1. Muscle Mass Loss Is a Potential Predictor of 90-Day Mortality in Older Adults with Aspiration Pneumonia.
- Author
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Maeda, Keisuke and Akagi, Junji
- Subjects
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MUSCULAR atrophy , *MORTALITY of older people , *SARCOPENIA , *DISEASE risk factors , *ASPIRATION pneumonia , *CHI-squared test , *CONFIDENCE intervals , *BIOELECTRIC impedance , *LONGITUDINAL method , *SCIENTIFIC observation , *PROBABILITY theory , *MULTIPLE regression analysis , *PROPORTIONAL hazards models , *SEVERITY of illness index , *DATA analysis software , *SKELETAL muscle , *DESCRIPTIVE statistics , *KAPLAN-Meier estimator , *LOG-rank test , *ODDS ratio , *BARTHEL Index , *OLD age ,MORTALITY risk factors - Abstract
Objectives To investigate the association between loss of muscle mass and aspiration pneumonia ( AP). Design Prospective observational cohort. Setting Acute geriatric hospital. Participants Individuals admitted to the hospital for AP (N = 151; mean age 85.9; 49.7% male). Measurements Appendicular skeletal muscle index ( ASMI; appendicular skeletal muscle mass divided by height squared) was used to evaluate muscle mass. Data on age, sex, body mass index, Mini Nutritional Assessment-Short Form score, Barthel Index score, Charlson Comorbidity Index score, and pneumonia severity (Japanese version of the CURB-65 (C (confusion), U (blood urea nitrogen ≥20 mg/ dL), R (respiratory rate ≥30 breaths/min), B (systolic blood pressure <90 mmHg or diastolic blood pressure ≤60 mmHg), 65 (aged ≥65) severity score (A- DROP)) were obtained. Outcomes included 30- and 90-day mortality. Results Mild, moderate, severe, and extremely severe AP were observed in 1.3%, 70.2%, 25.8%, and 2.6% of participants, respectively. On Kaplan-Meier analysis, participants in the lowest ASMI quartile for each sex were more likely to die than those in the other quartiles (log-lank test P = .005). Multivariate logistic analyses showed that ASMI and A- DROP were independent predictors of 90-day mortality; only A- DROP was a significant predictor of 30-day mortality ( P < .001). Cox regression analysis also showed that the first ASMI quartile was independently associated with mortality (hazard ratio = 2.19; 95% confidence interval = 1.06-4.52; P = .03). Conclusion Low muscle mass is a potential predictor of long-term mortality in individuals with AP. Prospectively preventing muscle mass deterioration may be beneficial for recovery from AP in older adults. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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