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首页> 外文期刊>Journal of Cachexia, Sarcopenia and Muscle >Development and relative validity of a new field instrument for detection of geriatric cachexia: preliminary analysis in hip fracture patients
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Development and relative validity of a new field instrument for detection of geriatric cachexia: preliminary analysis in hip fracture patients

机译：一种新型的老年性恶病质检测现场仪器的开发和相对有效性：髋部骨折患者的初步分析

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BackgroundGeriatric cachexia is distinct from other age-related muscle wasting syndromes; however, detection and therefore treatment is challenging without the availability of valid instruments suitable for application in the clinical setting. This study assessed the sensitivity and specificity of a newly developed screening instrument utilising portable assessments against previously defined and commonly accepted diagnostic criteria for detection of geriatric cachexia.MethodsCross-sectional analyses from 71 older adults’ post-surgical fixation for hip fracture were performed. The diagnostic criteria required measures of appendicular skeletal muscle index derived from dual-energy X-ray absorptiometry and anorexia assessed by ≤70?% of estimated energy requirements. These assessments were replaced with mid-upper arm muscle circumference and the Simplified Nutritional Appetite Questionnaire, respectively, to create a field instrument suitable for screening geriatric cachexia. Sensitivity, specificity and positive and negative predictive values were calculated.ResultsThe current diagnostic algorithm identified few patients as cachectic (4/71; 5.6?%). The sensitivity and specificity of the geriatric cachexia screening tool was 75 and 97?%, respectively. The screening tool had a positive predictive value of 60?% and a negative predictive value of 99?%.ConclusionsGiven the unexpected prevalence of cachexia in such a vulnerable group, these results may suggest problems in operationalising of the consensus definition and diagnostic criteria. Although the application of a newly developed screening tool using portable field measures looks promising, the authors recommend additional research to identify the prevalence of geriatric cachexia, which captures all diagnostic criteria from the consensus definition. Future investigation may then be positioned to explore the predictive validity of screening tools using portable field measures, which potentially achieve higher sensitivity.
机译：背景老年恶病质不同于其他与年龄相关的肌肉萎缩综合征。然而，在没有适用于临床环境的有效仪器的情况下，检测以及因此的治疗具有挑战性。这项研究利用便携式评估方法，根据先前定义的和公认的诊断标准，评估了一种新开发的筛查仪器的敏感性和特异性，该标准用于检测老年恶病质。诊断标准要求采用双能X线骨密度仪和厌食症测得的阑尾骨骼肌指数，并以估计能量需求的≤70％进行评估。将这些评估分别替换为上臂中部肌肉围度和《简化营养食欲调查表》，以创建适合筛查老年恶病质的现场仪器。结果：目前的诊断算法几乎没有发现恶病质患者（4/71; 5.6％）。老年恶病质筛选工具的敏感性和特异性分别为75％和97％。筛查工具的阳性预测值为60％，阴性预测值为99％。结论鉴于这种弱势群体的恶病质发生率出乎意料，这些结果可能提示共识定义和诊断标准的操作存在问题。尽管使用便携式现场测量方法开发的新筛查工具的应用前景看好，但作者仍建议进行其他研究，以识别老年恶病质的患病率，该病将从共识定义中捕获所有诊断标准。然后，可以将未来的调查定位为使用便携式现场测量来探索筛选工具的预测有效性，这可能会实现更高的灵敏度。

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