Bedside Assessment of Quadriceps Muscle by Ultrasound after Admission for Acute Exacerbations of Chronic Respiratory Disease

Greening, Neil; Harvey-Dunstan, Theresa; Chaplin, Emma; Vincent, Emma E.; Morgan, Mike; Singh, Sally; Steiner, Michael

doi:10.1164/rccm.201503-0535oc

Cited by 94 publications

(96 citation statements)

References 30 publications

(27 reference statements)

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“…Furthermore, among those with COPD, higher levels of systemic inflammation biomarkers are associated with poorer physical function, exacerbations, and death (46,(49)(50)(51). Sarcopenia and cachexia are more common in patients with COPD than in matched healthy control subjects and are independently associated with reduced exercise capacity, functional performance, health status, readmission following hospitalization for acute exacerbation, and mortality (17,46,(52)(53)(54). In addition, adults with COPD exhibit skeletal muscle dysfunction at the biochemical, cellular, and structural levels (13,(55)(56)(57).…”

Section: Frailty In Pulmonary Diseasementioning

confidence: 99%

Frailty in Pulmonary and Critical Care Medicine

Singer

Lederer²,

Baldwin

2016

Annals ATS

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Conceptualized first in the field of geriatrics, frailty is a syndrome characterized by a generalized vulnerability to stressors resulting from an accumulation of physiologic deficits across multiple interrelated systems. This accumulation of deficits results in poorer functional status and disability. Frailty is a "state of risk" for subsequent disproportionate declines in health status following new exposure to a physiologic stressor. Two predominant models have emerged to operationalize the measurement of frailty. The phenotype model defines frailty as a distinct clinical syndrome that includes conceptual domains such as strength, activity, wasting, and mobility. The cumulative deficit model defines frailty by enumerating the number of age-related things wrong with a person. The biological pathways driving frailty include chronic systemic inflammation, sarcopenia, and neuroendocrine dysregulation, among others. In adults with chronic lung disease, frailty is independently associated with more frequent exacerbations of lung disease, all-cause hospitalization, declines in functional status, and all-cause mortality. In addition, frail adults who become critically ill are more likely develop chronic critical illness or severe disability and have higher in-hospital and long-term mortality rates. The evaluation of frailty appears to provide important prognostic information above and beyond routinely collected measures in adults with chronic lung disease and the critically ill. The study of frailty in these populations, however, requires multipronged efforts aimed at refining clinical assessments, understanding the mechanisms, and developing therapeutic interventions.Keywords: frailty; body composition; disability; health-related quality of life; mortality Correspondence and requests for reprints should be addressed to Jonathan P. Singer, M.D., M.S.,

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Section: Frailty In Pulmonary Diseasementioning

confidence: 99%

Frailty in Pulmonary and Critical Care Medicine

Singer

Lederer²,

Baldwin

2016

Annals ATS

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“…This global measure of frailty shows the effects of COPD on the whole system. These two measures, and others recently described,78 show that identification of individuals at risk of hospital readmission or death following hospitalisation may be a realistic prospect, allowing for targeted intervention.…”

Section: Introductionmentioning

confidence: 80%

Review of the British Thoracic Society Winter Meeting 2015, 2–4 December, London, UK

José

Chalmers

Greening

et al. 2016

Thorax

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“…One recent study showed that patients admitted for COPD exacerbations with smaller quadriceps size are at increased risk for readmission and death. 31 …”

Section: How Can Bedside Ultrasonography Be Used For Screening and Rimentioning

confidence: 99%