Risultati per: Sarcopenia: la prevenzione, il sospetto, la diagnosi e le azioni per il medico di medicina generale

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Circulation, Volume 150, Issue Suppl_1, Page A4145958-A4145958, November 12, 2024. Background:Sarcopenia is an objective and comprehensive marker of frailty and an important predictor of outcomes after cardiac surgery. Its utility is challenging due to difficulty in its assessment.Hypothesis:We hypothesize that sarcopenia defined as pectoralis major cross-sectional area (PMA) from CT Chest is a useful predictor of cardiac surgery outcomes.Aim:The aim of this study is to develop Gender Specific Cut-off Points for PMA as a marker for sarcopenia and to evaluate the associations between sarcopenia and post-operative cardiac surgery outcomes.Methods:This study includes 237 subjects with pre-operative CT Chest scans who underwent any Cardiac Surgery involving sternotomy from 2019 to 2023 at the Townsville University Hospital, Australia. The Pectoralis Major Muscle Area, Density and Thickness measurements were performed at the level of 4th thoracic vertebra in Axial view. The sarcopenia cut-off value was defined as the lowest sex-specific quartile in PMA. Intra and post-operative outcomes up to 30-days, were collected.Results:The Cut-off values for PMA were set at 1045mm2for males and 609mm2for females, with 59 subjects meeting the criteria for sarcopenia. Sarcopenic patients required longer hospitalization (10.8±6.93 vs 8.37±5.26 days; P=0.006), longer intubation and stay in ICU, and experienced more post-operative complications within the first 30 days after surgery (p=0.002). Post-operative mortality was similar in both groups.Logistic regression analysis revealed that sarcopenia is associated with increased risk in days of extended hospital stays (OR=5.08, 95% CI: 2.35-10.96, p

Objectives
To identify and map the available evidence for whether a test of handgrip strength (HGS) and/or the chair stand test (CST) have been used as screening tools for the detection of sarcopenia in elderly individuals within primary care settings.

Design
This study was designed as a scoping review, in accordance with the methodological framework for scoping reviews, developed by Arksey and O’Malley, and using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews.

Data sources
A literature search was conducted to identify relevant articles listed in PubMed and Scopus databases up to 16 October 2023.

Eligibility criteria
Studies including individuals aged ≥60 years who had undergone assessments of HGS and/or the CST in primary care settings were included.

Data extraction and synthesis
Following the article selection process, based on predetermined criteria for inclusion and exclusion, the selected articles were analysed regarding population demographics, the setting in which the research was conducted, the study design, used diagnostic tools and reported results.

Results
The search yielded 282 unique articles, of which 7 were included in the final analysis. All seven included articles had a cross-sectional study design, whereof one also had a longitudinal 3-year follow-up. The number of participants ranged from 75 to 719. Three of the articles used the diagnostic criteria presented by European Working Group on Sarcopenia in Older People (EWGSOP), two used the criteria by Asian Working Group for Sarcopenia 2019, one used the EWGSOP2 criteria and one applied both the EWGSOP and EWGSOP2 criteria to their data. All the articles used HGS to assess muscle strength. CST was not used for this purpose in any of the articles, although it was used to estimate physical performance or as part of the short physical performance battery. The prevalence of sarcopenia in the included articles was 12.0%–20.7%, while the prevalence of possible sarcopenia was 69.9%–73.3% and that of probable sarcopenia was 25.5%–94%.

Conclusion
None of the included articles aimed to study a test of HGS and/or the CST as screening tools for the detection of sarcopenia. However, four of the articles diagnosed possible or probable sarcopenia by using a test of HGS and/or the CST among elderly patients in a primary care setting. There is a need for more research to elucidate whether a test of HGS and/or the CST might be used for screening of sarcopenia in primary care.

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