肌少症与呼吸重症监护病房住院患者全因死亡率危险因素的相关分析

Analysis of the relationship between sarcopenia and the risk factors of all‑cause mortality in Respiratory Intensive Care Unit patients

目的:探究肌少症是否作为呼吸重症监护病房(RICU)住院患者全因死亡率的危险因素。方法:回顾性分析2017年3月—2022年3月武汉大学中南医院RICU住院患者223例,基于胸部CT计算骨骼肌指数(SMI),根据受试者工作特征(ROC)曲线得出不同性别阈值,将患者分为肌少症组81例和非肌少症组142例。比较两组患者的基线信息、临床合并症、住院期间不良结局。使用Logistic回归分析RICU住院患者住院死亡的危险因素。结果:2组患者中死亡率差异存在统计学意义(39.51%vs 16.90%,P<0.001);单因素及多因素Logistic回归分析均提示肌少症是RICU住院患者全因死亡率的独立危险因素(OR=3.211,95%CI:1.718~6.001,P<0.001;OR=2.642,95%CI:1.355~5.153,P=0.004)。结论:肌少症是RICU住院患者全因死亡率的危险因素,需早期识别干预以期减少住院期间不良结局的发生,改善患者的预后。

Objective:To investigate whether sarcopenia could be a risk factor for all-cause mortality in respiratory intensive care unit(RICU)patients.Methods:From March 2017 to March 2022,223 hospitalized patients in the RICU at Zhongnan Hospital of Wuhan University were analyzed retrospectively.The skeletal muscle index(SMI)based on the chest high-resolution CT was calculated,and the testing threshold in different genders was acquired according to receiver operating characteristic(ROC)curves.Then the patients were divided into the sarcopenia group(n=81)and non-sarcopenia group(n=142),their baseline information,comorbidities,and adverse events during hospitalization between the two groups were compared,and he risk factors of all-cause mortality in RICU patients were analyzed by using logistic regression.Results:The difference in mortality of the two groups was statistically significant(39.51%vs 16.90%,P<0.001);Both univariate and multivariable logistic regression revealed that sarcopenia is a risk factor of all-cause mortality in RICU patients(OR=3.211,95%CI:1.718-6.001,P<0.001;OR=2.642,95%CI:1.355-5.153,P=0.004).Conclusion:Sarcopenia is a risk factor for all-cause mortality in RICU patients.To reduce the incidence of adverse outcomes in hospitalization and improve the prognosis of patients,we need to identify and treat sarcopenia early.