Sarcopenia index as a predictor of clinical outcomes among older adult patients with acute exacerbation of chronic obstructive pulmonary disease: a cross-sectional study
Abstract Background Sarcopenia is a geriatric syndrome with progressive loss of skeletal muscle mass and function and has a negative impact on clinical outcomes associated with chronic obstructive pulmonary disease (COPD). Recently, the sarcopenia index (SI) was developed as a surrogate marker of sa...
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BMC
2023-02-01
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Series: | BMC Geriatrics |
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Online Access: | https://doi.org/10.1186/s12877-023-03784-7 |
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author | Xuanna Zhao Ruoxin Su Rongwei Hu Yujuan Chen Xiaoyong Xu Yalian Yuan Jinhong Zhang Wenchao Zhang Yu Yang Min Chen Dongming Li Bin Wu Dan Huang Dong Wu |
author_facet | Xuanna Zhao Ruoxin Su Rongwei Hu Yujuan Chen Xiaoyong Xu Yalian Yuan Jinhong Zhang Wenchao Zhang Yu Yang Min Chen Dongming Li Bin Wu Dan Huang Dong Wu |
author_sort | Xuanna Zhao |
collection | DOAJ |
description | Abstract Background Sarcopenia is a geriatric syndrome with progressive loss of skeletal muscle mass and function and has a negative impact on clinical outcomes associated with chronic obstructive pulmonary disease (COPD). Recently, the sarcopenia index (SI) was developed as a surrogate marker of sarcopenia based upon the serum creatinine to cystatin C ratio. We aimed to assess the value of SI for predicting clinically important outcomes among elderly patients with acute exacerbation of COPD (AECOPD). Methods This cross-sectional study included elderly patients with AECOPD in China from 2017 to 2021. Clinical data were collected from medical records, and serum creatinine and cystatin C were measured. Outcomes included respiratory failure, heart failure, severe pneumonia, invasive mechanical ventilation, and mortality. Binary logistic regression was used to analyze the association between SI and clinical outcomes. Results A total of 306 patients (260 men, 46 women, age range 60–88 years) were enrolled in this study. Among the total patients, the incidence of respiratory failure and severe pneumonia was negatively associated with SI values. After adjusting for potential confounding factors, binary logistic regression analyses showed that a higher SI was still independently associated with a lower risk of respiratory failure (odds ratio [OR]: 0.27, 95% confidence interval [CI]: 0.13–0.56, P < 0.05). In subgroup analysis, the incidence of respiratory failure was negatively associated with SI values in groups with both frequent exacerbation and non-frequent exacerbation. After adjustment for potential confounders, binary logistic regression analyses showed that a higher SI was also independently associated with a lower risk of respiratory failure in both groups (OR: 0.19, 95% CI: 0.06–0.64 and OR: 0.31, 95% CI: 0.11–0.85). However, there were no significant differences in the correlations between SI and the risk of heart failure, invasive mechanical ventilation, and mortality in all groups. Conclusion The SI based on serum creatinine and cystatin C can predict respiratory failure in patients with AECOPD and either frequent or infrequent exacerbations. This indicator provides a convenient tool for clinicians when managing patients with AECOPD in daily clinical practice. |
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issn | 1471-2318 |
language | English |
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publishDate | 2023-02-01 |
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spelling | doaj.art-e5f266ad49a84049a8d7465aab1a28d62023-02-12T12:22:02ZengBMCBMC Geriatrics1471-23182023-02-012311810.1186/s12877-023-03784-7Sarcopenia index as a predictor of clinical outcomes among older adult patients with acute exacerbation of chronic obstructive pulmonary disease: a cross-sectional studyXuanna Zhao0Ruoxin Su1Rongwei Hu2Yujuan Chen3Xiaoyong Xu4Yalian Yuan5Jinhong Zhang6Wenchao Zhang7Yu Yang8Min Chen9Dongming Li10Bin Wu11Dan Huang12Dong Wu13Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical UniversityDepartment of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical UniversityDepartment of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical UniversityDepartment of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical UniversityDepartment of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical UniversityDepartment of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical UniversityDepartment of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical UniversityDepartment of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical