Smaller erector spinae muscle size is associated with inability to recover activities of daily living after pneumonia treatment

• Published in: Respiratory investigation 2019-03, Vol.57 (2), p.191-197
• Main Authors: Minegishi, Yukihiro, Inoue, Sumito, Sato, Kento, Abe, Koya, Murano, Hiroaki, Furuyama, Kodai, Yang, Sujeong, Machida, Hiroyoshi, Nakano, Hiroshi, Sato, Masamichi, Nemoto, Takako, Sato, Chisa, Nishiwaki, Michiko, Kimura, Tomomi, Yamauchi, Keiko, Igarashi, Akira, Tokairin, Yoshikane, Shibata, Yoko, Watanabe, Masafumi
• Format: Article
• Language: English
• Subjects: Activities of Daily Living; Age Factors; Aged; Aged, 80 and over; Anti-Bacterial Agents - administration & dosage; Back Muscles - diagnostic imaging; Back Muscles - pathology; Body Mass Index; Computed tomography; Erector spinae muscle; Female; Humans; Logistic Models; Male; Nutritional Status; Pneumonia; Pneumonia, Bacterial - diagnostic imaging; Pneumonia, Bacterial - drug therapy; Pneumonia, Bacterial - pathology; Pneumonia, Bacterial - rehabilitation; Retrospective Studies; Severity of Illness Index; Thoracic Vertebrae; Tomography, X-Ray Computed; Treatment
• ISSN: 2212-5345; 2212-5353
• DOI: 10.1016/j.resinv.2018.11.002

Elderly patients who are hospitalized due to pneumonia experience deterioration of their activities of daily living (ADL) during this period; in some cases, this loss of ADL is not recovered at the end of antibiotic treatment. In this study, we examined whether erector spinae muscle cross-sectional area (ESMCSA) measured by computed tomography (CT) could predict a low level of ADL at the end of antibiotic treatment for pneumonia. Eighty patients (mean age 74.8 years) with pneumonia, who were admitted to Yamagata university hospital between 2015 and 2016, were analyzed retrospectively. In all cases, chest CT was performed on admission and ESMCSA was measured at the level of the 12th thoracic vertebra. Patient levels of ADL were also measured, both on admission and at the end of treatment, using the Barthel Index. Patients with lower levels of ADL at the end of treatment were significantly older and tended to have a lower body mass index, poorer nutritional status, and more severe pneumonia than did patients who were self-reliant. Significantly smaller ESMCSAs were noted in patients who required assistance at the end of treatment than in those who were self-reliant. In multivariate logistic regression analysis, smaller ESMCSA was significantly associated with a lower level of ADL at the end of treatment, independent of age, sex, severity of pneumonia, nutritional status, or dehydration status. These results suggest that ESMCSA can predict ADL level after antibiotic treatment of pneumonia.