Luque-Linero Paula, Frutos-Reoyo Emilio-Javier, Castilla-Guerra Luis, Rico-Corral Miguel-Ángel, Salamanca-Bautista Prado, Garrachón-Vallo Fernando
Department of Internal Medicine, Hospital Universitario Virgen Macarena, 41009 Seville, Spain.
Department of Rehabilitation and Physical Medicine, Hospital Universitario del Río Hortega, 47012 Valladolid, Spain.
J Clin Med. 2025 Jul 31;14(15):5388. doi: 10.3390/jcm14155388.
Sarcopenia has emerged as a key prognostic factor in patients with chronic limb-threatening ischemia (CLTI), with potential implications for clinical decision-making. This study aimed to assess the association between sarcopenia and clinical outcomes, mortality, and amputation, using simple, accessible screening tools in a CLTI population. In this prospective, single-center study conducted between December 2023 and December 2024, 170 patients with CTLI were enrolled. Sarcopenia screening was performed using the SARC-F (strength, assistance in walking, rising from a chair, climbing stairs, falls) questionnaires, handgrip strength measurement, and calf circumference, adjusted for body mass index and sex. The primary outcome was 6-month all-cause mortality and/or major amputation. Sarcopenia was identified in 77 patients (45.3%). Compared to non-sarcopenic individuals, sarcopenic patients were significantly older. They exhibited greater functional impairment, as well as poorer nutritional and muscle status. They also had significantly higher in-hospital mortality (16.9% vs. 3.2%, = 0.002), 30-day mortality (24.7% vs. 4.3%, = 0.001), and 6-month mortality (50.6% vs. 15.1%, = 0.001). Sarcopenia was significantly associated with the primary outcome in univariate analysis (HR: 2.05; 95% CI: 1.31-3.20; = 0.002) and remained an independent predictor after multivariate adjustment (HR: 1.95; 95% CI: 1.01-3.79; = 0.048). Sarcopenia is a strong, independent predictor of poor outcome in patients with CLTI. Its detection through simple tools offers an easy and cost-effective strategy to improve risk stratification and guide early intervention through exercise-based therapy.
肌肉减少症已成为慢性肢体威胁性缺血（CLTI）患者的关键预后因素，对临床决策具有潜在影响。本研究旨在使用简单、易获取的筛查工具，评估CLTI人群中肌肉减少症与临床结局、死亡率和截肢之间的关联。在这项于2023年12月至2024年12月进行的前瞻性单中心研究中，纳入了170例CTLI患者。使用SARC-F（力量、行走辅助、从椅子上起身、爬楼梯、跌倒）问卷、握力测量和小腿围度进行肌肉减少症筛查，并根据体重指数和性别进行调整。主要结局是6个月全因死亡率和/或大截肢。77例患者（45.3%）被诊断为肌肉减少症。与非肌肉减少症患者相比，肌肉减少症患者年龄显著更大。他们表现出更大的功能障碍，以及更差的营养和肌肉状态。他们的院内死亡率（16.9%对3.2%，P = 0.002）、30天死亡率（24.7%对4.3%，P = 0.001）和6个月死亡率（50.6%对15.1%，P = 0.001）也显著更高。在单因素分析中，肌肉减少症与主要结局显著相关（HR：2.05；95%CI：1.31 - 3.20；P = 0.002），多因素调整后仍为独立预测因素（HR：1.95；95%CI：1.01 - 3.79；P = 0.048）。肌肉减少症是CLTI患者预后不良的有力独立预测因素。通过简单工具检测肌肉减少症，为改善风险分层和通过运动疗法指导早期干预提供了一种简便且经济有效的策略。
