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手持式和固定式超声检测急性住院老年人体肌减少症的比较分析:一项有效性和可靠性研究。

Comparative analysis of hand-held and stationary ultrasound for detection of sarcopenia in acutely hospitalised older adults-a validity and reliability study.

机构信息

Department of Geriatric Medicine, Odense University Hospital, Svendborg, Denmark.

Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.

出版信息

Eur Geriatr Med. 2024 Aug;15(4):1017-1022. doi: 10.1007/s41999-024-01021-x. Epub 2024 Jul 20.

Abstract

BACKGROUND AND PURPOSE

Sarcopenia is a growing health concern among geriatric patients. Early diagnostics is importance to intervene and better muscle status and thus physical function. Ultrasound can be a valuable tool for patient-near diagnostics of sarcopenia. In recent time, ultrasound devices have evolved from larger stationary devices to minor hand-held devices that are more portable. However, the literature lacks research comparing quality of the different devices. The purpose of this study was to compare hand-held ultrasound (HH-US) to stationary ultrasound (S-US) in muscle assessment for detection of sarcopenia in acutely hospitalized older adults.

METHODS

A cross-sectional study using a convenience sample of acutely admitted older patients examined with both HH-US and S-US within a single session by the same examiner. Image analysis was performed using ImageJ, and was conducted by two raters: Rater 2 an experienced US examiner and Rater 1 an US examiner who received training from Rater 2. The Ultrasound sarcopenia index (USI) was used for evaluating sarcopenia. Validity and reliability of HH-US were analyzed using Cohen's Kappa and Student's t-test.

RESULTS

21 participants (mean age 83.4 years, 52% female). Results showed "substantial" intra-rater reliability (κ = 0.77 for Rater 1) and 'near-perfect' validity (κ = 0.92 for Rater 2). Inter-rater comparisons revealed no significant differences (p < 0.05).

CONCLUSION

HH-US is a potential method for detection of sarcopenia in acutely hospitalized older adults.

摘要

背景与目的

肌肉减少症是老年患者日益关注的健康问题。早期诊断对于干预和改善肌肉状况以及身体功能至关重要。超声检查可以作为一种对患者有益的诊断工具,用于肌肉减少症的诊断。近年来,超声设备已经从较大的台式设备发展为更小的手持式设备,更加便携。然而,目前文献中缺乏对不同设备质量的比较研究。本研究旨在比较手持式超声(HH-US)和台式超声(S-US)在急性住院老年患者肌肉评估中检测肌肉减少症的能力。

方法

这是一项使用便利抽样的横断面研究,在单次检查中,由同一位检查者使用 HH-US 和 S-US 对急性住院的老年患者进行检查。使用 ImageJ 进行图像分析,由两位评估者进行:评估者 2 是一位经验丰富的超声检查者,评估者 1 是一位接受评估者 2 培训的超声检查者。使用超声肌肉减少症指数(USI)评估肌肉减少症。使用 Cohen's Kappa 和 Student's t 检验分析 HH-US 的有效性和可靠性。

结果

共纳入 21 名参与者(平均年龄 83.4 岁,52%为女性)。结果显示,评估者 1 的内部一致性“很高”(κ=0.77),评估者 2 的有效性“非常高”(κ=0.92)。组间比较显示无显著差异(p<0.05)。

结论

HH-US 是一种用于检测急性住院老年患者肌肉减少症的潜在方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2bf/11377503/e52ef5153853/41999_2024_1021_Fig1_HTML.jpg

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