Yoshihiro Yoshimura1, Hidetaka Wakabayashi2, Fumihiko Nagano3, Takahiro Bise3, Sayuri Shimazu4, Ai Shiraishi3. 1. Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan. Electronic address: hanley.belfus@gmail.com. 2. Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Tokyo, Japan. 3. Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan. 4. Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan. Electronic address: shimazu@kumareha.jp.
Abstract
OBJECTIVE: The aim of our study was to evaluate the associations between baseline hemoglobin (Hb) levels and sarcopenia and outcomes in patients undergoing rehabilitation after stroke. METHODS: This retrospective cohort study included consecutive hospitalized post-stroke patients. Data on serum Hb level were extracted from medical records on tests performed within 24 h of admission. Primary outcome was the presence of sarcopenia at admission, diagnosed based on both low skeletal muscle mass and strength criteria per recently updated Asian Working Group for Sarcopenia 2019 guidelines. Other outcomes included the Functional Independence Measure-motor (FIM-motor) score at discharge and its change from baseline, and the Food Intake Level Scale (FILS) score (measure of dysphagia, FILS score < 7) at discharge. Multivariate analyses were used to determine the association between Hb levels at admission and outcomes of interest, adjusted for potential confounders. RESULTS: Data from 598 patients (mean age 72.1 years; 52.7% men) were included in the analysis. The mean Hb level at admission was 13.2 g/dL, and 86 (27.3%) men and 102 (36.0%) women had low Hb levels, i.e., 13.0 g/dL and 12.0 g/dL, respectively. In multivariate analyses, the baseline Hb level was independently associated with sarcopenia (odds ratio [OR]: 0.794, 95% confidence interval [CI]: 0.677-0.930, p = 0.004), FIM-motor score (β = 0.096, p = 0.045) at discharge and its change from baseline (β = 0.191, p = 0.018), and dysphagia (OR: 0.762, 95% CI: 0.595-0.961, p = 0.041) at discharge. CONCLUSION: Baseline low Hb levels were associated with sarcopenia, poorer recovery of physical function, and dysphagia in patients undergoing rehabilitation after stroke.
OBJECTIVE: The aim of our study was to evaluate the associations between baseline hemoglobin (Hb) levels and sarcopenia and outcomes in patients undergoing rehabilitation after stroke. METHODS: This retrospective cohort study included consecutive hospitalized post-strokepatients. Data on serum Hb level were extracted from medical records on tests performed within 24 h of admission. Primary outcome was the presence of sarcopenia at admission, diagnosed based on both low skeletal muscle mass and strength criteria per recently updated Asian Working Group for Sarcopenia 2019 guidelines. Other outcomes included the Functional Independence Measure-motor (FIM-motor) score at discharge and its change from baseline, and the Food Intake Level Scale (FILS) score (measure of dysphagia, FILS score < 7) at discharge. Multivariate analyses were used to determine the association between Hb levels at admission and outcomes of interest, adjusted for potential confounders. RESULTS: Data from 598 patients (mean age 72.1 years; 52.7% men) were included in the analysis. The mean Hb level at admission was 13.2 g/dL, and 86 (27.3%) men and 102 (36.0%) women had low Hb levels, i.e., 13.0 g/dL and 12.0 g/dL, respectively. In multivariate analyses, the baseline Hb level was independently associated with sarcopenia (odds ratio [OR]: 0.794, 95% confidence interval [CI]: 0.677-0.930, p = 0.004), FIM-motor score (β = 0.096, p = 0.045) at discharge and its change from baseline (β = 0.191, p = 0.018), and dysphagia (OR: 0.762, 95% CI: 0.595-0.961, p = 0.041) at discharge. CONCLUSION: Baseline low Hb levels were associated with sarcopenia, poorer recovery of physical function, and dysphagia in patients undergoing rehabilitation after stroke.