Adductor pollicis muscle as predictor of malnutrition in surgical patients

Background - In the compromised nutritional status, there is excessive skeletal muscle loss and decreased inflammatory response, contributing to increased morbidity and mortality and length of stay. Aim: To estimate the prevalence of malnutrition by measuring adductor pollicis muscle using cutoffs for surgical patients suggested in the literature. Methods: Cross-sectional study with 151 patients scheduled for elective surgical procedure. Nutritional assessment was performed by classical anthropometric measurements: arm circumference, triceps skinfold thickness, arm muscle circumference, corrected arm muscle area, BMI and percentage of weight loss and the extent of the adductor pollicis muscle in both hands. Results: The prevalence of malnutrition in patients was high. A significant association between nutritional diagnosis according to the measures of adductor pollicis muscle and arm circumference, BMI and triceps skinfold thickness but there was no association with arm muscular circumference, arm muscular area or percentage of weight loss. Conclusion: The adductor pollicis muscle has proved to be a good method to diagnose muscle depletion and malnutrition in surgical patients.

背景：当患者处于营养状况受损状态时，会出现过度的骨骼肌丢失与炎症反应减弱，进而导致发病率、死亡率升高以及住院时长延长。研究目的：采用文献中推荐的外科患者截断值，通过测量拇收肌（adductor pollicis muscle）来评估营养不良的患病率。方法：本研究为横断面研究，纳入151名拟行择期手术的患者。通过经典人体测量学指标开展营养评估：包括上臂围、三头肌皮褶厚度、上臂肌围、校正上臂肌面积、体重指数（BMI）、体重丢失百分比，以及双侧拇收肌的径线。结果：本研究纳入患者的营养不良患病率较高。根据拇收肌测量值得出的营养诊断结果，与上臂围、BMI及三头肌皮褶厚度存在显著相关性，但与上臂肌围、上臂肌面积以及体重丢失百分比无显著关联。结论：研究证实，拇收肌测量可作为外科患者骨骼肌消耗与营养不良诊断的有效方法。