Prevalence and risk factors of stroke-related sarcopenia at the subacute stage: A case control study

NO, NO, NO, not this useless shit. Give us protocols on how to prevent sarcopenia.

The whole goal of stroke research is to solve stroke, not just describe the problems from stroke. You'll want stroke solved before you become

the 1 in 4 per WHO that has a stroke.

 

Prevalence and risk factors of stroke-related sarcopenia at the subacute stage: A case control study

Ruihong Yao¹, Liqing Yao^2*, Amin Rao², Jibing Ou², Wenli Wang², Qinzhi Hou², Chunyan Xu² and Bu-Lang Gao¹

• ¹Medical Imaging Department, The First Affiliated Hospital of Kunming Medical University, Kunming, China
• ²Rehabilitation Medicine Department, The Second Affiliated Hospital of Kunming Medical University, Kunming, China

Purpose: To investigate the prevalence and risk factors of stroke-related sarcopenia (SRS) in hospitalized patients receiving rehabilitation treatment.

Methods: Approximately, 259 patients with stroke that satisfied the inclusion and exclusion criteria were consecutively recruited between June 2020 and July 2022. The epidemiologic data, history, clinical data, and measured data of the skeletal muscle index were collected. The patients were divided into the sarcopenia and non-sarcopenia group for comparison and analysis with the univariate and multivariate analysis.

Results: SRS was presented in 121 (46.7%) patients with a mean age of 59.6 ± 9.7 years, including 42 women and 79 men. Multivariate logistic regression analysis revealed the following parameters to be significant (p < 0.05) risk factors for SRS: college degree or above (OR, 2.1, 95% CI, 1.1–4.1), ICU stay (OR, 1.7, 95% CI, 1.06–2.8), pneumonia (OR, 1.9, 9% CI, 1.1–3.6), walking ability (OR, 2.6, 95% CI, 1.5–4.6), cognitive impairment (OR, 1.8, 95%, 1.1–2.9), aphasia (OR, 2.1, 95% CI, 1.2–3.5), nasogastric feeding (OR, 3.7, 95%, 1.9–7.3), age (OR, 1.04, 95% CI, 1–1.1), and creatine kinase (OR, 1.1, 95% CI,0.9–1.2).

Conclusions: Older age, light weight, severer clinical conditions, cognitive impairment, and significantly decreased levels of albumin, RAG, creatinine, uric acid, red blood cell count, hemoglobin, prealbumin, iron, and creatine kinase are more significantly present in patients with SRS compared with those without SRS.

Introduction

Sarcopenia is the loss of skeletal muscle mass and strength with aging and has become a worldwide social issue with an increased risk of adverse outcomes, including falls, fractures, longer hospitalization duration, physical disability, and mortality (1–4). The prevalence of sarcopenia reported in the literature varies with sex, age, race, and diagnostic criteria of sarcopenia (5), ranging from 15 to 50% in older adults (6), 3.1 to 29% in community dwelling residents (7), and 14–33% in patients receiving long-term care (8, 9). Sarcopenia usually has some common risk factors with some diseases, such as heart failure, cardiovascular disease (CVD), renal dialysis, fracture, diabetes mellitus (DM), and chronic obstructive pulmonary disease (COPD), which harbor the following common features, including physical inactivity, older age, malnutrition, inflammation or endocrine disorders (10). It has been reported that the prevalence of sarcopenia was 31.4, 31.1, and 26.8% in CVD, DM, and COPD, respectively (11). The loss of skeletal muscle mass and strength in patients with stroke is called stroke-related sarcopenia (SRS) (12, 13). The risk factors in primary sarcopenia include gender, age, and levels of exercise; however, the risk factors in SRS are unknown and cannot be prevented effectively. At the same time, the prevalence of SRS is not clear either. Both stroke and sarcopenia mainly happen in patients of more than 60 years of age. There are approximately 2.5 million cases of new stroke every year in China, and more than 60% of the patients with stroke remain disabled and need rehabilitation therapy, with 50% of patients suffering from hemiparesis and 30% unable to walk without assistance (14, 15). However, in rehabilitation therapy, most physicians care about the recovery of limb motor function but ignore the impact of sarcopenia on rehabilitation therapy because sarcopenia may prolong the recovery process. In sarcopenia, a combination of disuse, denervation, remodeling, inflammation, and spasticity accounts for a complex pattern of muscle tissue phenotype change and atrophy (12). SRS decreases the treatment effect and affects the quality of life of the patients, which has not been recognized in the guidelines for rehabilitation treatment of sarcopenia (16). Currently, the prevalence, risk factors, and clinical features of SRS in hospitalized patients with stroke are unknown, and it was hypothesized that knowledge of the above information would facilitate implementation of effective measures to prevent SRS and promote the recovery and rehabilitation of these patients. In order to assess the prevalence, risk factors, and clinical characteristics of SRS, patients with stroke were recruited and evaluated in this study with the standard of skeletal muscle mass measurement by bioelectrical impedance analysis (BIA) according to the 2019 consensus update on sarcopenia diagnosis and treatment of the Asian Working Group for sarcopenia (17).

More at link.