Long-term prognostic significance of sarcopenia in acute ischemic stroke

Abstract

Because sarcopenia is widely distributed in patients with acute ischemic stroke (AIS) and has not attracted enough attention, this study aims to explore the relationship between sarcopenia defined by temporal muscle thickness (TMT) and physical function and prognosis of patients with AIS. A total of 265 hospitalized nonsurgical AIS patients from 2015 to 2018, with an age range of 28 ~ 92, were analyzed retrospectively. The median value of TMT was used as the risk classification index of sarcopenia. The main results were the relationship between sarcopenia and Essen Stroke Risk Score, National Institutes of Health Stroke Scale, modified Rankin Score, water swallow test, venous thromboembolism assessment of medical inpatients, activities of daily living assessed by Barthel Index, and the relationship between TMT and final survival outcome. The mean TMT of men in the study cohort was higher than that of women. The measured values of TMT among different researchers had good consistency (intraclass correlation coefficient, 0.980; P < .001). After adjusting for confounding variables, logistic regression showed that sarcopenia was associated with Essen Stroke Risk Score (odds ratio, 1.89; P < .05) and Barthel Index (odds ratio, 1.67; P < .05). Kaplan-Meier analysis showed that the survival time of low TMT group was significantly lower than that of high TMT group (36 vs 49 months; P < .001). Multivariate Cox regression showed that there was causal correlation between sarcopenia and patient death (hazard ratio, 3.54; 95% confidence interval, 1.46–8.58; P < .01). As a potential comprehensive index, thickness of temporal muscle can be included in baseline evaluation to show the physical status, stroke recurrence, and survival prognosis of AIS patients.

Prognostic value of sarcopenic visceral obesity in hepatocellular carcinoma treated with TACE

“…[12,13] However, this also means that the corresponding changes in body composition can also objectively represent the state of the body, so it is important to measure and evaluate them dynamically, among which the quantitative analysis of body components such as skeletal muscle by Advantage Workstation through large-scale equipment such as CT has been widely proved to be effective and highly reproducible among different researchers, which is the same as our research results. [14,15] More importantly, our results reflect an interesting change in predictive power when sarcopenia is combined with other prognostic factors. Based on the multifactorial results of visceral obesity with sarcopenia, the prediction ability of the combination of skeletal muscle and fat components exceeds that of any single component.…”

“…[12,13] However, this also means that the corresponding changes in body composition can also objectively represent the state of the body, so it is important to measure and evaluate them dynamically, among which the quantitative analysis of body components such as skeletal muscle by Advantage Workstation through large-scale equipment such as CT has been widely proved to be effective and highly reproducible among different researchers, which is the same as our research results. [14,15]…”

The relationship between temporal muscle thickness and triglyceride glucose index in sarcopenia with mortality and third-month functional outcomes in patients after acute stroke

“…[4] Researchers have recently focused on sarcopenia in acute ischemic stroke. [5][6][7][8] While making these evaluations of sarcopenia, researchers tended to evaluate different parameters in terms of neurological disorders. They stated that temporal muscle thickness (TMT) and area were important for sarcopenia in patients with subarachnoid hemorrhage.…”

Predictive Value of Temporal Muscle Thickness for Sarcopenia after Acute Stroke in Older Patients

“…TMT correlates with sarcopenia risk [ 16 ] and hand grip strength [ 17 ] in patients with stroke. A low TMT has been found to be associated with significantly decreased survival [ 18 ], and severe dysphagia [ 19 ] in patients with acute stroke. Katsuki et al reported TMT cutoff values of 4.9 mm for women and 6.7 mm for men when identifying physical function at 3 months post-stroke in patients with subarachnoid hemorrhage under 75 years of age [ 20 ].…”

“…Katsuki et al reported TMT cutoff values of 4.9 mm for women and 6.7 mm for men when identifying physical function at 3 months post-stroke in patients with subarachnoid hemorrhage under 75 years of age [ 20 ]. TMT has also been shown to be associated with nutritional status in older adults [ 21 ] and progression-free survival in patients with head and neck squamous cell carcinoma [ 18 ]. TMT can be measured using computed tomography (CT), magnetic resonance imaging (MRI), and ultrasonography.…”