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揭示隐藏的负担:通过一致性和聚类分析探讨住院老年患者的肌肉减少症。

Unveiling a hidden burden: exploring sarcopenia in hospitalized older patients through concordance and cluster analysis.

机构信息

Hospital Universitario Mayor-Méderi, Calle 24 # 29-45, 9th floor, Bogotá, Colombia.

Escuela de Medicina y Ciencias de la Salud, Instituto Rosarista para el Estudio del Envejecimiento y la Longevidad, Universidad del Rosario, Bogotá, Colombia.

出版信息

BMC Geriatr. 2024 Oct 30;24(1):892. doi: 10.1186/s12877-024-05322-5.

Abstract

BACKGROUND

Sarcopenia has been shown to be an important condition with the ability to predict negative health outcomes, especially in hospitalized older adults; hence, its accurate identification has an important role in the prognosis of older patients.

AIM

The prevalence of sarcopenia among hospitalized older adults was assessed by employing three distinct diagnostic methods.

METHODS

Older adults who were hospitalized were recruited. Bioelectrical impedance analysis was used to assess muscle mass and body composition. Sarcopenia was diagnosed via the European and Asian criteria and via a modified approach in which the Colombian cutoff points for handgrip and gait speed were used. Finally, a cluster analysis was performed to classify the population.

RESULTS

The prevalence rates of sarcopenia and severe sarcopenia ranged from 7.3 to 31.6%. The agreement between approaches revealed substantial or almost perfect agreement in 30% of the sarcopenia comparisons and 46.6% of the severe sarcopenia comparisons. The cluster analysis defined three different clusters. The first cluster was associated with increased age, BMI and body fat and poorer functional status and muscle. The second cluster was the healthiest, with high functional status and muscle mass. The third cluster had intermediate characteristics.

DISCUSSION

This study highlights the requirements for standardized diagnostic criteria and precise body composition assessment tools in acute geriatric units and highlights the heterogeneity of older adults. Accurate assessment and well-defined diagnostic criteria will facilitate the implementation of appropriate management and interventions.

CONCLUSION

Sarcopenia is highly prevalent in hospitalized older adults, but the adjusted criteria and the inclusion of other parameters must be considered in the assessment.

摘要

背景

肌少症已被证明是一种能够预测负面健康结果的重要疾病,尤其是在住院的老年人中;因此,准确识别肌少症在老年患者的预后中具有重要作用。

目的

采用三种不同的诊断方法评估住院老年患者肌少症的患病率。

方法

招募住院的老年人。使用生物电阻抗分析评估肌肉量和身体成分。通过欧洲和亚洲标准以及通过使用哥伦比亚握力和步态速度截断值的改良方法诊断肌少症。最后,进行聚类分析对人群进行分类。

结果

肌少症和严重肌少症的患病率从 7.3%到 31.6%不等。方法之间的一致性在 30%的肌少症比较和 46.6%的严重肌少症比较中显示出实质性或几乎完美的一致性。聚类分析定义了三个不同的聚类。第一个聚类与年龄增长、BMI 和体脂肪增加以及功能状态和肌肉较差有关。第二个聚类是最健康的,具有较高的功能状态和肌肉量。第三个聚类具有中等特征。

讨论

本研究强调了在急性老年病房中需要标准化的诊断标准和精确的身体成分评估工具,并强调了老年人的异质性。准确的评估和明确的诊断标准将有助于实施适当的管理和干预措施。

结论

肌少症在住院的老年患者中患病率较高,但在评估时必须考虑调整后的标准和纳入其他参数。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c79/11523645/f5c7fc68eefe/12877_2024_5322_Fig1_HTML.jpg

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