PDF(Pubmed)
Abstract：
UNASSIGNED: Frailty, characterized by vulnerability, reduced reserves and increased susceptibility to severe events, is a significant concern in chronic haemodialysis (HD) patients. Sarcopenia, corresponding to the progressive loss of muscle mass and strength, may contribute to frailty by reducing functional capacity, mobility and autonomy. However, consensus lacks on the optimal bedside frailty index for chronic HD patients. This study investigated the influence of frailty on chronic HD patient survival and explored the associated factors.
UNASSIGNED: A total of 135 patients were enrolled from January to April 2019 and then followed up prospectively until April 2022. At inclusion, frailty was assessed by the Timed Up and Go (TUG) and Short Physical Performance Battery (SPPB) tests including gait speed, standing balance and lower limb muscle strength.
UNASSIGNED: From a total of 114 prevalent chronic HD patients (66% men, age 67.6 ± 15.1 years), 30 died during the follow-up period of 23.7 months (range 16.8-34.3). Deceased patients were older, had more comorbidities and a higher sarcopenia prevalence (P < .05). The TUG and SPPB test scores were significantly reduced in patients who had died [SPPB total score: 7.2 ± 3.3 versus 9.4 ± 2.5; TUG time 8.7 ± 5.8 versus 13.8 ± 10.5 (P < .05)]. Multivariate analysis showed that a higher SPPB score (total value >9) was associated with a lower mortality risk [hazard ratio 0.83 (95% confidence interval 0.74-0.92); P < .03). Each component of the SPPB test was also associated with mortality in univariate analysis, but only the SPPB balance test remained protective against mortality in multivariate analysis. Older age, lower handgrip strength and lower protein catabolic rate were associated with SPPB total scores <9, SPPB balance score and TUG time >10 s.
UNASSIGNED: Screening for frailty is crucial in chronic HD patients, and incorporating SPPB, especially the balance test, provides valuable insights. Diminished muscle strength and inadequate protein intake negatively influence the SPPB score and balance in chronic HD patients. Effective identification and management of frailty can therefore improve outcomes.
UNASSIGNED: NCT03845452.
UNASSIGNED: A total of 135 patients were enrolled from January to April 2019 and then followed up prospectively until April 2022. At inclusion, frailty was assessed by the Timed Up and Go (TUG) and Short Physical Performance Battery (SPPB) tests including gait speed, standing balance and lower limb muscle strength.
UNASSIGNED: From a total of 114 prevalent chronic HD patients (66% men, age 67.6 ± 15.1 years), 30 died during the follow-up period of 23.7 months (range 16.8-34.3). Deceased patients were older, had more comorbidities and a higher sarcopenia prevalence (P < .05). The TUG and SPPB test scores were significantly reduced in patients who had died [SPPB total score: 7.2 ± 3.3 versus 9.4 ± 2.5; TUG time 8.7 ± 5.8 versus 13.8 ± 10.5 (P < .05)]. Multivariate analysis showed that a higher SPPB score (total value >9) was associated with a lower mortality risk [hazard ratio 0.83 (95% confidence interval 0.74-0.92); P < .03). Each component of the SPPB test was also associated with mortality in univariate analysis, but only the SPPB balance test remained protective against mortality in multivariate analysis. Older age, lower handgrip strength and lower protein catabolic rate were associated with SPPB total scores <9, SPPB balance score and TUG time >10 s.
UNASSIGNED: Screening for frailty is crucial in chronic HD patients, and incorporating SPPB, especially the balance test, provides valuable insights. Diminished muscle strength and inadequate protein intake negatively influence the SPPB score and balance in chronic HD patients. Effective identification and management of frailty can therefore improve outcomes.
UNASSIGNED: NCT03845452.
摘要：
■脆弱，以脆弱性为特征，储备减少，对严重事件的易感性增加，是慢性血液透析（HD）患者的一个重要问题。肌肉减少症,对应于肌肉质量和力量的逐渐丧失，可能会降低功能能力，流动性和自主性。然而,对于慢性HD患者的最佳床边虚弱指数缺乏共识。这项研究调查了虚弱对慢性HD患者生存的影响，并探讨了相关因素。
■从2019年1月至4月共招募了135名患者，然后前瞻性随访至2022年4月。在纳入时，通过定时上升和前进（TUG）和短物理性能电池（SPPB）测试评估虚弱，包括步态速度，站立平衡和下肢肌肉力量。
■共有114名流行的慢性HD患者（66％的男性，年龄67.6±15.1岁)，随访23.7个月，30例死亡（范围16.8-34.3）。死者年龄较大，合并症较多，少肌症患病率较高（P<0.05）。死亡患者的TUG和SPPB测试得分显着降低[SPPB总分：7.2±3.3对9.4±2.5；TUG时间8.7±5.8对13.8±10.5（P<0.05）]。多变量分析显示，较高的SPPB评分（总值>9）与较低的死亡风险相关[风险比0.83（95％置信区间0.74-0.92）；P<.03）。SPPB检验的每个组成部分在单变量分析中也与死亡率相关，但在多变量分析中,只有SPPB平衡检验对死亡率仍有保护作用.年纪大了,较低的握力和较低的蛋白质分解代谢率与SPPB总分<9，SPPB平衡评分和TUG时间>10s相关。
■对慢性HD患者进行虚弱筛查至关重要，并结合SPPB，尤其是平衡测试，提供了宝贵的见解。肌肉力量减弱和蛋白质摄入不足会对慢性HD患者的SPPB评分和平衡产生负面影响。因此，有效识别和管理脆弱可以改善结果。
■NCT03845452。
■从2019年1月至4月共招募了135名患者，然后前瞻性随访至2022年4月。在纳入时，通过定时上升和前进（TUG）和短物理性能电池（SPPB）测试评估虚弱，包括步态速度，站立平衡和下肢肌肉力量。
■共有114名流行的慢性HD患者（66％的男性，年龄67.6±15.1岁)，随访23.7个月，30例死亡（范围16.8-34.3）。死者年龄较大，合并症较多，少肌症患病率较高（P<0.05）。死亡患者的TUG和SPPB测试得分显着降低[SPPB总分：7.2±3.3对9.4±2.5；TUG时间8.7±5.8对13.8±10.5（P<0.05）]。多变量分析显示，较高的SPPB评分（总值>9）与较低的死亡风险相关[风险比0.83（95％置信区间0.74-0.92）；P<.03）。SPPB检验的每个组成部分在单变量分析中也与死亡率相关，但在多变量分析中,只有SPPB平衡检验对死亡率仍有保护作用.年纪大了,较低的握力和较低的蛋白质分解代谢率与SPPB总分<9，SPPB平衡评分和TUG时间>10s相关。
■对慢性HD患者进行虚弱筛查至关重要，并结合SPPB，尤其是平衡测试，提供了宝贵的见解。肌肉力量减弱和蛋白质摄入不足会对慢性HD患者的SPPB评分和平衡产生负面影响。因此，有效识别和管理脆弱可以改善结果。
■NCT03845452。
