Sarcopenia predicts readmission and mortality in elderly patients in acute care wards: a prospective study.
Sarcopenia predicts readmission and mortality in elderly patients in acute care wards: a prospective study.
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DOI：
10.1002/jcsm.12163
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发表时间：
2017-04
期刊：
影响因子：
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通讯作者：
Dong B
中科院分区：
文献类型：
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作者：
Yang M;Hu X;Wang H;Zhang L;Hao Q;Dong B
本研究的目的是评估肌肉减少症的患病率，并调查急性护理病房老年住院患者人群中肌肉减少症与长期死亡率和再入院之间的相关性。我们在中国西部一家教学医院的急诊病房进行了一项前瞻性观察研究。根据先前验证的人体测量方程估计肌肉质量。用手持式测力计测量握力，通过4米步行试验测量身体表现。根据亚洲肌肉减少症工作组推荐的诊断算法定义肌肉减少症。在基线调查后的3年随访期内，通过电话访谈在12、24和36个月获得生存状态和再入院信息。纳入了288名受试者（平均年龄：81.1 ± 6.6岁）。49名参与者（17.0%）被确定为肌肉减少症。这种情况在男性和女性中相似（分别为16.9%和17.5%，P = 0.915）。在3年随访期间，49名男性（22.7%）和9名女性（16.4%）死亡（P = 0.307）。与非肌肉减少参与者相比，肌肉减少参与者的死亡率显著增加（分别为40.8%和17.1%，P < 0.001）。校正年龄、性别和其他混杂因素后，肌肉减少症是3年死亡率（校正风险比：2.49; 95%置信区间：1.25-4.95）和再入院（校正风险比：1.81; 95%置信区间：1.17-2.80）的独立预测因子。通过人体测量、步态速度和握力的组合评估的肌肉减少症对于预测急性监护病房老年患者的再入院和长期死亡率很有价值。
The aim of this study is to assess the prevalence of sarcopenia and investigate the associations between sarcopenia and long‐term mortality and readmission in a population of elderly inpatients in acute care wards. We conducted a prospective observational study in the acute care wards of a teaching hospital in western China. The muscle mass was estimated according to a previously validated anthropometric equation. Handgrip strength was measured with a handheld dynamometer, and physical performance was measured via a 4 m walking test. Sarcopenia was defined according to the recommended diagnostic algorithm of the Asia Working Group for Sarcopenia. The survival status and readmission information were obtained via telephone interviews at 12, 24, and 36 months during the 3 year follow‐up period following the baseline investigation. Two hundred and eighty‐eight participants (mean age: 81.1 ± 6.6 years) were included. Forty‐nine participants (17.0%) were identified as having sarcopenia. This condition was similar in men and women (16.9% vs. 17.5%, respectively, P = 0.915). During the 3 year follow‐up period, 49 men (22.7%) and 9 women (16.4%) died (P = 0.307). The mortality of sarcopenic participants was significantly increased compared with non‐sarcopenic participants (40.8% vs. 17.1%, respectively, P < 0.001). After adjusting for age, sex and other confounders, sarcopenia was an independent predictor of 3 year mortality (adjusted hazard ratio: 2.49; 95% confidential interval: 1.25–4.95) and readmission (adjusted hazard ratio: 1.81; 95% confidential interval: 1.17–2.80). Sarcopenia, which is evaluated by a combination of anthropometric measures, gait speed, and handgrip strength, is valuable to predict hospital readmission and long‐term mortality in elderly patients in acute care wards.