You wouldn't get sarcopenia if your competent? doctor had EXACT 100% RECOVERY PROTOCOLS! But I guess you don't have a functioning stroke doctor, do you?
- loss of muscle tissue as a natural(In stroke it is not natural) part of the aging process.
- loss of muscle tissue as a natural(In stroke it is not natural) part of the aging process.
Low Phase Angle and Skeletal Muscle Index Increase Hospital-Acquired Infections During Stroke Rehabilitation
Published:December 29, 2023DOI:https://doi.org/10.1016/j.jamda.2023.11.021
Abstract
Objectives
Sarcopenia is common in patients with stroke and may increase the risk of medical
complications such as infection. However, assessing sarcopenia in stroke patients
with consciousness disturbance, aphasia or severe paralysis is challenging. This study
aimed to investigate whether a combined assessment of phase angle (PhA) and skeletal
muscle index (SMI), estimated using bioelectrical impedance analysis, was associated
with 2 common nosocomial infections, hospital-acquired pneumonia (HAP) and urinary
tract infection (UTI), during inpatient stroke rehabilitation.
Design
Single-center retrospective observational study.
Settings and Participants
A total of 1068 patients with stroke admitted to a rehabilitation hospital between
January 2016 and September 2019 were analyzed.
Methods
The study variables included demographic characteristics, comorbidities, stroke severity,
blood chemistry and urine analysis, SMI, and PhA obtained using bioelectrical impedance
analysis. Patients were classified as normal, low PhA only, low SMI only, and low
PhA + SMI. Multivariate Cox proportional analysis was used to determine the variables
associated with HAP and UTI.
Results
A combination of low PhA + SMI was observed in 429 (40.2%) patients. Over a median
follow-up duration of 46 days, HAP occurred in 187 patients (17.5%) and UTI occurred
in 155 patients (14.5%). The low PhA + SMI group showed a significantly higher incidence
of HAP and UTI than the normal group (32.6% vs 4.6%, P < .001, for HAP; 20.7% vs 6.2%, P < .001, for UTI). In multivariate Cox analyses, low PhA and SMI were associated with
significantly higher rates of HAP [hazard ratio (HR) 3.36, 95% CI 1.796-6.304, P < .001] and UTI (HR 1.71, 95% CI 1.002-2.947, P < .05) after adjusting for confounding variables.
Conclusions and Implications
Combination of low PhA + SMI was independently associated with a higher risk of HAP
and UTI in stroke patients who underwent inpatient rehabilitation. Measuring PhA and
SMI using bioelectrical impedance analysis might be helpful in establishing care plans
in these population.
Keywords
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