Yu Ji Hoon, Lee Hyun Tak, Jang Seok Ki, Lee Ah Young, Seo Jun-Young
Department of Gastroenterology, Bundang Jesaeng General Hospital, Seongnam, Korea.
Department of Radiology, Bundang Jesaeng General Hospital, Seongnam, Korea.
Clin Endosc. 2025 May;58(3):425-437. doi: 10.5946/ce.2024.209. Epub 2025 Jan 21.
BACKGROUND/AIMS: Peptic ulcer bleeding (PUB) is a major cause of nonvariceal gastrointestinal bleeding. As the older population increases, the prevalence of sarcopenia is also growing. Although sarcopenia influences the prognosis of various diseases, its association with clinical outcomes of PUB remains unknown. Therefore, this study aimed to explore this correlation.
We retrospectively analyzed 2,050 patients who underwent esophagogastroduodenoscopy for suspected gastrointestinal bleeding between January 2014 and December 2021. Patients who underwent computed tomography scans were included for sarcopenia evaluation based on the psoas muscle index, defined as the total psoas area normalized by the square of the height of the patient. Sarcopenia was defined using specific cutoffs: ≤7.3 cm2/m2 and ≤5.1 cm2/m2 for men and women, respectively. The primary outcome measured was the 30-day mortality rate.
Out of 358 patients, 149 were diagnosed with sarcopenia. The 30-day mortality rate was significantly higher in patients with sarcopenia than in those without. Multivariate regression analysis revealed significant associations between sarcopenia, a high age, blood tests, and comorbidity score, and administration of inotropic agents with 30-day mortality.
Our study showed that the presence of sarcopenia, elevated comorbidity scores, and use of inotropes were associated with higher 30-day mortality rates. Considering that sarcopenia may influence the clinical outcomes in patients with PUB, it is crucial to manage patients with sarcopenia with particular care.
背景/目的：消化性溃疡出血（PUB）是非静脉曲张性胃肠道出血的主要原因。随着老年人口的增加，肌肉减少症的患病率也在上升。尽管肌肉减少症会影响各种疾病的预后，但其与PUB临床结局的关联仍不清楚。因此，本研究旨在探讨这种相关性。
我们回顾性分析了2014年1月至2021年12月期间因疑似胃肠道出血接受食管胃十二指肠镜检查的2050例患者。接受计算机断层扫描的患者被纳入肌肉减少症评估，评估基于腰大肌指数，即患者腰大肌总面积除以身高的平方。肌肉减少症的定义采用特定的临界值：男性≤7.3cm²/m²，女性≤5.1cm²/m²。测量的主要结局是30天死亡率。
在358例患者中，149例被诊断为肌肉减少症。肌肉减少症患者的30天死亡率显著高于无肌肉减少症的患者。多因素回归分析显示，肌肉减少症、高龄、血液检查、合并症评分以及使用血管活性药物与30天死亡率之间存在显著关联。
我们的研究表明，肌肉减少症、合并症评分升高以及使用血管活性药物与30天死亡率较高有关。鉴于肌肉减少症可能影响PUB患者的临床结局，对肌肉减少症患者进行特别护理至关重要。
