sarcopenia is associated with adverse health outcomes. Understanding the association between sarcopenia, multidimensional frailty, and prognosis is essential for improving patient care. The aim of this study was to assess the prevalence and prognostic signature of sarcopenia in an acute hospital setting co-led by internists and geriatricians. Sarcopenia was assessed by applying the European Working Group on Sarcopenia in Older People (EWGSOP2) algorithm, including the SARC-F score, handgrip strength, bioelectrical impedance analysis (BIA), and Timed Up and Go (TUG) test, to 97 older multimorbid inpatients (76.5 ± 6.8 years, 55% women). The patients underwent a Comprehensive Geriatric Assessment (CGA) including an evaluation of Geriatric Syndromes (GSs) and Resources (GR) and prognosis calculation using the CGA-based Multidimensional Prognostic Index (MPI), European Quality of life-5 Dimensions (EQ-5D-5L) scale, Rosenberg Self-Esteem Scale (RSES), and Geriatric Depression Scale (GDS). Information on survival and rehospitalizations was collected 1, 3, and 6 months after discharge. Sarcopenia was present in 63% (95% CI: 54-72%) of patients and categorized as probable (31%), confirmed (13%), and severe sarcopenia (18%). Sarcopenic patients showed significantly higher median MPI-values ( < 0.001), more GSs ( = 0.033), fewer GR ( = 0.003), lower EQ-5D-5L scores ( < 0.001), and lower RSES scores ( = 0.025) than non-sarcopenic patients. Six months after discharge, being sarcopenic at baseline was predictive of falls ( = 0.027) and quality of life ( = 0.043), independent of age, gender, and MPI. Sarcopenia is highly prevalent in older hospitalized multimorbid patients and is associated with poorer prognosis, mood, and quality of life up to 6 months after discharge, independent of age, sex, and MPI as surrogate markers of biological age.

摘要

肌肉减少症与不良健康结局相关。了解肌肉减少症、多维衰弱与预后之间的关联对于改善患者护理至关重要。本研究的目的是评估在内科医生和老年病医生共同主导的急性医院环境中肌肉减少症的患病率和预后特征。通过应用欧洲老年人肌肉减少症工作组(EWGSOP2)算法,包括SARC - F评分、握力、生物电阻抗分析(BIA)和定时起立行走(TUG)测试,对97名患有多种疾病的老年住院患者(76.5±6.8岁,55%为女性)进行肌肉减少症评估。患者接受了综合老年评估(CGA),包括老年综合征(GSs)和资源(GR)评估以及使用基于CGA的多维预后指数(MPI)、欧洲生活质量5维度(EQ - 5D - 5L)量表、罗森伯格自尊量表(RSES)和老年抑郁量表(GDS)进行预后计算。在出院后1、3和6个月收集生存和再次住院信息。63%(95%置信区间:54 - 72%)的患者存在肌肉减少症,分为可能(31%)、确诊(13%)和严重肌肉减少症(18%)。与非肌肉减少症患者相比,肌肉减少症患者的MPI中位数显著更高(<0.001),GSs更多(=0.033),GR更少(=0.003),EQ - 5D - 5L评分更低(<0.001),RSES评分更低(=0.025)。出院6个月后,基线时存在肌肉减少症可预测跌倒(=0.027)和生活质量(=0.043),独立于年龄、性别和MPI。肌肉减少症在患有多种疾病的老年住院患者中高度流行,并且与出院后长达6个月的较差预后、情绪和生活质量相关,独立于年龄、性别和作为生物学年龄替代指标的MPI。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e25/11172762/a0ee9a659a5c/jcm-13-03116-g001.jpg

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