Study of trends in anthropometric nutritional indices and the impact of adiposity among patients of subarachnoid hemorrhage
Study of trends in anthropometric nutritional indices and the impact of adiposity among patients of subarachnoid hemorrhage
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DOI：
10.4103/0028-3886.162026
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发表时间：
2015-07-01
期刊：
影响因子：
2.7
通讯作者：
Gupta, Sunil K.
中科院分区：
文献类型：
--
作者：
Dhandapani, Sivashanmugam;Kapoor, Ankur;Gupta, Sunil K.
背景：营养状况和肥胖在蛛网膜下腔出血（SAH）中的研究还没有达到显著的程度。本研究的目的是确定人体测量指标的趋势，并评估其对SAH.Methods患者的影响：我们前瞻性地研究了56例SAH患者的三头肌皮褶厚度（TSF），中臂围（MAC），中臂肌围（MAMC）和其他因素，以及它们与临床血管痉挛和死亡率的关系。中位MAC从入院时的29.3 cm（四分位距[IQR] 28-31 cm）显著降低至1周时的27 cm（IQR 26-29 cm）（P < 0.001）。中位TSF从入院时的34 mm（IQR 30-40 mm）降至1周时的30 mm（IQR 25-35 mm）（P < 0.001）。MAMC值在一周内未显示出显著变化。发生临床血管痉挛的患者的中位入院TSF为40 mm（IQR 35-45 mm），显著高于未发生血管痉挛的患者的中位入院TSF 35 mm（IQR 30-40 mm）（P = 0.03）。MAMC值在血管痉挛方面没有显著差异。与3个月时存活的患者1周时中位MAMC值的下降幅度（2.6% [IQR 2.1-6.6%]）相比，3个月时死亡的患者1周时中位MAMC值的下降幅度显著更大（7.7% [IQR 5.2-11.5%]）[P = 0.03]。然而，TSF值的下降在死亡率方面没有显著差异。在多变量分析中，只有入院时TSF、Hunt和Hess分级和Fisher分级与血管痉挛有显著相关性。这种关联是独立的其他预后因素和each other.Conclusion：过度肥胖的患者，测量TSF值增加，是显着相关的临床血管痉挛独立于其他预后因素，而下降MAMC，表明体蛋白catenosine，有一定的影响死亡率。
Background: Nutritional status and adiposity have not been studied to a significant extent in subarachnoid hemorrhage (SAH). The aim of this study was to determine the trends in anthropometric indices and assess their impact on patients with SAH.Methods: We prospectively studied in 56 patients with SAH, the triceps skinfold thickness (TSF), mid-arm circumference (MAC), mid-arm muscle circumference (MAMC), and other factors, and their relationship to clinical vasospasm and mortality.Results: The median MAC decreased significantly from 29.3 cm (interquartile range [IQR] 28-31 cm) at admission to 27 cm (IQR 26-29 cm) at 1-week (P < 0.001). The median TSF decreased significantly from 34 mm (IQR 30-40 mm) at admission to 30 mm (IQR 25-35 mm) at 1-week (P < 0.001). MAMC values did not show a significant change over a week. The patients who developed clinical vasospasm had significantly higher median admission TSF of 40 mm (IQR 35-45 mm), compared to the median admission TSF of 35 mm (IQR 30-40 mm) among those who did not develop vasospasm (P = 0.03). MAMC values did not differ significantly in relation to vasospasm. Patients who expired by 3 months had significantly greater fall in median MAMC values at 1-week (7.7% [IQR 5.2-11.5%]), compared to the fall in median MAMC values at 1-week among those who were alive at 3 months (2.6% [IQR 2.1-6.6%]) [P = 0.03]. However, the fall in TSF values did not differ significantly in relation to mortality. In multivariate analysis, only the admission TSF, Hunt and Hess and Fisher grades had a significant association with vasospasm. This association was independent of other prognostic factors and of each other.Conclusion: Excessive adiposity of patients, measured as an increased TSF value, is significantly associated with clinical vasospasm independent of other prognostic factors, while fall in MAMC, indicating somatic protein catabolism, has some impact on mortality.