Lin Yu-Li, Hou Jia-Sian, Lai Yu-Hsien, Wang Chih-Hsien, Kuo Chiu-Huang, Liou Hung-Hsiang, Hsu Bang-Gee
Division of Nephrology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97004, Taiwan.
School of Medicine, Tzu Chi University, Hualien 97004, Taiwan.
Diagnostics (Basel). 2020 Oct 31;10(11):890. doi: 10.3390/diagnostics10110890.
Sarcopenia is common in patients undergoing chronic hemodialysis, which leads to poor outcomes. SARC-F (sluggishness, assistance in walking, rising from a chair, climb stairs, falls), a self-report questionnaire, is recommended as an easily applied tool for screening sarcopenia in older people. However, there are limited data regarding its use in patients undergoing chronic hemodialysis. Therefore, we aimed to evaluate the association between SARC-F and mortality in these patients. SARC-F questionnaire was applied in 271 hemodialysis patients (mean age 64.4 ± 14.3 years) at baseline. The association between SARC-F and mortality during a 24-month follow-up was analyzed. During this follow-up period, 40 patients (14.8%) died. The discriminative power of SARC-F score for predicting mortality was 0.716 (95% confidence interval (CI) = 0.659-0.769; < 0.001). The best cut-off was a score ≥ 1, which provided 85.0% sensitivity, 47.2% specificity, 21.8% positive predictive value, and 94.8% negative predictive value. Kaplan-Meier curves showed that patients with SARC-F ≥ 1 exhibited a higher risk of mortality than those with SARC-F < 1 ( < 0.001). Moreover, a stepwise decline in survival with higher SARC-F scores was also observed. After full adjustments, SARC-F ≥ 1 was independently associated with increased mortality (hazard ratio = 2.87, 95% CI = 1.11-7.38; = 0.029). In conclusion, SARC-F applied for sarcopenia screening predicted mortality in patients undergoing chronic hemodialysis.
肌肉减少症在接受慢性血液透析的患者中很常见,这会导致不良后果。SARC-F(行动迟缓、行走辅助、从椅子上起身、爬楼梯、跌倒)是一种自我报告问卷,被推荐作为一种易于应用的工具,用于筛查老年人的肌肉减少症。然而,关于其在慢性血液透析患者中的应用数据有限。因此,我们旨在评估SARC-F与这些患者死亡率之间的关联。在基线时,对271名血液透析患者(平均年龄64.4±14.3岁)应用了SARC-F问卷。分析了SARC-F与24个月随访期间死亡率之间的关联。在该随访期间,40名患者(14.8%)死亡。SARC-F评分预测死亡率的辨别力为0.716(95%置信区间(CI)=0.659-0.769;P<0.001)。最佳截断值为评分≥1,其敏感性为85.0%,特异性为47.2%,阳性预测值为21.8%,阴性预测值为94.8%。Kaplan-Meier曲线显示,SARC-F≥1的患者比SARC-F<1的患者具有更高的死亡风险(P<0.001)。此外,还观察到随着SARC-F评分升高,生存率逐步下降。经过全面调整后,SARC-F≥1与死亡率增加独立相关(风险比=2.87,95%CI=1.11-7.38;P=0.029)。总之,应用于肌肉减少症筛查的SARC-F可预测慢性血液透析患者的死亡率。