Associations of Skeletal Muscle With Symptom Burden and Clinical Outcomes in Hospitalized Patients With Advanced Cancer
| Autor: | Florian J. Fintelmann, Christopher P. Bridge, Jennifer S. Temel, Areej El-Jawahri, J. Peter Marquardt, Eric Roeland, Till D. Best, Michael H. Rosenthal, Chinenye C. Azoba, Nora Horick, Emily E. Van Seventer, Amelie S. Troschel, Joseph A. Greer, Ryan D. Nipp, Richard Newcomb |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Sarcopenia medicine.medical_specialty Hospitalized patients Radiodensity 03 medical and health sciences Low muscle mass 0302 clinical medicine Neoplasms Internal medicine medicine Humans 030212 general & internal medicine Muscle Skeletal Aged business.industry Hazard ratio Symptom burden Skeletal muscle Odds ratio Middle Aged Advanced cancer Hospitalization medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Female business |
| Zdroj: | Journal of the National Comprehensive Cancer Network. 19:319-327 |
| ISSN: | 1540-1413 1540-1405 |
| Popis: | Background: Low muscle mass (quantity) is common in patients with advanced cancer, but little is known about muscle radiodensity (quality). We sought to describe the associations of muscle mass and radiodensity with symptom burden, healthcare use, and survival in hospitalized patients with advanced cancer. Methods: We prospectively enrolled hospitalized patients with advanced cancer from September 2014 through May 2016. Upon admission, patients reported their physical (Edmonton Symptom Assessment System [ESAS]) and psychological (Patient Health Questionnaire-4 [PHQ-4]) symptoms. We used CT scans performed per routine care within 45 days before enrollment to evaluate muscle mass and radiodensity. We used regression models to examine associations of muscle mass and radiodensity with patients’ symptom burden, healthcare use (hospital length of stay and readmissions), and survival. Results: Of 1,121 patients enrolled, 677 had evaluable muscle data on CT (mean age, 62.86 ± 12.95 years; 51.1% female). Older age and female sex were associated with lower muscle mass (age: B, –0.16; PPPP=.014), and higher BMI was associated with higher muscle mass (B, 0.58; PPPP=.016), ESAS-Total (B, –0.29; P=.002), PHQ-4-Depression (B, –0.03; P=.006), and PHQ-4-Anxiety (B, –0.03; P=.008) symptoms, as well as decreased hospital length of stay (B, –0.07; P=.005), risk of readmission or death in 90 days (odds ratio, 0.97; PPConclusions: Although muscle mass (quantity) only correlated with survival, we found that muscle radiodensity (quality) was associated with patients’ symptoms, healthcare use, and survival. These findings underscore the added importance of assessing muscle quality when seeking to address adverse muscle changes in oncology. |
| Databáze: | OpenAIRE |
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