住院患者肌肉减少症的横断面研究

Clin Nutr. 2015 Dec;34(6):1239-44.

Sarcopenia among hospitalized patients - A cross-sectional study.

Sousa AS, Guerra RS, Fonseca I, Pichel F, Amaral TF.

Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal.

Departamento de Bioquímica da Faculdade de Medicina, Universidade do Porto, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal.

UISPA-IDMEC, Faculdade de Engenharia, Universidade do Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal.

Centro Hospitalar do Porto, Largo Prof. Abel Salazar, 4099-001 Porto, Portugal.

BACKGROUND & AIMS: Data on the prevalence of sarcopenia among hospitalized older patients are scarce and there is no available information on the burden of sarcopenia among younger patients. The present study aims to increase the knowledge about the frequency of sarcopenia among hospitalized patients and to evaluate the influence of different diagnostic criteria in these estimates.

METHODS: A cross-sectional study was conducted in hospitalized adult patients. Sarcopenia was defined, according to the European Working Group on Sarcopenia in Older People (EWGSOP), as the presence of both low muscle mass, assessed by Bioelectrical Impedance Analysis (BIA), adjusted for height, and low muscle function (hand grip strength). Two other criteria were applied, also using hand grip strength for evaluating muscle function, one that also assessed muscle mass by BIA, but adjusted for weight, and another which estimated muscle mass based on mid-arm muscle circumference. Nutritional status was evaluated by Patient-Generated Subjective Global Assessment. The degree of agreement between the different diagnostic criteria was assessed using kappa. Multivariable logistic regression models were used in order to identify factors associated with sarcopenia.

RESULTS: 608 hospitalized adult patients aged ≥18 years composed the study sample. According to EWGSOP's criteria, 25.3% patients were sarcopenic. However, depending on age and on the applied criteria, frequency of sarcopenia varied from 5% to 41.1% for men and from 4.9% to 38.3% for women. There was 95.7% (k = 0.89) agreement between criteria that estimated muscle mass by BIA. According to EWGSOP criteria approximately 20% of the non-undernourished patients were sarcopenic. Furthermore, 29.5% of overweight and 18.7% of obese patients were sarcopenic. Factors associated with sarcopenia were male gender, age ≥65 years, moderate or severe dependence, being undernourished and admitted to a medical ward.

CONCLUSIONS: Sarcopenia is frequent among hospitalized patients and varies widely depending on the applied diagnostic criteria. Sarcopenia was identified in a considerable proportion of patients aged under ≥65 years and in non-undernourished, namely among overweight and obese.

KEYWORDS: Body composition; Hand grip strength; Hospital; Sarcopenia; Undernutrition

PMID: 25577017

DOI: 10.1016/j.clnu.2014.12.015