Yukihiro Minegishi1, Sumito Inoue2, Kento Sato3, Koya Abe4, Hiroaki Murano5, Kodai Furuyama6, Sujeong Yang7, Hiroyoshi Machida8, Hiroshi Nakano9, Masamichi Sato10, Takako Nemoto11, Chisa Sato12, Michiko Nishiwaki13, Tomomi Kimura14, Keiko Yamauchi15, Akira Igarashi16, Yoshikane Tokairin17, Yoko Shibata18, Masafumi Watanabe19. 1. Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan. Electronic address: kogepamna@yahoo.co.jp. 2. Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan. Electronic address: sinoue@med.id.yamagata-u.ac.jp. 3. Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan. Electronic address: k-sato@med.id.yamagata-u.ac.jp. 4. Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan. Electronic address: abeko1111@med.id.yamagata-u.ac.jp. 5. Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan. Electronic address: hi-murano@med.id.yamagata-u.ac.jp. 6. Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan. Electronic address: koudai.f@blue.ocn.ne.jp. 7. Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan. Electronic address: yangsj@med.id.yamagata-u.ac.jp. 8. Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan. Electronic address: h-machida@med.id.yamagata-u.ac.jp. 9. Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan. Electronic address: h-nakano@med.id.yamagata-u.ac.jp. 10. Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan. Electronic address: m-satoh@med.id.yamagata-u.ac.jp. 11. Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan. Electronic address: n.takako@med.id.yamagata-u.ac.jp. 12. Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan. Electronic address: chisa@med.id.yamagata-u.ac.jp. 13. Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan. Electronic address: m-nishi@med.id.yamagata-u.ac.jp. 14. Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan. Electronic address: tomomi-i@med.id.yamagata-u.ac.jp. 15. Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan. Electronic address: kyamauchi@med.id.yamagata-u.ac.jp. 16. Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan. Electronic address: akigaras@med.id.yamagata-u.ac.jp. 17. Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan. Electronic address: ytoukair@med.id.yamagata-u.ac.jp. 18. Department of Pulmonary Medicine, Fukushima Medical University, 1 Hikarigaoka Fukushima City, Fukushima, 960-1295, Japan. Electronic address: shibatay@fmu.ac.jp. 19. Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan. Electronic address: m-watanabe@med.id.yamagata-u.ac.jp.
Abstract
BACKGROUND: Elderly patients who are hospitalized due to pneumonia experience deterioration of their activities of daily living (ADL) during this period; in some cases, this loss of ADL is not recovered at the end of antibiotic treatment. In this study, we examined whether erector spinae muscle cross-sectional area (ESMCSA) measured by computed tomography (CT) could predict a low level of ADL at the end of antibiotic treatment for pneumonia. METHODS: Eighty patients (mean age 74.8 years) with pneumonia, who were admitted to Yamagata university hospital between 2015 and 2016, were analyzed retrospectively. In all cases, chest CT was performed on admission and ESMCSA was measured at the level of the 12th thoracic vertebra. Patient levels of ADL were also measured, both on admission and at the end of treatment, using the Barthel Index. RESULTS: Patients with lower levels of ADL at the end of treatment were significantly older and tended to have a lower body mass index, poorer nutritional status, and more severe pneumonia than did patients who were self-reliant. Significantly smaller ESMCSAs were noted in patients who required assistance at the end of treatment than in those who were self-reliant. In multivariate logistic regression analysis, smaller ESMCSA was significantly associated with a lower level of ADL at the end of treatment, independent of age, sex, severity of pneumonia, nutritional status, or dehydration status. CONCLUSION: These results suggest that ESMCSA can predict ADL level after antibiotic treatment of pneumonia.
BACKGROUND: Elderly patients who are hospitalized due to pneumonia experience deterioration of their activities of daily living (ADL) during this period; in some cases, this loss of ADL is not recovered at the end of antibiotic treatment. In this study, we examined whether erector spinae muscle cross-sectional area (ESMCSA) measured by computed tomography (CT) could predict a low level of ADL at the end of antibiotic treatment for pneumonia. METHODS: Eighty patients (mean age 74.8 years) with pneumonia, who were admitted to Yamagata university hospital between 2015 and 2016, were analyzed retrospectively. In all cases, chest CT was performed on admission and ESMCSA was measured at the level of the 12th thoracic vertebra. Patient levels of ADL were also measured, both on admission and at the end of treatment, using the Barthel Index. RESULTS:Patients with lower levels of ADL at the end of treatment were significantly older and tended to have a lower body mass index, poorer nutritional status, and more severe pneumonia than did patients who were self-reliant. Significantly smaller ESMCSAs were noted in patients who required assistance at the end of treatment than in those who were self-reliant. In multivariate logistic regression analysis, smaller ESMCSA was significantly associated with a lower level of ADL at the end of treatment, independent of age, sex, severity of pneumonia, nutritional status, or dehydration status. CONCLUSION: These results suggest that ESMCSA can predict ADL level after antibiotic treatment of pneumonia.
Authors: Luise Roehrich; Simon H Sündermann; Isabell Anna Just; Laurenz Kopp Fernandes; Julia Stein; Natalia Solowjowa; Johanna Mulzer; Marcus Mueller; Manfred Hummel; Jan Knierim; Evgenij Potapov; Volkmar Falk; Felix Schoenrath Journal: ESC Heart Fail Date: 2022-01-06