Prevalence of sarcopenia in chronic obstructive patients hospitalized in pneumology at the CHU of Clermont-Ferrand

Abstract : Background. COPD is characterized by a loss of skeletal muscle mass. Associated with a decrease in physical performance, it defines sarcopenia. The objective of this study is to describe the prevalence of sarcopenia in patients with chronic obstructive pulmonary insufficiency during hospitalization for acute exacerbation. The evolution of sarcopenia at six months and the survival at one year of these patients were also studied. Methods. We prospectively included hospitalized patients and measured their body composition, handgrip strength and respiratory function, including maximum inspiratory pressure (MIP) representative of diaphragmatic function. The same measurements were performed at six months in consultation. Sarcopenia was defined by a low skeletal muscle mass index (SMI) measured by body impedance analysis, and a decreased handgrip strength (HGS), based on the criteria of the European Working Group on Sarcopenia in Older Adults (EWGSOP). Survival data were collected eighteen months after hospitalization. Results. We analyzed data from fifty-four patients, aged 68 ± 9 years and BMI 26.9 ± 7.8 kg/m2, with an average FEV1 of 1.13 ± 0.49 L (45 ± 16%). Sarcopenia was observed in 48% of patients during hospitalization and in 30% of patients in consultation. At six months, the SMI improved more for men than women (+5% vs -3%, p = 0.01), it tends to improve more for patients taking oral nutritional supplements (+13% vs +1%, p = 0.05). HGS tends to increase more in physically active patients (+324% vs. +7%, p = 0.05). In multivariate analysis, SMI and MIP were linked (p = 0.03). The one-year survival rate was lower in sarcopenic patients (65% vs. 86%, p = 0.03). Conclusion. Sarcopenia in chronic obstructive pulmonary insufficiency is prevalent during exacerbation and in a stable state. It exposes to lower survival. A multimodal management reduces its prevalence.
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Loïc Perrot. Prevalence of sarcopenia in chronic obstructive patients hospitalized in pneumology at the CHU of Clermont-Ferrand. Life Sciences [q-bio]. 2018. ⟨dumas-02003136⟩

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