Dao Thang, Soh Cheng Hwee, Reijnierse Esmee M, Guan Lihuan, Maier Andrea B
Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia,
Department of Medicine, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia,
Gerontology. 2025;71(3):203-213. doi: 10.1159/000543620. Epub 2025 Jan 20.
Sarcopenia is highly prevalent in older inpatients. However, it is unclear if sarcopenia is documented routinely in geriatric rehabilitation. This study aimed to investigate the documentation of sarcopenia in medical records among geriatric rehabilitation patients.
Geriatric rehabilitation inpatients in a statewide hospital in VIC, Australia, were included. Patient characteristics, muscle measurements, and medical records at admission and discharge were collected. Sarcopenia was defined using the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). Patient characteristics were compared between the groups with documented and non-documented sarcopenia using the Wilcoxon rank-sum or chi-square test.
Of 1,890 geriatric rehabilitation inpatients (aged 83.4 [interquartile range: 77.6-88.4] years, 56.3% female), muscle measurements were available in 1,334 patients at admission. The prevalence of sarcopenia was 20.8% (n = 278). Sarcopenia was documented in 68 out of 1,890 patients; 23 of them did not have muscle mass or muscle strength measured. Forty-five patients with muscle measurements available were documented with sarcopenia either at discharge from acute admissions (n = 9), on rehabilitation admission (n = 25), or at discharge from rehabilitation (n = 26). Of these 45 patients, 8 patients had sarcopenia following the EWGSOP2 criteria. Compared with patients without sarcopenia documented, patients documented with sarcopenia had lower body mass index and sarcopenia screening (Strength, Assistance in Walking, Rise from a Chair, Climb Stairs, Falls History [SARC-F]) scores and higher Clinical Frailty Scale (CFS) scores and were likely to come from nursing homes.
Documentation of sarcopenia was lower than the prevalence of sarcopenia in geriatric rehabilitation inpatients. Sarcopenia was incorrectly documented as data on muscle measurement were missing to define sarcopenia. Practitioners likely used clinical impressions to document sarcopenia, rather than the formal diagnostic criteria.
肌肉减少症在老年住院患者中非常普遍。然而,目前尚不清楚在老年康复中是否常规记录了肌肉减少症。本研究旨在调查老年康复患者病历中肌肉减少症的记录情况。
纳入澳大利亚维多利亚州一家全州性医院的老年康复住院患者。收集患者的特征、肌肉测量数据以及入院和出院时的病历。采用欧洲老年人肌肉减少症工作组2(EWGSOP2)的标准定义肌肉减少症。使用Wilcoxon秩和检验或卡方检验比较有记录和无记录肌肉减少症的两组患者的特征。
在1890例老年康复住院患者(年龄83.4岁[四分位间距:77.6 - 88.4岁],女性占56.3%)中,1334例患者在入院时有肌肉测量数据。肌肉减少症的患病率为20.8%(n = 278)。1890例患者中有68例记录了肌肉减少症;其中23例未测量肌肉量或肌肉力量。45例有肌肉测量数据的患者在急性入院出院时(n = 9)、康复入院时(n = 25)或康复出院时(n = 26)被记录为患有肌肉减少症。在这45例患者中,8例符合EWGSOP2标准的肌肉减少症。与未记录肌肉减少症的患者相比,记录有肌肉减少症的患者体重指数和肌肉减少症筛查(力量、行走辅助、从椅子上起身、爬楼梯、跌倒史[SARC - F])得分较低,临床衰弱量表(CFS)得分较高,且可能来自养老院。
老年康复住院患者中肌肉减少症的记录率低于其患病率。由于缺少定义肌肉减少症的肌肉测量数据,肌肉减少症被错误记录。从业者可能使用临床印象而非正式诊断标准来记录肌肉减少症。