Impact of trunk and appendicular skeletal muscle mass on improving swallowing function in acute stroke patients
Impact of trunk and appendicular skeletal muscle mass on improving swallowing function in acute stroke patients
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躯干和四肢骨骼肌质量对改善急性脑卒中患者吞咽功能的影响
DOI：
10.1016/j.jstrokecerebrovasdis.2022.106636
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发表时间：
2022
影响因子：
2.5
通讯作者：
Matsumoto Ayaka
中科院分区：
文献类型：
--
作者：
Sato Yoichi;Yoshimura Yoshihiro;Abe Takafumi;Nagano Fumihiko;Matsumoto Ayaka
目的探讨干尾骨骼肌质量对急性脑卒中患者出院时吞咽功能的影响。材料和方法本回顾性队列研究纳入急性脑卒中住院患者。入院5天内采用生物电阻抗法测定骨骼肌质量。主要终点是急性出院时的吞咽功能，使用功能性口服摄入量表（FOIS）进行评估。次要结局是功能性独立进食量表（FIM-eating）评分和住院时间。结果231例患者（年龄72.2岁，男性151例）的数据被纳入分析。中位躯干肌肉质量指数（TMI）在男性和女性中分别为8.2和6.8 kg/m2。男性和女性的中位阑尾骨骼肌质量指数（ASMI）分别为7.7和5.7 kg/m2。高TMI组在出院时各性别的fim进食评分均较高（p< 0.001）。高ASMI组男性和女性的FOIS （p= 0.039和0.048）和FIM-eating评分（p= 0.046和0.047）分别较高。在多变量分析中，TMI与fim进食评分独立相关（β= 0.330,p< 0.001）；ASMI与FOIS （β= 0.229,p= 0.039）和FIM-eating评分（β= 0.111,p= 0.032）独立相关。结论骨骼肌量对吞咽功能和进食活动有部位特异性影响。这一发现可能有助于设计更个性化的康复方案。
ObjectivesTo investigate the effect of trunk and appendicular skeletal muscle mass on the swallowing function at discharge in acute stroke patients.Materials and methodsThis retrospective cohort study included patients hospitalized after acute strokes. Skeletal muscle mass was measured by bioelectrical impedance analysis within 5 days of admission. The primary outcome was swallowing function at acute hospital discharge, assessed using the Functional Oral Intake Scale (FOIS). Secondary outcomes were Functional Independence Measure-eating (FIM-eating) scores and length of hospital stay.ResultsData from 231 patients (age 72.2 years; 151 men) were included in the analysis. The median trunk muscle mass index (TMI) was 8.2 and 6.8 kg/m2in men and women, respectively. The median appendicular skeletal muscle mass index (ASMI) was 7.7 and 5.7 kg/m2in men and women, respectively. The high TMI group had higher FIM-eating scores at discharge in each sex (p< 0.001). The high ASMI group had higher FOIS (p= 0.039 and 0.048) and FIM-eating scores at discharge (p= 0.046 and 0.047) in men and women, respectively. On multivariate analysis, TMI was independently associated with FIM-eating scores (β= 0.330,p< 0.001); ASMI was independently associated with FOIS (β= 0.229,p= 0.039) and FIM-eating scores (β= 0.111,p= 0.032).ConclusionsSkeletal muscle mass had site-specific impacts on swallowing function and eating activities. This finding may contribute to the design of more individualized rehabilitation programs.