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Low thoracic skeletal mass index, a novel marker to predict recurrence of aspiration pneumonia in the elderly stroke patients.

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  • Author(s): Gil BM;Gil BM; Im S; Im S; Hong YJ; Hong YJ; Kang HS; Kang HS
  • Source:
    PloS one [PLoS One] 2024 Dec 12; Vol. 19 (12), pp. e0315427. Date of Electronic Publication: 2024 Dec 12 (Print Publication: 2024).
  • Publication Type:
    Journal Article
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
    • Publication Information:
      Original Publication: San Francisco, CA : Public Library of Science
    • Subject Terms:
      Pneumonia, Aspiration*/diagnostic imaging ; Stroke*/complications ; Stroke*/diagnostic imaging ; Recurrence*; Humans ; Male ; Female ; Aged ; Retrospective Studies ; Aged, 80 and over ; Tomography, X-Ray Computed ; Muscle, Skeletal/pathology ; Muscle, Skeletal/diagnostic imaging ; Deglutition Disorders/diagnosis ; Middle Aged
    • Abstract:
      Competing Interests: The authors have declared that no competing interests exist.
      Purpose: We investigated whether thoracic skeletal muscle mass index at the diagnosis of aspiration pneumonia (AP) is a predictor for AP recurrence and explored predicting factors for AP recurrence in patients with stroke.
      Patients and Methods: This study retrospectively reviewed data of patients with AP who were diagnosed with stroke and who had full medical follow-up data from January 2014 to July 2020 in the Catholic University of Korea Bucheon St. Mary's Hospital. AP was defined based on clinical signs and/or symptoms suggestive of pneumonia and radiologic findings of pneumonic infiltrations in the dependent portions of the lung. We measured thoracic muscle volume using the cross-sectional area (CSA) of the erector spinae muscle (ESMCSA, cm2) at the 12th vertebral region. Computed tomography scans at the time of AP diagnosis during the acute stroke period were used for analysis and respective CSAs were divided by height squared (m2) to yield the muscle index at T12 (T12MI, cm2/m2) to normalize for stature. Multivariate logistic regression models were used to investigate relationships between clinical parameters and AP recurrence.
      Results: During the study period, a total of 268 stroke patients with dysphagia who developed AP were analyzed. The mean T12MI of patients with and without recurrence of AP was 622.3±184.1 cm2/m2 and 708.1±229.9 cm2/m2, respectively (P = 0.001). Multivariate logistic regression revealed that lower T12MI (P = 0.038) and older age (P = 0.007) were independent predictors of AP recurrence in patients with stroke and dysphagia.
      Conclusion: Low thoracic muscle index at the diagnosis of initial AP after stroke can predict subsequence AP recurrence.
      (Copyright: © 2024 Gil et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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    • Publication Date:
      Date Created: 20241212 Date Completed: 20241212 Latest Revision: 20241214
    • Publication Date:
      20250114
    • Accession Number:
      PMC11637400
    • Accession Number:
      10.1371/journal.pone.0315427
    • Accession Number:
      39666645