Screening for sarcopenia and frailty in patients with chronic ulcers: a cross-sectional study

Abstract Background Patients with venous ulcers report multiple comorbidities and are more likely to be physically inactive. Sarcopenia and frailty increase vulnerability to dependence and/or death. Objectives To investigate the occurrence of sarcopenia and frailty in patients with chronic venous ulcers. Methods Observational study with cross-sectional design. Nine patients (67.4 ± 8.42 years) with lower limb venous ulcers classified as CEAP 6 according to International Consensus on Chronic Venous Diseases criteria (open and active ulcer) were evaluated. Sarcopenia was assessed and classified by assessment of strength (manual dynamometry), gait speed (10-meter walk test), and muscle mass (calf circumference). Frailty screening was based on the Fried criteria, consisting of five components: unintentional weight loss; exhaustion; weakness; slow gait speed; and low physical activity. Results Frailty was more frequent (n=9; 100%) than sarcopenia (n=1; 11,1%). The most common Fried criterion was exhaustion (n=9; 100%), followed by low physical activity (n=8; 88,8%), muscle weakness (n=5; 55%), and unintentional weight loss. Finally, the least frequent criterion was slow walking speed (n=2; 22.2%). In the subject diagnosed with sarcopenia, both weakness and reduced muscle mass were observed (n=1; 11,1%). Conclusions Patients with chronic venous ulcers exhibit frailty or pre-frailty and the components that comprise the condition of frailty in this population are exhaustion, low physical activity, and muscle weakness. Sarcopenia was identified in a small proportion of the patients.## 摘要 ### 背景 慢性静脉性溃疡患者多伴有多种基础疾病，且更易出现体力活动不足。肌肉减少症（sarcopenia）与衰弱症（frailty）会提升患者发生功能依赖乃至死亡的风险。 ### 研究目的 探讨慢性静脉性溃疡患者中肌肉减少症与衰弱症的发生情况。 ### 研究方法 本研究为横断面观察性研究。纳入9例符合《慢性静脉疾病国际共识》标准、CEAP分级为6级（活动性开放性溃疡）的下肢静脉性溃疡患者，年龄为67.4±8.42岁。通过肌力评估（手动握力测定法）、10米步行试验、小腿围测量分别评估患者肌力、步态速度与肌肉质量，以此对肌肉减少症进行评估与分级。衰弱症筛查采用Fried衰弱标准，包含5项核心指标：非刻意性体重下降、疲乏感、肌力减退、步态速度减慢及体力活动水平低下。 ### 研究结果 衰弱症的检出率（n=9；100%）高于肌肉减少症（n=1；11.1%）。最常见的Fried衰弱指标为疲乏感（n=9；100%），其次为体力活动不足（n=8；88.8%）、肌力减退（n=5；55.6%）与非刻意性体重下降。检出率最低的指标为步态速度减慢（n=2；22.2%）。仅1例患者（11.1%）被确诊为肌肉减少症，同时存在肌力减退与肌肉量降低。 ### 研究结论 慢性静脉性溃疡患者多存在衰弱症或衰弱前期，该人群衰弱症的核心构成要素为疲乏感、体力活动不足与肌力减退。仅少数患者被检出肌肉减少症。