关键词: 肺移植, 手术前, 肌少症, 影响因素分析, 护理

Abstract:

Objective To investigate the prevalence and influencing factors of sarcopenia in lung transplant candidates，providing a basis for early identification of high-risk populations and the development of individualized intervention strategies. Methods A retrospective analysis was conducted on the clinical data of patients who completed lung transplant evaluation at a tertiary hospital in Zhejiang Province between January 2022 and December 2023. Skeletal muscle index was assessed at the level of the 12th thoracic vertebra using chest CT. Based on established cut off values，patients were categorized into sarcopenia and non-sarcopenia groups. Univariate analysis and logistic regression were employed to identify factors associated with sarcopenia in lung transplant candidates. Results A total of 268 eligible patients were included（with 289 cases collected and 21 excluded），and the prevalence of sarcopenia was 46.6%. Multivariate logistic regression analysis indicated that age >60 years （OR=7.324，95%CI：1.974~27.183，P=0.003），low body mass index（BMI；compared with underweight patients，ORs for normal，overweight，and obese patients were 0.021，0.035，and 0.046，respectively，all P<0.001），and a reduced percentage of predicted forced vital capacity（OR=0.964，95%CI：0.942~0.986，P=0.002） were significant factors influencing sarcopenia. Conclusion Sarcopenia is highly prevalent in lung transplant candidates，and its risk is influenced by multiple factors including age，nutritional status，and pulmonary function. Nursing staff should strengthen early identification and dynamic monitoring of high-risk patients and implement goal-oriented individualized interventions to optimize functional status during the waiting period and improve post-transplant outcomes.

Key words: Lung Transplantation, Preoperative, Sarcopenia, Root Cause Analysis, Nursing Care