Ganbat Uyanga, Byambaa Altan-Ochir, Tang Portia, Feldman Boris, Arishenkoff Shane, Meneilly Graydon, Madden Kenneth
Department of Medicine, Gerontology and Diabetes Research Laboratory, Division of Geriatric Medicine, University of British Columbia, 186-828 W 10th Street, Vancouver, BC V5Z 1M9, Canada.
Department of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC V6T 1Z3, Canada.
Age Ageing. 2025 Mar 28;54(4). doi: 10.1093/ageing/afaf103.
BACKGROUND: Predicting hospital length of stay (LOS) can potentially improve healthcare resource allocation. Recent studies suggest that point-of-care ultrasound (POCUS), specifically measurements of muscle thickness (MT), may be valuable in assessing patient outcomes, including LOS. This study investigates the hypothesis that quadriceps MT and echo intensity (EI) can predict patient outcomes, particularly LOS. METHODS: Quadriceps MT and EI were measured using POCUS in patients admitted to a hospital's acute medical unit. Predictor variables included age, sex, MT, EI and the Charlson Comorbidity Index (CCI). The outcome variable was hospital LOS. RESULTS: One hundred twenty participants were included (average age 76 ± 7, with 64 women and 56 men). The mean LOS was 27 ± 31 days, and the mean MT was 20 ± 6 mm. Sex-based differences in MT were statistically significant (P = .032). Patients with prolonged LOS over 30 days had lower MT (mean 17 mm vs. 21 mm, P < .0001). One unit increase in MT was significantly associated with ~1.5 fewer days of hospital LOS, and one CCI score increase was associated with almost three more days of hospital LOS. Having low MT significantly increased the odds of staying in the hospital longer than 30 days by more than three times in all models. CONCLUSION: Muscle thickness is a strong predictor of hospital LOS, highlighting the potential of POCUS for assessing patient outcomes.
背景：预测住院时间（LOS）可能会改善医疗资源的分配。最近的研究表明，床旁超声（POCUS），特别是肌肉厚度（MT）的测量，可能在评估患者预后（包括住院时间）方面具有价值。本研究调查了股四头肌MT和回声强度（EI）能否预测患者预后，尤其是住院时间的假设。 方法：在一家医院急性内科病房收治的患者中，使用POCUS测量股四头肌MT和EI。预测变量包括年龄、性别、MT、EI和Charlson合并症指数（CCI）。结果变量是住院时间。 结果：纳入了120名参与者（平均年龄76±7岁，其中64名女性和56名男性）。平均住院时间为27±31天，平均MT为20±6毫米。MT的性别差异具有统计学意义（P = 0.032）。住院时间超过30天的患者MT较低（平均17毫米对21毫米，P < 0.0001）。MT每增加一个单位，与住院时间减少约1.5天显著相关，CCI评分每增加一分，与住院时间增加近三天相关。在所有模型中，MT较低显著增加了住院时间超过30天的几率，是原来的三倍多。 结论：肌肉厚度是住院时间的有力预测指标，突出了POCUS在评估患者预后方面的潜力。
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