Triagem da sarcopenia e fragilidade em pacientes com úlceras venosas crônicas: um estudo transversal

Gomes, Tamiris Carolini; Trombini, Kelly Cristina Blaszkowski; Martins, Marcos Vinícius Soares; Martins, Hilana Rickli Fiuza

doi:10.1590/1677-5449.190054

Cited by 5 publications

(2 citation statements)

References 21 publications

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“…A quick frailty assessment using a wearable device can provide a practical digital biomarker, which may serve as a surrogate for these clinical outcomes. Moreover, a higher level of exhaustion may indirectly indicate a higher risk of complications, 49 including malnutrition and lower-extremity skin perfusion and tissue oxygenation levels. Therefore, patients identified with exhaustion phenotype may take a different health trajectory (i.e., longer healing duration, higher chances for recurrent wound) than individuals with similar conditions without exhaustion.…”

Section: Discussionmentioning

confidence: 99%

The Application of Digital Frailty Screening to Triage Nonhealing and Complex Wounds

Mishra

Bara

Zulbaran-Rojas

et al. 2022

J Diabetes Sci Technol

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Objective: We investigated the association between the complexity of diabetic foot ulcers (DFUs) and frailty. Research Design and Methods: Individuals (n = 38) with Grade 2 Wagner DFU were classified into 3 groups based on the Society for Vascular Surgery risk-stratification for major limb amputation as Stage 1 at very low risk (n = 19), Stage 2 at low risk (n = 9), and Stage 3 to 4 at moderate-to-high risk (n = 10) of major limb amputation. Frailty status was objectively assessed using a validated digital frailty meter (FM). The FM works by quantifying weakness, slowness, rigidity, and exhaustion over a 20-second repetitive elbow flexion-extension exercise using a wrist-worn sensor. FM generates a frailty index (FI) ranging from 0 to 1; higher values indicate progressively greater severity of frailty. Skin perfusion pressure (SPP), albumin, and tissue oxygenation level (SatO2) were also measured. One-way analysis of variance (ANOVA) was used to identify group effect for wound complexity. Pearson’s correlation coefficient was used to assess the associations with frailty and clinical endpoints. Results: Frailty index was higher in Stage 3 and 4 as compared to Stage 1 ( d = 1.4, P < .01) and Stage 2 ( d = 1.2, P < .01). Among assessed frailty phenotypes, exhaustion was correlated with SPP ( r = −0.63, P < .01) and albumin ( r = −0.5, P < .01). Conclusion: Digital biomarkers of frailty may predict complexity of DFU and thus triage individuals who can be treated more simply in their primary clinic versus higher risk patients who require prompt referral to multidisciplinary, more complex care.

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Section: Discussionmentioning

confidence: 99%

The Application of Digital Frailty Screening to Triage Nonhealing and Complex Wounds

Mishra

Bara

Zulbaran-Rojas

et al. 2022

J Diabetes Sci Technol

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“…The presence of frailty has been studied in nine venous leg ulcer patients, of which 100% scored ‘frail’ according to the five Fried criteria (see Appendix S3 ). 12 , 33 In 50 diabetic foot ulcer patients, 64% had moderate to severe frailty on the Edmonton Frail Scale. 34 , 35 Additional observational studies are needed to prove more accurately frailty prevalence and burden of disease in leg ulcer patients.…”

Section: Discussionmentioning

confidence: 99%

A prospective, multicentre study to assess frailty in elderly patients with leg ulcers (GERAS study)

Zorge

Scheerders

Dudink

et al. 2022

Acad Dermatol Venereol

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Background: Although leg ulcers are a burdensome disease most common in those aged 65 years and older, frailty in this population has not yet been well established. Objectives:The aim of this study was to prospectively explore and compare the presence of frailty in elderly patients with chronic leg or foot ulcers by applying different validated frailty screening methods in three healthcare settings and to assess the feasibility of frailty screening. Methods:We compared frailty of leg ulcer patients referred to an academic hospital with a non-academic hospital, leg ulcer patients receiving (primary) homecare, and a dermato-oncology patient population (control group). Frailty and quality of life were assessed using four validated questionnaires: the Groninger Frailty Indicator, Geriatric-8, Mini-Cog and Wound Quality of Life. To analyse data multiple (non)parametric tests were performed.Results: Fifty of 60 included leg ulcer patients (83%) scored "frail" on at least one frailty questionnaire (GFI, G8 or Mini-Cog). The number of patients scoring "frail" on two or three out of three applied frailty questionnaires were significantly higher in the academic and homecare ulcer population compared with the non-academic ulcer population and control group (p = 0.002). In the academic ulcer population mean Wound Quality of Life scores were 30.2 (SD 17.6), compared with 17.7 (SD 13.1) in the non-academic and 15.0 (SD 10.4) in the homecare ulcer population (p = 0.002). Conclusion:The majority of patients suffering from leg ulcers in this study was frail.The highest frailty prevalence was observed in the academic and homecare ulcer populations. The largest impaired quality of life was reported in the academic ulcer population. In dermatology practice, implementing frailty screening and initiating appropriate (paramedical) supportive care should be considered to improve patient outcomes.

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Efeitos do fortalecimento muscular do tríceps sural na função da bomba venosa na insuficiência venosa crônica

Schmidt

Gomes²,

Martins

et al. 2021

J. vasc. bras.

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Resumo Contexto A insuficiência venosa crônica (IVC) é uma doença comum, uma disfunção da bomba muscular da panturrilha que repercute na hemodinâmica das estruturas. Objetivos Analisar os efeitos dos exercícios de fortalecimento muscular da panturrilha na hemodinâmica venosa em pacientes com IVC. Métodos O estudo contou com a participação de 13 pacientes e 25 membros inferiores com IVC, classificados entre C1 e C5 da classificação Clínica, Etiologia, Anatomia e Fisiopatologia (CEAP), oriundos do ambulatório de cirurgia vascular do Hospital Universitário Regional dos Campos Gerais. As variáveis analisadas foram dinamometria isométrica, goniometria, perimetria, adipometria no início, primeiro mês, segundo mês e final da aplicação do protocolo de exercícios. Resultados Os valores da dorsiflexão e da plantiflexão aumentaram 5º (p < 0,001). Na adipometria notou-se uma redução de 5 mm (p < 0,001). Quando separados em grupos pela CEAP, na C2 houve aumento de 5º na dorsiflexão (p = 0,02) e na plantiflexão (p < 0,001); na C3 houve aumento de 5º na dorsiflexão (p = 0,003) e redução de 1 mm na adipometria (p < 0,004); na C1 houve aumento da perimetria de 1,2 cm (p = 0,04). Conclusões A aplicação de protocolos de exercícios deveria ser considerada como uma forma de tratamento para IVC, pois impacta positivamente em fatores de risco e nas funções que estão deterioradas pela patologia.

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Triagem da sarcopenia e fragilidade em pacientes com úlceras venosas crônicas: um estudo transversal

Cited by 5 publications

References 21 publications

The Application of Digital Frailty Screening to Triage Nonhealing and Complex Wounds

The Application of Digital Frailty Screening to Triage Nonhealing and Complex Wounds

A prospective, multicentre study to assess frailty in elderly patients with leg ulcers (GERAS study)

Efeitos do fortalecimento muscular do tríceps sural na função da bomba venosa na insuficiência venosa crônica

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