{"title":"ACC/AHA A、B、C期心力衰竭残疾患者肌肉减少症与医疗事件和住院康复结果的关系","authors":"Hideki Arai MD, PhD , Masafumi Nozoe PT, PhD , Kuniyasu Kamiya PT, PhD , Tatsuyuki Fukuoka SLP, PhD , Satoru Matsumoto MD","doi":"10.1016/j.arrct.2025.100483","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To assess the associations of sarcopenia with medical events and inpatient rehabilitation outcomes in American College of Cardiology (ACC)/American Heart Association (AHA) stage A, B, and C patients with heart failure (HF) and disabilities.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Setting</h3><div>Inpatient rehabilitation ward.</div></div><div><h3>Participants</h3><div>ACC/AHA stage A, B, and C patients with HF (N=293) with or without sarcopenia who had disabilities because of neurologic disorders, musculoskeletal disorders, or hospital-associated deconditioning.</div></div><div><h3>Interventions</h3><div>None.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcomes were medical events such as death and illness requiring interhospital transport for specialized medical care. The secondary outcomes were inpatient rehabilitation outcomes, including improvement efficiency of the FIM (gain in FIM score divided by length of stay) for motor function (FIM-M) and cognitive function (FIM-C).</div></div><div><h3>Results</h3><div>The adjusted hazard ratio indicating risk for medical events in the ACC/AHA stage A, B, and C HF with sarcopenia group relative to those without sarcopenia group was 2.93 (95% CI, 1.12-7.67). The β coefficients of the ACC/AHA stage A, B, and C HF with sarcopenia group relative to those without sarcopenia group for the improvement efficiencies of FIM-M and FIM-C were 0.11 (lower confidence limit: −0.33, upper confidence limit: 0.56) and −0.28 (lower confidence limit: −1.51, upper confidence limit: 0.997), respectively.</div></div><div><h3>Conclusions</h3><div>This study showed that sarcopenia was significantly associated with medical events but not with inpatient rehabilitation outcomes in ACC/AHA stage A, B, and C HF patients with disabilities.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 3","pages":"Article 100483"},"PeriodicalIF":2.0000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Associations of Sarcopenia With Medical Events and Inpatient Rehabilitation Outcomes in ACC/AHA Stage A, B, and C Heart Failure Individuals With Disabilities\",\"authors\":\"Hideki Arai MD, PhD , Masafumi Nozoe PT, PhD , Kuniyasu Kamiya PT, PhD , Tatsuyuki Fukuoka SLP, PhD , Satoru Matsumoto MD\",\"doi\":\"10.1016/j.arrct.2025.100483\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>To assess the associations of sarcopenia with medical events and inpatient rehabilitation outcomes in American College of Cardiology (ACC)/American Heart Association (AHA) stage A, B, and C patients with heart failure (HF) and disabilities.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Setting</h3><div>Inpatient rehabilitation ward.</div></div><div><h3>Participants</h3><div>ACC/AHA stage A, B, and C patients with HF (N=293) with or without sarcopenia who had disabilities because of neurologic disorders, musculoskeletal disorders, or hospital-associated deconditioning.</div></div><div><h3>Interventions</h3><div>None.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcomes were medical events such as death and illness requiring interhospital transport for specialized medical care. The secondary outcomes were inpatient rehabilitation outcomes, including improvement efficiency of the FIM (gain in FIM score divided by length of stay) for motor function (FIM-M) and cognitive function (FIM-C).</div></div><div><h3>Results</h3><div>The adjusted hazard ratio indicating risk for medical events in the ACC/AHA stage A, B, and C HF with sarcopenia group relative to those without sarcopenia group was 2.93 (95% CI, 1.12-7.67). The β coefficients of the ACC/AHA stage A, B, and C HF with sarcopenia group relative to those without sarcopenia group for the improvement efficiencies of FIM-M and FIM-C were 0.11 (lower confidence limit: −0.33, upper confidence limit: 0.56) and −0.28 (lower confidence limit: −1.51, upper confidence limit: 0.997), respectively.</div></div><div><h3>Conclusions</h3><div>This study showed that sarcopenia was significantly associated with medical events but not with inpatient rehabilitation outcomes in ACC/AHA stage A, B, and C HF patients with disabilities.</div></div>\",\"PeriodicalId\":72291,\"journal\":{\"name\":\"Archives of rehabilitation research and clinical translation\",\"volume\":\"7 3\",\"pages\":\"Article 100483\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2025-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Archives of rehabilitation research and clinical translation\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2590109525000588\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"REHABILITATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of rehabilitation research and clinical translation","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2590109525000588","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"REHABILITATION","Score":null,"Total":0}
Associations of Sarcopenia With Medical Events and Inpatient Rehabilitation Outcomes in ACC/AHA Stage A, B, and C Heart Failure Individuals With Disabilities
Objective
To assess the associations of sarcopenia with medical events and inpatient rehabilitation outcomes in American College of Cardiology (ACC)/American Heart Association (AHA) stage A, B, and C patients with heart failure (HF) and disabilities.
Design
Retrospective cohort study.
Setting
Inpatient rehabilitation ward.
Participants
ACC/AHA stage A, B, and C patients with HF (N=293) with or without sarcopenia who had disabilities because of neurologic disorders, musculoskeletal disorders, or hospital-associated deconditioning.
Interventions
None.
Main Outcome Measures
The primary outcomes were medical events such as death and illness requiring interhospital transport for specialized medical care. The secondary outcomes were inpatient rehabilitation outcomes, including improvement efficiency of the FIM (gain in FIM score divided by length of stay) for motor function (FIM-M) and cognitive function (FIM-C).
Results
The adjusted hazard ratio indicating risk for medical events in the ACC/AHA stage A, B, and C HF with sarcopenia group relative to those without sarcopenia group was 2.93 (95% CI, 1.12-7.67). The β coefficients of the ACC/AHA stage A, B, and C HF with sarcopenia group relative to those without sarcopenia group for the improvement efficiencies of FIM-M and FIM-C were 0.11 (lower confidence limit: −0.33, upper confidence limit: 0.56) and −0.28 (lower confidence limit: −1.51, upper confidence limit: 0.997), respectively.
Conclusions
This study showed that sarcopenia was significantly associated with medical events but not with inpatient rehabilitation outcomes in ACC/AHA stage A, B, and C HF patients with disabilities.