接受康复治疗的患者基线骨骼肌质量指数与不良事件和康复效果的关系

IF 1.9 Q2 REHABILITATION

Archives of rehabilitation research and clinical translation Pub Date : 2024-03-01 DOI:10.1016/j.arrct.2023.100314

Hideki Arai MD , Syuya Okada PT , Tatsuyuki Fukuoka SLP, PhD , Masafumi Nozoe PT, PhD , Kuniyasu Kamiya PT, PhD , Satoru Matsumoto MD , Takeshi Morimoto MD, PhD MPH

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引用次数: 0

摘要

目的评估基线骨骼肌质量指数（SMI）与康复患者的不良事件和康复结果之间的关系。参与者409名患者（平均年龄79岁；男性167人[41%]）因神经系统疾病、肌肉骨骼疾病或医院相关的衰竭而接受康复治疗。根据亚洲肌少症工作组对肌少症的定义，患者被分为两组：低SMI（男性为7.0 kg/m2，女性为5.7 kg/m2）和高SMI（男性为≥7.0 kg/m2，女性为≥5.7 kg/m2）。次要结果为康复结果，包括运动功能FIM（FIM-M）和认知功能FIM（FIM-C）的效率得分（功能独立性测量[FIM]得分的变化除以住院时间）。相对于高 SMI 组，低 SMI 组发生不良事件的调整后危险比（95% 置信区间）为 2.79（1.06-7.34）。两组的 FIM-M 效率评分[平均值（± SD），低 SMI 组：0.4 (0.58) vs 高 SMI 组：0.47 (0.54)，P=.3]和 FIM-C 效率评分[平均值（± SD），0.05 (0.14) vs 0.06 (0.2)，P=.4]无明显差异。多元线性回归模型未显示低SMI组与FIM-M效率或FIM-C效率评分之间存在显著关联（分别为β=0.064，P=.3；β=-0.05，P=.4）。

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Association of Baseline Skeletal Muscle Mass Index With Adverse Events and Rehabilitation Outcomes in Patients Admitted for Rehabilitation

Objective

To assess the associations of baseline skeletal muscle mass index (SMI) with adverse events and rehabilitation outcomes in patients admitted for rehabilitation.

Design

A retrospective cohort study.

Participants

The subjects were 409 patients (mean age, 79 years; men, 167 [41%]) undergoing rehabilitation because of neurologic disease, musculoskeletal disorders, or hospital-associated deconditioning. Patients were divided into 2 groups according to the definition of sarcopenia by the Asian Working Group for Sarcopenia: those with low SMI (<7.0 kg/m² in men and <5.7 kg/m² in women) and those with high SMI (≥7.0 kg/m² in men and ≥5.7 kg/m² in women).

Interventions

Not applicable.

Main Outcome Measures

The primary outcomes were adverse events including death and acute illness requiring transfer to other hospitals for specialized treatments. The secondary outcomes were rehabilitation outcomes including the efficiency scores (changes in functional independence measure [FIM] score divided by length of stay) of FIM for motor function (FIM-M) and FIM for cognitive function (FIM-C).

Results

Of the 409 patients, 299 (73%) had a low SMI. The adjusted hazard ratio (95% confidence interval) of the low SMI group relative to the high SMI group for adverse events was 2.79 (1.06-7.34). There were no significant differences between the 2 groups in FIM-M efficiency scores [mean ± SD, low SMI group: 0.4 (0.58) vs high SMI group: 0.47 (0.54), P=.3] and FIM-C efficiency scores [mean ± SD, 0.05 (0.14) vs 0.06 (0.2), P=.4]. Multiple linear regression models did not show significant associations between the low SMI group and FIM-M efficiency or FIM-C efficiency scores (β=0.064, P=.3; β=−0.05, P=.4, respectively).