BACKGROUND Pre-stroke sarcopenia associated with poor functional outcomes. However, diagnosis of pre-stroke sarcopenia is often difficult in patients with acute stroke. Thus, we investigated the reliability and validity of measuring temporal muscle thickness (TMT) as an indicator of sarcopenia risk and its relationship with functional outcome in older patients with acute stroke. METHODS We conducted a cross-sectional and longitudinal study of the patients with acute elderly stroke in a single neurosurgical hospital. We measured TMT manually using brain computed tomography (CT) by two examiners. Sarcopenia risk, malnutrition risk, inflammation, comorbidities, and modified Rankin Scale (mRS) scores at 3 months after stroke were additionally assessed. Inter-rater reliability of TMT was determined by calculating the intra-class correlation coefficient ([ICC] 2,1). Multiple linear regression analyses was used to determine whether sarcopenia risk was independently associated with TMT, and logistic regression was used to evaluate the relationship between TMT and poor functional outcome (mRS > 3). RESULTS A total 289 acute elderly stroke patients (163 men and 126 women; mean age: 76 years) were enrolled in this study. Regarding the reproducibility of TMT, good reliability was found; ICC2,1 = 0.759 (95 % confidence interval = 0.705-0.804). Multiple linear regression analyses for TMT after adjusting for potential confounders showed that sarcopenia risk was independently associated with TMT in older patients with acute stroke (β = -0.138, p = 0.02). After adjusting for variables, disease severity and comorbidities were the only independent predictors for poor functional outcome, but not TMT. CONCLUSIONS TMT measurement using brain CT is a reliable and variable method to evaluate sarcopenia risk, but is not related to functional outcome in older patients with acute stroke.

中文翻译：

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测量颞肌厚度作为评估老年急性卒中患者肌肉减少症风险及其与功能结果关系的信度和效度

背景 卒中前肌肉减少症与不良的功能结果相关。然而，急性卒中患者的卒中前肌肉减少症的诊断通常很困难。因此，我们研究了测量颞肌厚度 (TMT) 作为肌肉减少症风险指标的可靠性和有效性及其与老年急性卒中患者功能结果的关系。方法 我们对一家神经外科医院的急性老年卒中患者进行了横断面和纵向研究。我们由两名检查员使用脑计算机断层扫描 (CT) 手动测量 TMT。此外还评估了卒中后 3 个月的肌肉减少症风险、营养不良风险、炎症、合并症和改良 Rankin 量表 (mRS) 评分。TMT 的评分者间可靠性通过计算类内相关系数 ([ICC] 2,1) 来确定。多元线性回归分析用于确定肌肉减少症风险是否与 TMT 独立相关，逻辑回归用于评估 TMT 与不良功能结果（mRS > 3）之间的关系。结果 共有 289 名急性老年卒中患者（163 名男性和 126 名女性；平均年龄：76 岁）参加了这项研究。关于TMT的再现性，发现了良好的可靠性；ICC2,1 = 0.759（95% 置信区间 = 0.705-0.804）。调整潜在混杂因素后对 TMT 的多元线性回归分析显示，在老年急性卒中患者中，肌肉减少症风险与 TMT 独立相关（β = -0.138，p = 0.02）。调整变量后，疾病严重程度和合并症是功能预后不良的唯一独立预测因素，但不是 TMT。结论 使用脑 CT 进行 TMT 测量是评估肌肉减少症风险的可靠且可变的方法，但与老年急性卒中患者的功能结果无关。