Muscle changes on muscle ultrasound and adverse outcomes in acute hospitalized older adults
Muscle changes on muscle ultrasound and adverse outcomes in acute hospitalized older adults
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肌肉超声的肌肉变化和急性住院老年人的不良后果
DOI：
10.1016/j.nut.2022.111698
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发表时间：
2022
期刊：
影响因子：
4.4
通讯作者：
Kuzuya Masafumi
中科院分区：
文献类型：
--
作者：
Nagae Masaaki;Umegaki Hiroyuki;Yoshiko Akito;Fujita Kosuke;Komiya Hitoshi;Watanabe Kazuhisa;Yamada Yosuke;Sakai Tomomichi;Kuzuya Masafumi
目的肌肉超声是一种非侵入性技术，可以识别肌肉组织的数量和质量。它不仅用于肌肉减少症的诊断，而且在临床实践中用于预测预后。现在越来越多的人认识到，在急性住院期间检测到的肌肉变化表明急性肌肉减少症会导致更糟糕的结果。然而，据我们所知，很少有研究对住院的老年人进行调查。本研究的目的是确定肌肉超声的肌肉变化是否可以预测急性住院老年人的不良预后。方法本前瞻性、观察性队列研究纳入145名急性住院老年人。入院时和7 d后分别评估双侧大腿前壁厚度（BATT）、回声强度（EI）和股四头肌校正EI。主要结局是死亡率，次要结局是出院后3个月的医院相关并发症和日常生活活动（ADLs）下降。结果入院后7 d BATT、EI和校正EI的变化分别为0.2%、0.0%和0.2%。死亡率、医院相关并发症和ADL下降率分别为8.7%、52.8%和43%。多变量logistic回归分析显示，入院时BATT值与死亡率倾向相关。BATT、EI和收集EI的变化与不良结局无关。结论肌肉超声显示的急性肌肉变化与急性住院老年人的死亡率、ADL下降或医院相关并发症无关。需要在不同的环境下进行更多的研究来阐明肌肉超声在临床实践中的价值。
ObjectivesMuscle ultrasound is a non-invasive technique that enables identification of the quantity and quality of muscle tissue. It has been used not only for diagnosis of sarcopenia but also for prediction of outcomes in clinical practice. There is now increasing awareness that muscle changes detected during acute hospitalization indicate acute sarcopenia leading to worse outcomes. However, to our knowledge, few studies have investigated this in hospitalized older adults. The aim of this study was to determine whether muscle changes on muscle ultrasound can predict poor outcomes in acute hospitalized older adults.MethodsThis prospective, observational cohort study involved 145 acute hospitalized older adults. Bilateral anterior thigh thickness (BATT), echo intensity (EI), and corrected EI of the quadriceps were assessed on admission and 7 d later. The primary outcome was mortality, and the secondary outcomes were hospital-associated complications and decline in activities of daily living (ADLs) at 3 mo after discharge.ResultsChanges in BATT, EI, and corrected EI at 7 d after admission were found in 0.2%, 0.0%, and 0.2% of cases, respectively. The respective rates for mortality, hospital-associated complications, and ADL decline were 8.7%, 52.8%, and 43%, respectively. Multivariable logistic regression analysis showed that the BATT value at admission tended to be associated with mortality. Changes in BATT, EI, and collected EI were not associated with adverse outcomes.ConclusionsAcute muscle changes on muscle ultrasound were not associated with mortality, ADL decline, or hospital-associated complications in acute hospitalized older adults. More research in various settings is needed to clarify the value of muscle ultrasound in clinical practice.