老年住院患者急性肌萎缩的Meta分析

Arthur George Gonzales, M. Ramos
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引用次数: 1

摘要

目的:确定老年住院患者急性少肌症的患病率。搜索策略:使用的电子书目数据库是通过PUBMED的MEDLINE和Cochrane图书馆(Cochrane系统评价数据库、Cochrane对照试验中央登记册(Central)、Cochran方法学登记册)。搜索策略包括适当的MeSH和其他自由文本术语的组合,包括以下关键词:“少肌症”、“急性护理”、“住院治疗”和“老年人”。搜索没有语言限制。只要少肌症的诊断至少包括对肌肉质量的评估,就对报告住院老年人少肌症患病率的摘要和随后选择的完整研究进行了审查。选择标准:观察研究涉及住院急性护理医院的老年患者>65岁,没有少肌症。根据EWGSOP或AWGS定义诊断出院后少肌症。数据收集和分析:所有合格研究的所有已发表报告均由两名独立评审员进行评估。数据是提取的数据,并对收集的不同变量进行汇总分析。主要结果:本研究确定了6项观察性研究,涉及2106名参与者,其中418名住院老年人患有少肌症,患病率为19.8%。患有少肌血症的老年患者的年龄显著高于没有少肌症的患者2.91岁(95%CI,2.18至3.65),而BMI显著较低。患有或不患有少肌症的男性老年人的比例没有显著差异。在少肌症患者中,吸烟者的比例更高。吸烟者患少肌症的风险是非吸烟者的1.26倍(RR=1.26;95%可信区间:1.07-1.48)。在住院的老年少肌症患者中,住院时间没有显著差异,但死亡率(RR=2.69;95%置信区间:1.96-3.69)和再入院风险(RR=1.48;95%置信度:1.27-1.72)更高。结论:本综述结果显示,老年住院患者急性少肌症的患病率为19.8%,有少肌症患者的年龄明显高于无少肌症者,而BMI较低。老年少肌症患者中吸烟者的比例也较高。此外,这项荟萃分析的结果表明,患有或不患有少肌症的老年患者的住院时间没有显著差异。然而,老年急性少肌症患者的死亡率和再入院率明显较高。
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Meta-Analysis of Acute Sarcopenia among Hospitalized Elderly Patients
Objective: To determine the prevalence of acute sarcopenia in elderly hospitalised patients. Search strategy: The electronic bibliographic databases used are MEDLINE via PUBMED and The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Methodology Register). The search strategy included a combination of appropriate MeSH and other free-text terms including the following key words: “sarcopenia”, “acute care”, “hospitalisation”, and “elderly”. There was no language restriction for the searches. Abstracts and subsequently selected full studies reporting the prevalence of sarcopenia in elderly adults admitted to inpatient hospitals were reviewed as long as the diagnosis of sarcopenia included at least the assessment of muscle mass. Selection criteria: Observational studies involving elderly Patient > 65 y/o, admitted in an acute care hospital with no sarcopenia. Diagnosis of sarcopenia upon discharged based on EWGSOP or AWGS definition. Data collection and analysis: All published reports of all eligible studies were evaluated by two independent reviewers. Data were extracted data and pooled analysis was done on the different variables collected. Main results: The present study identified six observational studies involving 2106 participants with 418 hospitalized elderly noted to have sarcopenia, showing a prevalence of 19.8%. The age of elderly patients with sarcopenia was significantly higher than those without sarcopenia by 2.91 years (95% CI, 2.18 to 3.65) while the BMI was significantly lower. No significant difference was noted in the proportion of male elderly with or without sarcopenia. A higher proportion of smokers were noted among those with sarcopenia. The risk of smokers for sarcopenia was 1.26x higher than non-smokers (RR = 1.26; 95% CI: 1.07-1.48). No significant difference was observed in the length of stay, but a higher risk for mortality (RR = 2.69; 95% CI: 1.96-3.69) and readmission (RR = 1.48; 95% CI: 1.27-1.72) was noted among hospitalized elderly patients with sarcopenia. Conclusion: The results of this review showed that the prevalence of acute sarcopenia among elderly hospitalized patients was 19.8%. The age of elderly patients with sarcopenia was significantly higher than those without sarcopenia while the BMI was lower. The proportion of smokers was also higher among elderly patients with sarcopenia. Moreover, the results of this meta-analysis showed that the length of stay.was not significantly different between elderly patients with or without sarcopenia. However, mortality and readmission rate were significantly higher among elderly patients with acute sarcopenia.
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