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dc.contributor.authorMartins, Ana Clara Guerreiropt_BR
dc.contributor.authorOliveira, Ana Claudia Tonelli dept_BR
dc.contributor.authorOrzechowski, Romanpt_BR
dc.contributor.authorDalla Corte, Roberta Rigopt_BR
dc.contributor.authorMoriguchi, Emílio Hideyukipt_BR
dc.contributor.authorMello, Renato Gorga Bandeira dept_BR
dc.date.accessioned2018-07-10T02:33:27Zpt_BR
dc.date.issued2017pt_BR
dc.identifier.issn2296-858Xpt_BR
dc.identifier.urihttp://hdl.handle.net/10183/180325pt_BR
dc.description.abstractObjective: To evaluate the capacity of total anterior thigh thickness, quadriceps muscle thickness, and quadriceps contractile index, all measured by bedside ultrasound, to predict rehospitalization, functional decline, and death in elderly patients 3 months after hospital discharge. To evaluate intra and interobserver reproducibility of the dominant thigh evaluation method by point of care ultrasound. Methods: Cohort study of patients aged 65 years or more admitted to a medium complexity unit in a teaching hospital in southern Brazil. Comprehensive geriatric assessment and ultrasound evaluation of the dominant thigh of each participant were performed. After 3 months of hospital discharge, telephone contact was made to evaluate the outcomes of rehospitalization or death and functional decline—assessed by the 100 points Barthel scale and defined as a decrease of five or more points. Results: 100 participants were included. There was no statistically significant difference between intraobserver measurements in the GEE method analysis (p > 0.05), and the mean bias obtained in Bland–Altman plots was close to zero in all four analyses performed, suggesting good intra and interobserver agreement. There was a significant correlation between the echographic measurements (quadriceps thickness and contractile index) and gait speed, timed up and go, and handgrip tests. There was a significant association between contractile index (quadriceps thickness over total anterior thigh thickness multiplied by 100) lower than 60% and functional decline (relative risk 1.35; CI 95% 1.10–1.65; p = 0.003) as well as between the thickness of the quadriceps and rehospitalization or death, in both individuals with preserved walking capacity and in bedridden elders (relative risk 1.34; CI 95% 1.02–1.75; p = 0.04). Conclusion: The ultrasonographic method to evaluate thigh thickness was easily applicable and reproducible. The thickness of the quadriceps could predict rehospitalization or death, even in those patients without walking capacity—unable to perform gait speed and timed up and go tests. Additionally, the contractile index was associated with functional decline after 3 months of hospital discharge. This is a promising result, which highlights the bedside ultrasound of the quadriceps as a potential tool for the prognosis evaluation of bedridden hospitalized elderly patients.en
dc.format.mimetypeapplication/pdfpt_BR
dc.language.isoengpt_BR
dc.relation.ispartofFrontiers in medicine. Lausanne. Vol. 4 (July 2017), 102, 8 p.pt_BR
dc.rightsOpen Accessen
dc.subjectHospitalizationen
dc.subjectHospitalizaçãopt_BR
dc.subjectUltrassonografiapt_BR
dc.subjectFunctional declineen
dc.subjectElderlyen
dc.subjectIdosopt_BR
dc.subjectEstudos de coortespt_BR
dc.subjectPoint of care ultrasounden
dc.subjectBrasilpt_BR
dc.subjectComprehensive geriatric assessmenten
dc.titleBedside ultrasound of quadriceps to predict rehospitalization and functional decline in hospitalized elderspt_BR
dc.typeArtigo de periódicopt_BR
dc.identifier.nrb001070886pt_BR
dc.type.originEstrangeiropt_BR


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