Introduction Hospitalization is associated with acute changes in sarcopenia status in older people, but the influencing factors are not fully understood. Pre-admission care dependency level as a risk factor has not yet been investigated. Objective Evaluate if pre-admission care dependency level is an independent predictor of sarcopenia changes following hospitalization. Setting and subjects Data came from the Sarcopenia 9+ EAMA Project, a European prospective multi-centre study. For this study, 227 hospitalised older people were included from four different hospitals in Belgium, Spain and Poland, between 18 February 2019 and 5 September 2020. Methods Sarcopenia status at admission and discharge were calculated using a combined score (desirability value) based on muscle mass (calf circumference), strength (grip) and function (walking speed). Ratio of admission to discharge status was the outcome (desirability ratio; 1.00 meaning no difference). Predictor variable was the pre-admission care dependency level, classified into three groups: independent older people living at home, dependent older people living at home and older people living in a care home. Linear regression models were applied, considering potential confounders. Results Mean desirability ratio for dependent older people living at home (‘middle dependent group’) was lower (0.89) compared to independent older people (0.98; regression coefficient −0.09 [95% CI −0.16, −0.02]) and care home patients (1.05; −0.16 [95% CI −0.01, −0.31]). Adjusting for potential confounders or using another statistical approach did not affect the main results. Conclusion Dependent older people living at home were at higher risk of deterioration in sarcopenia status following hospitalization. In-depth studies investigating causes and potential interventions of these findings are needed.

中文翻译：

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住院后急性肌肉减少症的变化：入院前护理依赖水平的影响

引言 住院与老年人肌肉减少症状态的急剧变化有关，但其影响因素尚不完全清楚。入院前护理依赖程度作为风险因素尚未被调查。目的评估入院前护理依赖水平是否是住院后肌肉减少症变化的独立预测因子。设置和对象 数据来自欧洲前瞻性多中心研究 Sarcopenia 9+ EAMA 项目。在这项研究中，2019 年 2 月 18 日至 2020 年 9 月 5 日期间，来自比利时、西班牙和波兰的四家不同医院的 227 名住院老年人被纳入研究。方法使用基于肌肉的综合评分（期望值）计算入院和出院时的肌肉减少症状态质量（小腿围）、力量（抓地力）和功能（步行速度）。结果是入院与出院状态的比率（理想比率；1.00 表示无差异）。预测变量是入院前护理依赖水平，分为三组：住在家里的独立老年人、住在家里的依赖老年人和住在护理院的老年人。考虑到潜在的混杂因素，应用了线性回归模型。结果 与独立老年人 (0.98; 回归系数 -0.09 [95% CI -0.16, -0.02]) 和疗养院患者相比，居住在家里的受抚养老年人（“中间受抚养人组”）的平均期望比率较低（0.89） （1.05；-0.16 [95% CI -0.01, -0.31]）。调整潜在的混杂因素或使用其他统计方法不会影响主要结果。结论 居家生活的依赖老年人在住院后肌肉减少症恶化的风险较高。需要深入研究调查这些发现的原因和可能的干预措施。