Prognostic value of preoperative sarcopenia in gastric cancer: A 10-year follow-up study
Hua‐Long ZhengLing-Hua WeiBin-Bin XuHong-Hong ZhengZhen XueQi‐Yue ChenJian‐Wei XieChao‐Hui ZhengChang‐Ming HuangJian‐Xian LinPing Li
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Background: Early detection and prevention of sarcopenia are essential for maintaining the functional health of older adults. There is a close association between sarcopenia and physical activity levels. Possible sarcopenia is a precursor to sarcopenia, which can accurately predict sarcopenia
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Sarcopenia is one of geriatric syndromes, characterized by decreased muscle mass accompanied by decreased muscle strength and/or performance. It is more prevalent with increase in age, and the prevalence depends on the criteria applied and the characteristic of the elderly. Sarcopenia has a higher risk of morbidity and mortality in elderly patients. The definition criteria of sarcopenia are still controversial, but diagnostic criteria from the Asian Working Group for Sarcopenia and the European Working Group on Sarcopenia in Older People (EWGSOP) are the most used criteria for clinical practice. Pathogenesis sarcopenia involved a multifactorial process and is divided into intrinsic and extrinsic factors. Risk factors for sarcopenia include constitutional factors, aging, lifestyle, changes in body condition, and chronic diseases. Based on that, sarcopenia is divided into primary and secondary sarcopenia. There are three stage of sarcopenia, which are pre-sarcopenia, sarcopenia, and severe sarcopenia. Nutrition and exercise are the two main pillars to manage sarcopenia.
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Sarcopenia is a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength. It is the major pathway leading to physical frailty, an important geriatric syndrome and an important problem in the elderly population. There are multiple factors leading to sarcopenia and frailty and for preventing them is important to determine the biochemical factors involved. We conducted a study on 143 elderly patients hospitalized during a nine months period. Demographic data were collected and biochemical parameters were determined. Sarcopenia was determined through muscle mass and muscle strength. The average age of the persons included in the study was 77.13 ± 6.30 years, without differences between gender distributions. To assess the relationship between the biochemical parameters and the presence of sarcopenia, the patients were divided into two groups: the group with sarcopenia and the group without sarcopenia. The analysis of the relationships between the presence of sarcopenia and the biochemical parameters determined within the study group, revealed that sarcopenia is correlated with blood glucose (p = 0.002, r = - 0.266), creatinine (p=0.010, r= -0.221) and also creatinine clearance (p=0.017, r=0.207). Biochemical determinations are important in determining sarcopenia and frailty and are of high importance before establishing any measure of treatment or prevention.
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Background: Early detection and prevention of sarcopenia arecritical. There is a close association between sarcopenia and physical activity levels. Possible sarcopenia is a precursor to sarcopenia, which can accurately predict sarcopenia. According to the tertiary prevention system, the diagnosis of possible sarcopenia has significant implications for the early detection of sarcopenia and the reduction of its prevalence.
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Background Although most people with relapsing onset multiple sclerosis (R-MS) eventually transition to secondary progressive multiple sclerosis (SPMS), little is known about disability progression in SPMS. Methods All R-MS patients in the Cardiff MS registry were included. Cox proportional hazards regression was used to examine a) hazard of converting to SPMS and b) hazard of attaining EDSS 6.0 and 8.0 in SPMS. Results 1611 R-MS patients were included. Older age at MS onset (hazard ratio [HR] 1.02, 95%CI 1.01–1.03), male sex (HR 1.71, 95%CI 1.41–2.08), and residual disability after onset (HR 1.38, 95%CI 1.11–1.71) were asso- ciated with increased hazard of SPMS. Male sex (EDSS 6.0 HR 1.41 [1.04–1.90], EDSS 8.0 HR 1.75 [1.14–2.69]) and higher EDSS at SPMS onset (EDSS 6.0 HR 1.31 [1.17–1.46]; EDSS 8.0 HR 1.38 [1.19–1.61]) were associated with increased hazard of reaching disability milestones, while older age at SPMS was associated with a lower hazard of progression (EDSS 6.0 HR 0.94 [0.92–0.96]; EDSS 8.0: HR 0.92 [0.90–0.95]). Conclusions Different factors are associated with hazard of SPMS compared to hazard of disability progres- sion after SPMS onset. These data may be used to plan services, and provide a baseline for comparison for future interventional studies and has relevance for new treatments for SPMS RobertsonNP@cardiff.ac.uk
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The hazard ratio and median survival time are the routine indicators in survival analysis. We briefly introduced the relationship between hazard ratio and median survival time and the role of proportional hazard assumption. We compared 110 pairs of hazard ratio and median survival time ratio in 58 articles and demonstrated the reasons for the difference by examples. The results showed that the hazard ratio estimated by the Cox regression model is unreasonable and not equivalent to median survival time ratio when the proportional hazard assumption is not met. Therefore, before performing the Cox regression model, the proportional hazard assumption should be tested first. If proportional hazard assumption is met, Cox regression model can be used; if proportional hazard assumption is not met, restricted mean survival times is suggested.风险比（hazard ratio，HR）和中位生存时间是生存分析时的常规分析和报告指标。本文简要介绍了HR和中位生存时间的关系以及比例风险假定在这两者之间的作用，分析了检索出的58篇文献中的110对风险比和中位生存时间比的差异，并通过实例阐明了产生这种差异的原因。结果表明，在不满足比例风险假定时，Cox回归模型计算得到的风险比是不合理的，且与中位生存时间之比不等价。因此，在使用Cox回归模型前，应先进行比例风险假定的检验，只有符合比例风险假定时才能使用该模型；当不符合比例风险假定时，建议使用限制性平均生存时间。.
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