The incidence of sarcopenia among hospitalized older patients: results from the Glisten study
The incidence of sarcopenia among hospitalized older patients: results from the Glisten study
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DOI：
10.1002/jcsm.12224
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发表时间：
2017-12-01
影响因子：
8.9
通讯作者：
Landi, Francesco
中科院分区：
文献类型：
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作者：
Martone, Anna Maria;Bianchi, Lara;Landi, Francesco
背景：在疾病和康复期间瘦体重的重要性的新证据不断涌现。在如此强烈的应激期内保持瘦体重会影响患者和治疗结果。然而，关于老年人在住院期间发生石棺减少的数据很少。这项研究的目的是评估住院的老年患者中石棺减少的发展情况。方法我们使用了由Gruppo Lavoro Italiano SarCopenia-Trattamento e Nutrizione(GLISTEN)在意大利大学医院的12个急性护理病房(内科和老年科)进行的多中心意大利研究的394名参与者的数据。这项研究旨在确定入院时石棺减少的患病率以及住院期间肌肉质量和力量的变化。骨质疏松症的定义是骨骼质量指数(kg/m(2))低、握力低或步行速度慢[欧洲老年人肉质疏松症工作组(EWGSOP)标准]。结果394例患者(其中女性211例，占样本的53%)的平均年龄为79.6+/-6.4岁。在入院时没有石棺减少的患者中，14.7%的研究样本在出院时符合EWGSOP的石棺减少诊断标准。住院期间骨质疏松症的发生率与卧床天数显著相关，但与住院总时间无关。特别是，出现骨质疏松症的患者平均卧床时间为5.1天，而出院时无骨质疏松症的患者平均卧床时间为3.2天(P=0.02)。骨质疏松症患者的体重指数显著低于非骨质疏松症患者(分别为25.0±3.8 kg/m(2)vs.27.6±4.9 kg/m(2)，P<；0.001)。同样，在住院期间发生骨质疏松症的患者入院时的骨骼质量指数显著降低。结论住院期间发生的骨质疏松症相对常见，并与营养状况和卧床休息天数有关。
Background New evidence is emerging on the importance of lean body mass during periods of illness and recovery. The preservation of lean body mass during such periods of intense stress impacts both patient and treatment outcomes. However, data concerning the incidence of sarcopenia among older people during hospitalization are scarce. The objective of this study was to evaluate the development of sarcopenia in a sample of hospitalized older subjects.Methods We used data of 394 participants from the multicentre Italian Study conducted by the Gruppo Lavoro Italiano Sarcopenia-Trattamento e Nutrizione (GLISTEN) in 12 Acute Care Wards (Internal Medicine and Geriatrics) of University Hospitals across Italy. This study was designed to determine the prevalence of sarcopenia at hospital admission and the change in muscle mass and strength during hospitalization. Sarcopenia was defined as low skeletal mass index (kg/m(2)) along with either low handgrip strength or slow walking speed [European Working Groups on Sarcopenia in Older People (EWGSOP) criteria]. Estimation of skeletal muscle mass was performed by bioelectrical impedance analysis (BIA).Results The mean age of the 394 enrolled patients (including 211 females who accounted for 53% of the sample) was 79.6 +/- 6.4 years. Among those without sarcopenia at hospital admission, 14.7% of the study sample met the EWGSOP sarcopenia diagnostic criteria at discharge. The incidence of sarcopenia during hospitalization was significantly associated with the number of days spent in bed but was not correlated with the total length of hospital stay. In particular, patients who developed sarcopenia spent an average of 5.1 days in bed compared with 3.2 days for those with no sarcopenia at discharge (P = 0.02). Patients with sarcopenia showed a significantly lower body mass index compared with non-sarcopenic peers (25.0 +/- 3.8 kg/m(2) vs. 27.6 +/- 4.9 kg/m(2), respectively; P < 0.001). Similarly, the skeletal mass index at admission was significantly lower among patients who developed sarcopenia during hospital stay.Conclusions Incident sarcopenia during hospital stay is relatively common and is associated with nutritional status and the number of days of bed rest.