Mondo Laure, Louis Chloé, Saboul Hinda, Beernaert Laetitia, De Breucker Sandra
Geriatric Department, Hôpital Universitaire de Bruxelles (HUB), Erasme Campus, 808 Route de Lennik, 1070 Brussels, Belgium.
Geriatric Department, Hôpitaux Universitaires de Genève (HUG), Rue Gabrielle Perret-Gentil 4, 1205 Geneva, Switzerland.
J Clin Med. 2025 Aug 1;14(15):5424. doi: 10.3390/jcm14155424.
: Sarcopenia is a systemic condition linked to increased morbidity and mortality in older adults. Point-of-Care Ultrasound (POCUS) offers a rapid, bedside method to assess muscle mass. This study evaluates the diagnostic accuracy of POCUS compared to Dual-energy X-ray Absorptiometry (DXA), the gold standard method, and explores its prognostic value in old patients undergoing surgery for hip fractures. : In this prospective, single-center study, 126 patients aged ≥ 70 years and hospitalized with hip fractures were included. Sarcopenia was defined according to the revised 2018 EWGSOP2 criteria. Muscle mass was assessed by the Appendicular Skeletal Muscle Mass Index (ASMI) using DXA and by the thickness of the rectus femoris (RF) muscle using POCUS. : Of the 126 included patients, 52 had both DXA and POCUS assessments, and 43% of them met the diagnostic criteria for sarcopenia or severe sarcopenia. RF muscle thickness measured by POCUS was significantly associated with ASMI (R = 0.30; < 0.001). POCUS showed a fair diagnostic accuracy in women (AUC 0.652) and an excellent accuracy in men (AUC 0.905). Optimal diagnostic thresholds according to Youden's index were 5.7 mm for women and 9.3 mm for men. Neither RF thickness, ASMI, nor sarcopenia status predicted mortality or major postoperative complications. : POCUS is a promising, accessible tool for diagnosing sarcopenia in old adults with hip fractures. Nonetheless, its prognostic utility remains uncertain and should be further evaluated in long-term studies.
肌肉减少症是一种与老年人发病率和死亡率增加相关的全身性疾病。床旁超声（POCUS）提供了一种快速的床旁方法来评估肌肉质量。本研究评估了POCUS与双能X线吸收法（DXA，金标准方法）相比的诊断准确性，并探讨了其在接受髋部骨折手术的老年患者中的预后价值。：在这项前瞻性单中心研究中，纳入了126例年龄≥70岁且因髋部骨折住院的患者。肌肉减少症根据2018年修订的EWGSOP2标准进行定义。使用DXA通过四肢骨骼肌质量指数（ASMI）评估肌肉质量，使用POCUS通过股直肌（RF）厚度评估肌肉质量。：在纳入的126例患者中，52例同时进行了DXA和POCUS评估，其中43%符合肌肉减少症或严重肌肉减少症的诊断标准。POCUS测量的RF肌肉厚度与ASMI显著相关（R = 0.30；<0.001）。POCUS在女性中显示出尚可的诊断准确性（AUC 0.652），在男性中显示出优异的准确性（AUC 0.905）。根据约登指数，女性的最佳诊断阈值为5.7 mm，男性为9.3 mm。RF厚度、ASMI或肌肉减少症状态均不能预测死亡率或术后主要并发症。：POCUS是一种有前景的、可及的工具，用于诊断髋部骨折老年患者的肌肉减少症。尽管如此，其预后效用仍不确定，应在长期研究中进一步评估。
