European geriatric medicine · 2025
Skeletal muscle thickness and echo intensity may reflect the risk of malnutrition and physical dysfunction in acutely hospitalized older patients.
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Yoshiko Akito, Nakashima Hirotaka, Nagae Masaaki, Sakai Tomomichi, Matsui Yosuke, Umegaki Hiroyuki
Аннотация
PURPOSE: Ultrasound is a bedside assessment tool used in some medical specialties. Studies have used this modality for the assessment of the skeletal muscle in hospitalized older patients for whom functional tests and imaging assessment by magnetic resonance imaging and computed tomography are not feasible. This study aimed to investigate whether skeletal muscle thickness (MT) and echo intensity (EI) obtained via ultrasonography are parameters for detecting the risk of malnutrition and physical conditions in acutely hospitalized older patients.
METHODS: Fifty-nine men and women (31 men, 28 women; 84.4 ± 5.7 years) hospitalized for acute care were included. B-mode ultrasonographic images were obtained within 1 week of admission. MT and EI were measured in the rectus femoris (RF), vastus lateralis (VL), and vastus intermedius (VI) muscles. We utilized the Mini Nutritional Assessment-Short Form (MNA-SF), handgrip strength, calf circumference, the Barthel Index (BI), instrumental activities of daily living (ADL) scale, and the clinical frailty scale (CFS) to determine malnutrition and physical conditions in the participants.
RESULTS: Stepwise regression analysis showed that the MNA-SF, BI, IADL, handgrip strength, calf circumference, and CFS scores were explained by MT in the VL and EI in the VI and RF (adjusted R2 = 0.13-0.29, P < 0.05). The receiver operating characteristic analysis revealed that the MT and EI detect malnutrition, decreased ADL, and lower handgrip strength (area under the curve was 0.19-0.76, P < 0.05).
CONCLUSION: These results suggest that the MT and EI in the quadriceps may reflect malnutrition risk and physical conditions in acutely hospitalized older patients.
METHODS: Fifty-nine men and women (31 men, 28 women; 84.4 ± 5.7 years) hospitalized for acute care were included. B-mode ultrasonographic images were obtained within 1 week of admission. MT and EI were measured in the rectus femoris (RF), vastus lateralis (VL), and vastus intermedius (VI) muscles. We utilized the Mini Nutritional Assessment-Short Form (MNA-SF), handgrip strength, calf circumference, the Barthel Index (BI), instrumental activities of daily living (ADL) scale, and the clinical frailty scale (CFS) to determine malnutrition and physical conditions in the participants.
RESULTS: Stepwise regression analysis showed that the MNA-SF, BI, IADL, handgrip strength, calf circumference, and CFS scores were explained by MT in the VL and EI in the VI and RF (adjusted R2 = 0.13-0.29, P < 0.05). The receiver operating characteristic analysis revealed that the MT and EI detect malnutrition, decreased ADL, and lower handgrip strength (area under the curve was 0.19-0.76, P < 0.05).
CONCLUSION: These results suggest that the MT and EI in the quadriceps may reflect malnutrition risk and physical conditions in acutely hospitalized older patients.