Canonico Silvia, Ottaviani Silvia, Tagliafico Luca, Casabella Andrea, Signori Alessio, Ponzano Marta, Marelli Cristina, Nencioni Alessio, Monacelli Fiammetta
Section of Geriatrics, Department of Internal Medicine and Medical Specialties (DIMI), University of Genoa, Genoa, Italy.
IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
Front Med (Lausanne). 2024 Aug 6;11:1439353. doi: 10.3389/fmed.2024.1439353. eCollection 2024.
Sarcopenia, characterized by muscle mass, strength, and performance decline, significantly impacts outcomes in older adults. This study aims to assess the predictive value of calf circumference (CC), in conjunction with SARC-F and hand grip, concerning in-hospital complications and post-discharge mortality among hospitalized frail older adults.
A cohort of 158 hospitalized patients aged over 65 years underwent Comprehensive Geriatric Assessment and sarcopenia screening, including CC measurement. Multivariable regression analyses, adjusted for confounders, were conducted to assess predictive associations.
The study cohort, comprising 53% males with a median age of 86 years, exhibited significant sarcopenia prevalence based on SARC-F (85% indicating sarcopenia), hand grip strength (probable sarcopenia in 77% of males and 72% of females), and CC (sarcopenia in 83%). Multivariate analysis, adjusting for age, sex, Clinical Frailty Scale (CFS), and Mini Nutritional Assessment-Short Form (MNA-SF), demonstrated associations of CC and SARC-F with in-hospital complications, while CC also showed a significant association with reduced risks of in-hospital mortality (OR 0.441, 95% CI 0.257 to 0.754, = 0.003) and 90-day mortality (OR 0.714, 95% CI 0.516 to 0.988, = 0.043).
This study provides insights into the predictive accuracy of sarcopenia screening tools on mortality in real-world hospitalized older adults with frailty. Notably, CC emerges as a robust predictor of mortality outcomes. Further research is warranted to validate and elucidate the respective contributions of CC and frailty to mortality in vulnerable populations.
肌肉减少症以肌肉质量、力量和功能下降为特征，对老年人的预后有重大影响。本研究旨在评估小腿围度（CC）联合SARC - F和握力对住院体弱老年人院内并发症和出院后死亡率的预测价值。
对158名65岁以上的住院患者进行综合老年评估和肌肉减少症筛查，包括测量CC。进行多变量回归分析，并对混杂因素进行调整，以评估预测关联。
该研究队列中男性占53%，中位年龄为86岁，基于SARC - F（85%表明存在肌肉减少症）、握力（77%的男性和72%的女性可能存在肌肉减少症）和CC（83%存在肌肉减少症），肌肉减少症患病率显著。多变量分析在调整年龄、性别、临床衰弱量表（CFS）和简易营养评估简表（MNA - SF）后，显示CC和SARC - F与院内并发症有关，同时CC还与降低院内死亡风险（OR 0.441，95% CI 0.257至0.754，P = 0.003）和90天死亡率（OR 0.714，95% CI 0.516至0.988，P = 0.043）显著相关。
本研究为肌肉减少症筛查工具对实际住院体弱老年人死亡率的预测准确性提供了见解。值得注意的是，CC成为死亡率结果的有力预测指标。有必要进行进一步研究，以验证并阐明CC和衰弱对脆弱人群死亡率的各自贡献。
