RESUMO
Sarcopenia is an important risk factor for hip fracture in older people. Nevertheless, this condition is overlooked in clinical practice. This study aimed to explore the factors associated with sarcopenia among older patients hospitalized for hip fracture, to identify a predictive model of sarcopenia based on variables related to this condition, and to evaluate the performance of screening tools in order to choose the most suitable to be adopted in routine care of older people with hip fracture. A cross-sectional study was undertaken with 90 patients (mean age 83.4 ± 7.2 years), by assessing sociodemographic and clinical characteristics, anthropometric measures, such as body mass index (BMI) and calf circumference (CC), the functional status (Barthel Index), the nutritional status (MNA-SF), and the adherence to the Mediterranean Diet (MEDAS). Diagnosis of sarcopenia was established according to the criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2). The analysis of variables associated with sarcopenia was performed using multivariate logistic regression models. Clusters of sarcopenia were explored with heatmaps and predictive risk models were estimated. Sarcopenia was confirmed in 30% of hip fracture patients. Variables with the strongest association with sarcopenia were BMI (OR = 0.79 [0.68−0.91], p < 0.05) and CC (OR = 0.64 [0.51−0.81], p < 0.01). CC showed a relatively high predictive capacity of sarcopenia (area under the curve: AUC = 0.82). Furthermore, CC could be a valuable tool to predict sarcopenia risk compared with the currently used screening tools, SARC-F and SARC-CalF (AUC, 0.819 vs. 0.734 and 0.576, respectively). More studies are needed to validate these findings in external study populations.
Assuntos
Fraturas do Quadril , Sarcopenia , Humanos , Idoso , Idoso de 80 Anos ou mais , Sarcopenia/diagnóstico , Estudos Transversais , Inquéritos e Questionários , Fraturas do Quadril/complicações , Perna (Membro) , Avaliação GeriátricaRESUMO
La artrosis trapeciometacarpiana es una enfermedad frecuente, dolorosa e invalidante. Afecta a un 16-25% de la población, principalmente a mujeres en edad media. El tratamiento de primera línea se basa en medidas conservadoras con antiinflamatorios y ortesis, así como infiltraciones intrarticulares con corticoides o ácido hialurónico. Cuando estas medidas fracasan, se recurre a la cirugía. Se presenta un estudio observacional, descriptivo, retrospectivo realizado en 14 pacientes con rizartrosis que fueron tratados de junio a septiembre de 2015 empleando una infiltración intrarticular de corticoides y se analizan los resultados obtenidos a las 4 semanas y 6 meses de la infiltración. La edad media de los pacientes fue de 51,6 años y fueron 11 mujeres y 3 hombres. La enfermedad fue bilateral en el 36% de los casos. Pasadas 4 semanas de la infiltración, todos los pacientes mejoraron del dolor y función excepto 4 pacientes que refirieron no sentir mejoría funcional y 2 de ellos tampoco presentaron alivio en el dolor. Tras 6 meses de seguimiento, 2 de los pacientes que habían presentado mejoría inicial recayeron y solicitaron nueva infiltración. El resto de los pacientes no presentó modificaciones significativas en su dolor o incapacidad funcional con respecto a la encuesta previa. Actualmente, la infiltración de corticoides intraarticulares se utiliza como tratamiento sintomático temporal, mejorando la calidad de vida en un gran número de pacientes
Osteoarthritis of the trapeziometacarpal joint is an usual, painful and disabling disease. It affects at 16-25% population, mainly middle-aged women. First line therapy includes painkillers and orthesis as well as intraarticular corticoids or hialuronic acid injections. Once these methods fails, orthopedics usually resort to surgery. The aim of this report is to revise the results obtained in an observational, descriptive and retrospective study in pacients suffering from thumb arthritis treated with an intraarticular corticoids injection between June and September 2015. The study was completed by 14 patients out of 17. They filled a survey with personal dates and we asked them to punctuate their pain and functional disability between 1 and 10 before the injection, 4-5 weeks and 6 months afterwards. The average age was 51,6 and we had 11 women and 3 men. We found 36% of cases with bilateral affection Four weeks after the injection, all patients got better excepting 4 patients who did not have disabling improvement and just 2 of them did not feel pain relief. Six months later, only 2 patients had had pain again and asked for a new injection. The others related to continue feeling well. Nowadays, corticoids intraarticular injection is used as a symtomathic temporal treatment, succeeding in a great number of cases
