Abstract：
Pulmonary tuberculosis is a severe disease with a high mortality rate. However, whether sarcopenia is a risk factor for in-hospital mortality remains unclear. The SARC-F (five items: strength, assistance in walking, rising from a chair, climbing stairs, and falls) is a questionnaire developed to screen for sarcopenia. This study aimed to determine whether the high risk of sarcopenia, assessed using the SARC-F questionnaire, affects in-hospital mortality in older patients with pulmonary tuberculosis.
This was a retrospective, observational study. We included patients with active pulmonary tuberculosis aged ≥65 years who required inpatient treatment between 30 April 2021 and 30 November 2022. We assessed sarcopenia using SARC-F, and SARC-F ≥ 4 points at admission was defined as a high risk of sarcopenia. The primary outcome was all-cause mortality during hospitalisation. We extracted information on age, sex, body mass index, comorbidities, blood and biochemical tests, modified Glasgow Prognostic Score, calf circumference, geriatric nutritional risk index, physiotherapy, and length of hospital stay from medical records.
We included 147 patients (mean age: 83.0 ± 7.8 years; males: 61.9%). Ninety-three (63.3%) patients had a high risk of developing sarcopenia. Patients with a high risk of sarcopenia were significantly older (mean: 85.0 ± 7.1 years), had a lower body mass index (median: 18.1 kg/m2, range: 16.1-20.5 kg/m2), had a higher modified Glasgow Prognostic Score (median: 2, range: 2-2), and had a lower calf circumference (mean: 26.8 ± 3.6 cm), had a lower geriatric nutritional risk index (mean: 72.2 ± 12.9) than those without high-risk sarcopenia. More patients with a high risk of sarcopenia underwent physiotherapy (93.5%) than those without high-risk sarcopenia (P < 0.01, all). Kaplan-Meier survival curves showed that patients with a high risk of sarcopenia had significantly lower overall survival than those without high-risk sarcopenia (log-rank test, P = 0.001). Logistic regression analysis for in-hospital mortality showed that a high risk of sarcopenia significantly affected in-hospital mortality (odds ratio [OR]: 6.425, 95% confidence interval [CI]: 1.399-47.299). In addition, logistic regression analysis for each item of SARC-F showed that assistance in walking (OR: 3.931, 95% CI: 1.816-9.617) and rising from a chair (OR: 2.458, 95% CI: 1.235-5.330) significantly affected in-hospital mortality.
A high risk of sarcopenia, as assessed using SARC-F at admission, was a risk factor for in-hospital mortality in older patients with pulmonary tuberculosis. Among the SARC-F items, assistance in walking and rising from a chair were the risk factors for in-hospital mortality.
This was a retrospective, observational study. We included patients with active pulmonary tuberculosis aged ≥65 years who required inpatient treatment between 30 April 2021 and 30 November 2022. We assessed sarcopenia using SARC-F, and SARC-F ≥ 4 points at admission was defined as a high risk of sarcopenia. The primary outcome was all-cause mortality during hospitalisation. We extracted information on age, sex, body mass index, comorbidities, blood and biochemical tests, modified Glasgow Prognostic Score, calf circumference, geriatric nutritional risk index, physiotherapy, and length of hospital stay from medical records.
We included 147 patients (mean age: 83.0 ± 7.8 years; males: 61.9%). Ninety-three (63.3%) patients had a high risk of developing sarcopenia. Patients with a high risk of sarcopenia were significantly older (mean: 85.0 ± 7.1 years), had a lower body mass index (median: 18.1 kg/m2, range: 16.1-20.5 kg/m2), had a higher modified Glasgow Prognostic Score (median: 2, range: 2-2), and had a lower calf circumference (mean: 26.8 ± 3.6 cm), had a lower geriatric nutritional risk index (mean: 72.2 ± 12.9) than those without high-risk sarcopenia. More patients with a high risk of sarcopenia underwent physiotherapy (93.5%) than those without high-risk sarcopenia (P < 0.01, all). Kaplan-Meier survival curves showed that patients with a high risk of sarcopenia had significantly lower overall survival than those without high-risk sarcopenia (log-rank test, P = 0.001). Logistic regression analysis for in-hospital mortality showed that a high risk of sarcopenia significantly affected in-hospital mortality (odds ratio [OR]: 6.425, 95% confidence interval [CI]: 1.399-47.299). In addition, logistic regression analysis for each item of SARC-F showed that assistance in walking (OR: 3.931, 95% CI: 1.816-9.617) and rising from a chair (OR: 2.458, 95% CI: 1.235-5.330) significantly affected in-hospital mortality.