UniversityDepartment of Geriatrics, Affiliated Hospital of Guangdong Medical UniversityDepartment of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical UniversityDepartment of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical UniversityDepartment of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical UniversityDepartment of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical UniversityDepartment of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical UniversityAbstract Background Sarcopenia is a geriatric syndrome with progressive loss of skeletal muscle mass and function and has a negative impact on clinical outcomes associated with chronic obstructive pulmonary disease (COPD). Recently, the sarcopenia index (SI) was developed as a surrogate marker of sarcopenia based upon the serum creatinine to cystatin C ratio. We aimed to assess the value of SI for predicting clinically important outcomes among elderly patients with acute exacerbation of COPD (AECOPD). Methods This cross-sectional study included elderly patients with AECOPD in China from 2017 to 2021. Clinical data were collected from medical records, and serum creatinine and cystatin C were measured. Outcomes included respiratory failure, heart failure, severe pneumonia, invasive mechanical ventilation, and mortality. Binary logistic regression was used to analyze the association between SI and clinical outcomes. Results A total of 306 patients (260 men, 46 women, age range 60–88 years) were enrolled in this study. Among the total patients, the incidence of respiratory failure and severe pneumonia was negatively associated with SI values. After adjusting for potential confounding factors, binary logistic regression analyses showed that a higher SI was still independently associated with a lower risk of respiratory failure (odds ratio [OR]: 0.27, 95% confidence interval [CI]: 0.13–0.56, P < 0.05). In subgroup analysis, the incidence of respiratory failure was negatively associated with SI values in groups with both frequent exacerbation and non-frequent exacerbation. After adjustment for potential confounders, binary logistic regression analyses showed that a higher SI was also independently associated with a lower risk of respiratory failure in both groups (OR: 0.19, 95% CI: 0.06–0.64 and OR: 0.31, 95% CI: 0.11–0.85). However, there were no significant differences in the correlations between SI and the risk of heart failure, invasive mechanical ventilation, and mortality in all groups. Conclusion The SI based on serum creatinine and cystatin C can predict respiratory failure in patients with AECOPD and either frequent or infrequent exacerbations. This indicator provides a convenient tool for clinicians when managing patients with AECOPD in daily clinical practice.https://doi.org/10.1186/s12877-023-03784-7Sarcopenia indexCreatinineCystatin CElderly patientsAcute exacerbation of chronic obstructive pulmonary diseaseClinical outcomes |
spellingShingle | Xuanna Zhao Ruoxin Su Rongwei Hu Yujuan Chen Xiaoyong Xu Yalian Yuan Jinhong Zhang Wenchao Zhang Yu Yang Min Chen Dongming Li Bin Wu Dan Huang Dong Wu Sarcopenia index as a predictor of clinical outcomes among older adult patients with acute exacerbation of chronic obstructive pulmonary disease: a cross-sectional study BMC Geriatrics Sarcopenia index Creatinine Cystatin C Elderly patients Acute exacerbation of chronic obstructive pulmonary disease Clinical outcomes |
title | Sarcopenia index as a predictor of clinical outcomes among older adult patients with acute exacerbation of chronic obstructive pulmonary disease: a cross-sectional study |
title_full | Sarcopenia index as a predictor of clinical outcomes among older adult patients with acute exacerbation of chronic obstructive pulmonary disease: a cross-sectional study |
title_fullStr | Sarcopenia index as a predictor of clinical outcomes among older adult patients with acute exacerbation of chronic obstructive pulmonary disease: a cross-sectional study |
title_full_unstemmed | Sarcopenia index as a predictor of clinical outcomes among older adult patients with acute exacerbation of chronic obstructive pulmonary disease: a cross-sectional study |
title_short | Sarcopenia index as a predictor of clinical outcomes among older adult patients with acute exacerbation of chronic obstructive pulmonary disease: a cross-sectional study |
title_sort | sarcopenia index as a predictor of clinical outcomes among older adult patients with acute exacerbation of chronic obstructive pulmonary disease a cross sectional study |
topic | Sarcopenia index Creatinine Cystatin C Elderly patients Acute exacerbation of chronic obstructive pulmonary disease Clinical outcomes |
url | https://doi.org/10.1186/s12877-023-03784-7 |
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