Gubarev Waldemar, Klinke Jan, Voßmann Ulrike, Cantré Daniel, Zendeh Zartoshti Bijan, Rafaelian Artem, Arsenovic Milos, Dubinski Daniel, Won Sae-Yeon, Gessler Florian, Freiman Thomas, Storch Alexander, Wittstock Matthias
Department of Neurology, University Medical Center Rostock, Rostock, Germany.
Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, Rostock, Germany.
Front Neurol. 2025 May 16;16:1564550. doi: 10.3389/fneur.2025.1564550. eCollection 2025.
INTRODUCTION: Estimating the prognosis of spontaneous intracerebral hemorrhage (ICH) is of great importance. It has not been conclusively clarified whether sarcopenia is predictive for the functional outcome in ICH. Determining the temporalis muscle thickness (TMT) may be helpful for estimating sarcopenia. An association of TMT with outcome (mRS) has been shown in cerebellar ischemia and traumatic brain injury. METHODS: The present retrospective study of 488 consecutive patients with ICH aimed to investigate the association of sarcopenia as assessed by TMT with mRS. In addition to biometric data, ICH subtype and severity [modified ICH score (mICH)], occurrence of complications and mRS at discharge and after 90 days were recorded. The influence of sarcopenia assessed by TMT as the surrogate marker using head imaging (cCT, cMRT) on mRS was analyzed by ordinal regression analysis. Dichotomization into sarcopenic and non-sarcopenic patients was carried out using standard threshold values. RESULTS: Finally, 322 patients were analyzed [median (IQR) age: 77 (66-83) years; 57.5% male]. Sarcopenic patients were older ( < 0.001), had lower BMI ( = 0.025) and higher mICH scores ( < 0.001) compared to non-sarcopenic patients. There was no significant difference in the overall distribution of mRS scores between sarcopenic and non-sarcopenic patients at discharge (unadjusted common OR: 1.28; 95% CI: 0.85-1.92; = 0.236), but at 90 days favoring the non-sarcopenic over the sarcopenic group (unadjusted common OR: 1.41; 95% CI: 1.07-2.12; = 0.049). The results did not subsist statistical adjustment to candidate covariates by multivariate ordinal regression. DISCUSSION: In conclusion, sarcopenia as assessed by TMT seems to have limited prognostic value in ICH.
引言:评估自发性脑出血(ICH)的预后至关重要。肌肉减少症是否可预测ICH的功能结局尚未得到最终明确。确定颞肌厚度(TMT)可能有助于评估肌肉减少症。在小脑缺血和创伤性脑损伤中,已显示TMT与结局(改良Rankin量表[mRS])相关。 方法:本项对488例连续性ICH患者的回顾性研究旨在调查通过TMT评估的肌肉减少症与mRS之间的关联。除生物特征数据外,还记录了ICH亚型和严重程度[改良ICH评分(mICH)]、并发症的发生情况以及出院时和90天后的mRS。使用头部成像(计算机断层扫描[cCT]、磁共振成像[cMRT])将TMT作为替代标志物评估的肌肉减少症对mRS的影响通过有序回归分析进行分析。使用标准阈值将患者分为肌肉减少症患者和非肌肉减少症患者。 结果:最终,对322例患者进行了分析[年龄中位数(四分位间距):77(66 - 83)岁;57.5%为男性]。与非肌肉减少症患者相比,肌肉减少症患者年龄更大(<0.001)、体重指数更低(=0.025)且mICH评分更高(<0.001)。出院时,肌肉减少症患者和非肌肉减少症患者的mRS评分总体分布无显著差异(未调整的共同比值比:1.28;95%置信区间:0.85 - 1.92;=0.236),但在90天时非肌肉减少症组优于肌肉减少症组(未调整的共同比值比:1.41;95%置信区间:1.07 - 2.12;=0.049)。多变量有序回归对候选协变量进行统计调整后,结果不成立。 讨论:总之,通过TMT评估的肌肉减少症在ICH中的预后价值似乎有限。
Acta Neurochir (Wien). 2025-5-29
Mult Scler Relat Disord. 2022-2
Semin Neurol. 2024-6
J Clin Med. 2023-12-11
Front Neurol. 2023-9-26
Clin Neurol Neurosurg. 2023-10
Nat Rev Dis Primers. 2023-3-16
J Clin Med. 2022-10-31
Medicine (Baltimore). 2022-8-26