BackgroundAcute sarcopenia is sarcopenia lasting less than 6 months, typically following acute illness or injury. It may impact patient recovery and quality of life, advancing to chronic sarcopenia. However, its development and assessment remain poorly understood, particularly during hospitalisation. This systematic review aimed to elucidate the incidence of acute sarcopenia and examine changes in muscle parameters during hospitalisation.MethodsEighty‐eight papers were included in the narrative synthesis; 33 provided data for meta‐analyses on the effects of hospitalisation on handgrip strength (HGS), rectus femoris cross‐sectional area (RFCSA) and various muscle function tests. Meta‐regressions were performed for length of hospital stay (LoS) and age for all meta‐analyses; sex was also considered for HGS.ResultsAcute sarcopenia development was assessed in four studies with a pooled incidence of 18% during hospitalisation. Incidence was highest among trauma patients in intensive care (59%), whereas it was lower among medical and surgical patients (15%–20%). Time of development ranged from 4 to 44 days. HGS remained stable during hospitalisation (SMD = 0.05, 95% CI = −0.18:0.28, p = 0.67) as did knee extensor strength. LoS affected HGS performance (θ = 0.04, 95% CI = 0.001:0.09, p = 0.045) but age (p = 0.903) and sex (p = 0.434) did not. RFCSA, reduced by 16.5% over 3–21 days (SMD = −0.67, 95% CI = −0.92:−0.43, p < 0.001); LoS or time between scans did significantly predict the reduction (θ = −0.04, 95% CI = −0.077:−0.011, p = 0.012). Indices of muscle quality also reduced. Muscle function improved when assessed by the short physical performance battery (SMD = 0.86, 95% CI = 0.03:1.69, p = 0.046); there was no change in 6‐min walk (p = 0.22), timed up‐and‐go (p = 0.46) or gait speed tests (p = 0.98). The only significant predictor of timed up‐and‐go performance was age (θ = −0.11, 95% CI = −0.018:−0.005, p = 0.009).ConclusionsAssessment and understanding of acute sarcopenia in clinical settings are limited. Incidence varies between clinical conditions, and muscle parameters are affected differently. HGS and muscle function tests may not be sensitive enough to identify acute changes during hospitalisation. Currently, muscle health deterioration may be underdiagnosed impacting recovery, quality of life and overall health following hospitalisation. Further evaluation is necessary to determine the suitability of existing diagnostic criteria of acute sarcopenia. Muscle mass and quality indices might need to become the primary determinants for muscle health assessment in hospitalised populations.

中文翻译：

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急性肌肉减少症：住院期间其发生率和肌肉参数变化的系统评价和荟萃分析


背景急性肌肉减少症是指持续时间少于 6 个月的肌肉减少症，通常发生在急性疾病或损伤之后。它可能会影响患者的康复和生活质量，发展为慢性肌肉减少症。然而，对其发展和评估仍然知之甚少，尤其是在住院期间。本系统评价旨在阐明急性肌肉减少症的发生率，并检查住院期间肌肉参数的变化。方法叙述综合包括 88 篇论文;33 项为住院对握力 （HGS）、股直肌横截面积 （RFCSA） 和各种肌肉功能测试影响的荟萃分析提供了数据。对所有 meta 分析的住院时间 （LoS） 和年龄进行 meta 回归;性也被考虑用于 HGS。结果在 4 项研究中评估了急性肌肉减少症的发展，住院期间的合并发生率为 18%。重症监护创伤患者的发病率最高 （59%），而内科和外科患者的发病率较低 （15%-20%）。显影时间从 4 到 44 天不等。HGS 在住院期间保持稳定 （SMD = 0.05,95% CI = -0.18：0.28，p = 0.67），膝伸肌力量也是如此。LoS 影响 HGS 性能 （θ = 0.04,95% CI = 0.001：0.09，p = 0.045），但年龄 （p = 0.903） 和性别 （p = 0.434） 没有。RFCSA，在 3-21 天内降低了 16.5%（SMD = -0.67,95% CI = -0.92：-0.43，p < 0.001）;LoS 或扫描间隔时间确实显着预测了减少 （θ = -0.04,95% CI = -0.077：-0.011，p = 0.012）。肌肉质量指数也有所降低。通过短期体能电池评估肌肉功能时，肌肉功能有所改善 （SMD = 0.86,95% CI = 0.03：1.69，p = 0.046）;6 分钟步行 （p = 0.22）、计时起跑 （p = 0.46） 或步态速度测试 （p = 0.98）。定时起跑表现的唯一重要预测因子是年龄 （θ = -0.11,95% CI = -0.018：-0.005，p = 0.009）。结论临床环境中急性肌肉减少症的评估和理解有限。发病率因临床情况而异，肌肉参数受到影响也不同。HGS 和肌肉功能检查可能不够敏感，无法识别住院期间的急性变化。目前，肌肉健康状况恶化可能被低估，影响住院后的恢复、生活质量和整体健康状况。有必要进一步评估以确定现有急性肌肉减少症诊断标准的适用性。肌肉质量和质量指标可能需要成为住院人群肌肉健康评估的主要决定因素。