A high risk of sarcopenia, as assessed using SARC-F at admission, was a risk factor for in-hospital mortality in older patients with pulmonary tuberculosis. Among the SARC-F items, assistance in walking and rising from a chair were the risk factors for in-hospital mortality.
摘要：
目的：肺结核是一种病死率高的重症疾病。然而,肌少症是否是院内死亡的危险因素尚不清楚.SARC-F（五个项目：力量，帮助行走,从椅子上站起来,爬楼梯,和跌倒）是为筛查肌肉减少症而开发的问卷。本研究旨在确定肌少症的高风险，使用SARC-F问卷进行评估，影响老年肺结核患者的院内死亡率。
方法：这是一个回顾性研究，观察性研究。我们纳入了2021年4月30日至2022年11月30日期间需要住院治疗的年龄≥65岁的活动性肺结核患者。我们使用SARC-F评估肌肉减少症，入院时SARC-F≥4分被定义为肌肉减少症的高风险。主要结果是住院期间的全因死亡率。我们提取了年龄信息，性别,身体质量指数,合并症,血液和生化检查,改良的格拉斯哥预后评分，小腿周长,老年营养风险指数，物理治疗,和住院时间从医疗记录。
结果：我们纳入了147例患者（平均年龄：83.0±7.8岁；男性：61.9%）。93例（63.3％）患者发生肌少症的风险很高。患有肌肉减少症高风险的患者年龄明显较大（平均：85.0±7.1岁），体重指数较低（中位数：18.1kg/m2，范围：16.1-20.5kg/m2），有较高的修正格拉斯哥预后评分（中位数：2，范围：2-2），小腿围较低（平均：26.8±3.6厘米），老年营养风险指数（平均值：72.2±12.9）低于没有高风险肌少症的患者。有较高风险的肌少症患者接受物理治疗（93.5％）多于没有高风险的肌少症患者（P<0.01，均）。Kaplan-Meier生存曲线显示，与没有高风险肌少症的患者相比，具有高风险肌少症的患者的总生存率显着降低（log-rank检验，P=0.001)。住院死亡率的Logistic回归分析显示，肌肉减少症的高风险显著影响住院死亡率（比值比[OR]：6.425，95%置信区间[CI]：1.399-47.299）。此外,SARC-F各项目的logistic回归分析显示,辅助行走(OR:3.931,95%CI:1.816-9.617)和起立椅子(OR:2.458,95%CI:1.235-5.330)显著影响住院死亡率。
结论：肌少症的高风险，根据入院时使用SARC-F评估，是老年肺结核患者院内死亡的危险因素.在SARC-F项目中，辅助行走和从椅子上起身是院内死亡的危险因素.
方法：这是一个回顾性研究，观察性研究。我们纳入了2021年4月30日至2022年11月30日期间需要住院治疗的年龄≥65岁的活动性肺结核患者。我们使用SARC-F评估肌肉减少症，入院时SARC-F≥4分被定义为肌肉减少症的高风险。主要结果是住院期间的全因死亡率。我们提取了年龄信息，性别,身体质量指数,合并症,血液和生化检查,改良的格拉斯哥预后评分，小腿周长,老年营养风险指数，物理治疗,和住院时间从医疗记录。
结果：我们纳入了147例患者（平均年龄：83.0±7.8岁；男性：61.9%）。93例（63.3％）患者发生肌少症的风险很高。患有肌肉减少症高风险的患者年龄明显较大（平均：85.0±7.1岁），体重指数较低（中位数：18.1kg/m2，范围：16.1-20.5kg/m2），有较高的修正格拉斯哥预后评分（中位数：2，范围：2-2），小腿围较低（平均：26.8±3.6厘米），老年营养风险指数（平均值：72.2±12.9）低于没有高风险肌少症的患者。有较高风险的肌少症患者接受物理治疗（93.5％）多于没有高风险的肌少症患者（P<0.01，均）。Kaplan-Meier生存曲线显示，与没有高风险肌少症的患者相比，具有高风险肌少症的患者的总生存率显着降低（log-rank检验，P=0.001)。住院死亡率的Logistic回归分析显示，肌肉减少症的高风险显著影响住院死亡率（比值比[OR]：6.425，95%置信区间[CI]：1.399-47.299）。此外,SARC-F各项目的logistic回归分析显示,辅助行走(OR:3.931,95%CI:1.816-9.617)和起立椅子(OR:2.458,95%CI:1.235-5.330)显著影响住院死亡率。
结论：肌少症的高风险，根据入院时使用SARC-F评估，是老年肺结核患者院内死亡的危险因素.在SARC-F项目中，辅助行走和从椅子上起身是院内死亡的危险因素.
