ワカバヤシ ヒデタカ   Wakabayashi Hidetaka
  若林 秀隆
   所属   医学部 医学科(東京女子医科大学病院)
   職種   教授・基幹分野長
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Sarcopenia is associated with worse recovery of physical function and dysphagia and a lower rate of home discharge in Japanese hospitalized adults undergoing convalescent rehabilitation.
掲載誌名 正式名:Nutrition (Burbank, Los Angeles County, Calif.)
略  称:Nutrition
ISSNコード:18731244/08999007
掲載区分国外
巻・号・頁 61,pp.111-118
著者・共著者 Yoshimura Yoshihiro, Wakabayashi Hidetaka, Bise Takahiro, Nagano Fumihiko, Shimazu Sayuri, Shiraishi Ai, Yamaga Makio, Koga Hiroaki
担当区分 2nd著者
発行年月 2019/05
概要 OBJECTIVE:The aim of this study was to evaluate the effect of sarcopenia on functional outcomes, including activities of daily living (ADLs); dysphagia status; and the rate of home discharge, among hospitalized adults receiving convalescent rehabilitation.METHODS:A retrospective cohort study was conducted with 898 patients newly admitted to in-hospital convalescent rehabilitation wards at a single rehabilitation hospital in Japan. Baseline sarcopenia was diagnosed using muscle mass index and handgrip strength according to the criteria of the European Working Group on Sarcopenia in Older People, with the cutoff values of the Asian Working Group for Sarcopenia. The primary outcome was ADLs, assessed by Functional Independence Measure motor (FIM-motor) score at hospital discharge. The secondary outcomes included dysphagia, assessed by the Food Intake Level Scale (FILS), at discharge, and the rate of home discharge. Three multivariate analyses revealed an association between sarcopenia and the clinical outcomes. Each analysis adjusted for the following confounders: age, sex, time from onset, premorbid ADLs, comorbidities, cognitive level, nutritional status, major drugs, and admission diagnoses.RESULTS:After enrollment, 795 patients (mean age 74.9 ± 13.2 y; 59% women) were included in the final analysis. Admission diagnoses included stroke (n = 276; 34.7%), musculoskeletal disorders (n = 382; 48.1%), and hospital-associated deconditioning (n = 137; 17.2%). Of the 795 patients examined, 402 (50.6%) had sarcopenia. The multiple linear regression analysis showed that sarcopenia was independently associated with FIM motor score at discharge in patients with all disease types (β = -0.189 [stroke], -0.240 [musculoskeletal disorders], -0.230 [hospital-associated deconditioning]; all P < 0.05), with FILS score at discharge only in patients with musculoskeletal disorders (β = -0.271, P < 0.001)
DOI 10.1016/j.nut.2018.11.005
PMID 30710883