Graduate School of Rehabilitation Science, Hyogo Medical University, 1-3-6 Minatojima, Chuo Ward, Kobe, Hyogo, 650-8530, Japan; Department of Rehabilitation Technology, Sanuki Municipal Hospital, 387-1 Ishida Higashi Kou, Sangawa-cho, Sanuki City, Kagawa, 769-2393, Japan.
Graduate School of Rehabilitation Science, Hyogo Medical University, 1-3-6 Minatojima, Chuo Ward, Kobe, Hyogo, 650-8530, Japan.
Respir Med. 2024 Oct;232:107746. doi: 10.1016/j.rmed.2024.107746. Epub 2024 Aug 3.
Whether muscle mass and muscle quality affect the prognosis of elderly patients with aspiration pneumonia is unclear. This study aimed to evaluate the relationship between erector spinae muscle mass and muscle quality on the 30-day prognosis of elderly patients with aspiration pneumonia.
Two hundred fifty-eight patients who were diagnosed with aspiration pneumonia and admitted to Sanuki Municipal Hospital for pulmonary rehabilitation intervention were included. The cross-sectional area (ESM/BSA) and CT values (ESM) of the erector spinae muscles at the 12th thoracic vertebra were measured on chest CT images to represent muscle mass and quality, respectively. The primary outcome was defined as 30-day survival.
Twenty-six patients died within 30 days after hospitalization. The ESM/BSA ratio was significantly greater in the survival group than in the nonsurvival group (p = 0.001). The cutoff values for 30-day survival were calculated as follows: the ESM/BSA was 11.046 cm/m in male patients and 9.600 cm/m in female patients; the ESM was 26.85 HU in male patients and 8.00 HU in female patients. A higher ESM/BSA significantly improved 30-day survival, while ESM did not show a significant difference. Cox proportional hazards regression analysis revealed that the ESM/BSA was independently associated with 30-day short-term prognosis (hazard ratio 0.34, p = 0.034).
The short-term prognosis of elderly patients with aspiration pneumonia may be more strongly influenced by muscle mass than by the muscle quality of the erector spinae muscles.
肌量和肌肉质量是否会影响老年吸入性肺炎患者的预后尚不清楚。本研究旨在评估老年人吸入性肺炎患者竖脊肌肌量和肌肉质量与 30 天预后的关系。
共纳入 258 例诊断为吸入性肺炎并入住日本栗岛市医院进行肺部康复干预的患者。在胸部 CT 图像上测量第 12 胸椎处竖脊肌的横截面积（ESM/BSA）和 CT 值（ESM），分别代表肌肉量和质量。主要结局定义为 30 天生存。
26 例患者在住院后 30 天内死亡。存活组的 ESM/BSA 比值显著大于非存活组（p=0.001）。30 天生存的截断值计算如下：男性患者的 ESM/BSA 为 11.046 cm/m，女性患者为 9.600 cm/m；男性患者的 ESM 为 26.85 HU，女性患者为 8.00 HU。较高的 ESM/BSA 显著提高了 30 天生存率，而 ESM 则无显著差异。Cox 比例风险回归分析显示，ESM/BSA 与 30 天短期预后独立相关（风险比 0.34，p=0.034）。
老年吸入性肺炎患者的短期预后可能受肌量影响比受竖脊肌肌肉质量影响更大。
