Muscle changes on muscle ultrasound and adverse outcomes in acute hospitalized older adults

• Published in: Nutrition (Burbank, Los Angeles County, Calif.) Vol. 102; p. 111698
• Main Authors: Nagae, Masaaki, Umegaki, Hiroyuki, Yoshiko, Akito, Fujita, Kosuke, Komiya, Hitoshi, Watanabe, Kazuhisa, Yamada, Yosuke, Sakai, Tomomichi, Kuzuya, Masafumi
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Inc 01.10.2022; Elsevier Limited
• Subjects: Activities of daily living; Adults; Adverse outcomes; Body mass index; Clinical medicine; Comorbidity; Data collection; Echo intensity; Frailty; Hospitalization; Hospitalized; Mortality; Muscle strength; Muscle thickness; Muscles; Musculoskeletal system; Observational studies; Older people; Quadriceps muscle; Regression analysis; Sarcopenia; Thigh; Ultrasonic imaging; Ultrasonic testing; Ultrasound; United States > US; Japan; Echo intensity; Adverse outcomes; Sarcopenia; Hospitalized; Muscle thickness
• ISSN: 0899-9007; 1873-1244
• DOI: 10.1016/j.nut.2022.111698

•Muscle ultrasound is a non-invasive technique that enables identification of the quantity and quality of muscle tissue.•Muscle changes during hospitalization for acute illness have been attracting attention as indicators acute sarcopenia.•Acute muscle changes on muscle ultrasound were not associated with mortality, decline in activities of daily living, or hospital-associated complications in acute hospitalized older adults.•Chronic muscle conditions had a larger effect on adverse outcomes than acute muscle changes among acute hospitalized older adults, indicating a need to evaluate muscle on admission. Muscle ultrasound is a non-invasive technique that enables identification of the quantity and quality of muscle tissue. It has been used not only for diagnosis of sarcopenia but also for prediction of outcomes in clinical practice. There is now increasing awareness that muscle changes detected during acute hospitalization indicate acute sarcopenia leading to worse outcomes. However, to our knowledge, few studies have investigated this in hospitalized older adults. The aim of this study was to determine whether muscle changes on muscle ultrasound can predict poor outcomes in acute hospitalized older adults. This prospective, observational cohort study involved 145 acute hospitalized older adults. Bilateral anterior thigh thickness (BATT), echo intensity (EI), and corrected EI of the quadriceps were assessed on admission and 7 d later. The primary outcome was mortality, and the secondary outcomes were hospital-associated complications and decline in activities of daily living (ADLs) at 3 mo after discharge. Changes in BATT, EI, and corrected EI at 7 d after admission were found in 0.2%, 0.0%, and 0.2% of cases, respectively. The respective rates for mortality, hospital-associated complications, and ADL decline were 8.7%, 52.8%, and 43%, respectively. Multivariable logistic regression analysis showed that the BATT value at admission tended to be associated with mortality. Changes in BATT, EI, and collected EI were not associated with adverse outcomes. Acute muscle changes on muscle ultrasound were not associated with mortality, ADL decline, or hospital-associated complications in acute hospitalized older adults. More research in various settings is needed to clarify the value of muscle ultrasound in clinical practice.