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

摘要：

目的 探讨肺移植等候期患者肌少症的发生现状及影响因素，为临床早期识别高风险人群、制订个体化干预策略提供依据。 方法 回顾性分析2022年1月至2023年12月在浙江省某三级甲等综合医院完成肺移植评估的患者临床资料，利用胸部CT于胸椎第12节水平评估骨骼肌指数，依据界值标准分为肌少症组与非肌少症组。采用单因素分析、Logistic回归分析筛选肺移植等候期患者肌少症的影响因素。 结果 最初纳入肺移植等候期患者289例，脱落21例，最终纳入268例，其肌少症发生率为46.6%。多因素Logistic回归分析结果显示，年龄>60岁（OR=7.324，95%CI为1.974~27.183，P=0.003）、体重指数偏低（正常、超重、肥胖者相较于低体重者，OR分别为0.021、0.035、0.046，均P<0.001）及用力肺活量占预计值的百分比下降（OR=0.964，95%CI为0.942~0.986，P=0.002）是影响肌少症发生的因素。结论 肺移植等候期患者肌少症发生率较高，其风险受年龄、营养状况及肺功能多因素影响。护士应加强对高危人群的早期识别与动态监测，实施以目标为导向的个体化干预，以优化其等候期功能状态并改善移植预后。

关键词: 肺移植, 手术前, 肌少症, 影响因素分析, 护理