Low muscle mass in the internal medicine ward: Prevalence and survival implications

IF 4.7 3区医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL

Archives of Medical Research Pub Date : 2024-10-15 DOI:10.1016/j.arcmed.2024.103103

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引用次数: 0

Abstract

Background

Low muscle mass is common in hospitalized patients. It is associated with adverse clinical outcomes. Reported prevalence varies widely due to non-universally accepted diagnostic criteria and the heterogeneity of the populations studied. Non-surgical ill patients are underrepresented in the literature.

Aims

To estimate the prevalence of low muscle index and its impact on survival in patients admitted to an internal medicine unit.

Methods

We prospectively enrolled patients with abdominal CT scans on admission to the Internal Medicine ward. We assessed muscle mass index (L3MI) at the level of the L3 lumbar vertebra. The primary outcome was to estimate the prevalence of low muscle mass on admission. Secondary outcomes were to determine the relationship of low L3MI with hospital mortality, length of stay, nosocomial infections, and hospital readmission.

Results

One hundred and seven patients were included. The prevalence of low L3MI was 46.7%. An L3MI of 46.3 cm²/m² in men and 40.9 cm²/m² in women predicted death at one year with a sensitivity of 66% and a specificity of 78% (AUC = 0.62 [95% CI 0.38–0.86]) and 69 and 66% (AUC of 0.63 [95% IC 0.47–0.78]), respectively. In-hospital mortality, death at 60, 90, and 360 d, and hospital readmission were significantly higher in patients with low L3MI.

Conclusion

Almost half of the patients admitted to an internal medicine ward have low muscle mass index. The cutoff point of 40.9 cm²/m² in females and 46.3 cm²/m² in males predicts relevant clinical variables. We established the better L3MI cutoff value to predict 12-month mortality.

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内科病房的低肌肉质量：发病率和对生存的影响

背景住院病人普遍存在肌肉质量低的问题。它与不良的临床结果有关。由于诊断标准未被普遍接受，且所研究的人群具有异质性，因此报告的发病率差异很大。目的估计内科病房住院病人低肌肉指数的患病率及其对生存的影响。方法我们前瞻性地招募了内科病房住院时接受腹部 CT 扫描的病人。我们评估了腰椎L3水平的肌肉质量指数（L3MI）。主要结果是估计入院时低肌肉质量的发生率。次要结果是确定低 L3MI 与住院死亡率、住院时间、院内感染和再次入院的关系。低 L3MI 患病率为 46.7%。男性 L3MI 为 46.3 cm2/m2，女性为 40.9 cm2/m2，预测一年后死亡的敏感性为 66%，特异性为 78%（AUC = 0.62 [95% CI 0.38-0.86]）；预测一年后死亡的敏感性为 69%，特异性为 66%（AUC 为 0.63 [95% IC 0.47-0.78]）。低 L3MI 患者的院内死亡率、60 d、90 d 和 360 d 死亡率以及再入院率均显著较高。女性 40.9 cm2/m2 和男性 46.3 cm2/m2 的临界点可预测相关的临床变量。我们确定了预测 12 个月死亡率的较佳 L3MI 临界值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of Medical Research 医学-医学：研究与实验

CiteScore

12.50

自引率

0.00%

发文量

审稿时长

28 days

期刊介绍： Archives of Medical Research serves as a platform for publishing original peer-reviewed medical research, aiming to bridge gaps created by medical specialization. The journal covers three main categories - biomedical, clinical, and epidemiological contributions, along with review articles and preliminary communications. With an international scope, it presents the study of diseases from diverse perspectives, offering the medical community original investigations ranging from molecular biology to clinical epidemiology in a single publication.