Correlation of Sarcopenia With Modified Frailty Index as a Predictor of Outcome in Critically Ill Elderly Patients: A Cross-Sectional Study

Abstract

Introduction: Frailty phenotype represents weight loss, decreased functional and physical capacity and activity, falls, slow gait, and memory impairment. Sarcopenia is a generalized and progressive loss of skeletal muscle mass, strength, and function, which occurs due to primary effects of aging and secondary effects of other causes including diseases, malnutrition, and inactivity.Materials and Methods: This prospective cross-sectional study was performed on 70 critically ill geriatric patients (of age > 60 years) admitted in Medicine ICU (MICU) from December 2020 to May 2021 at a rural medical school at Wardha in central rural India. We assessed sarcopenia in all the patients by the European Working Group on Sarcopenia in Older People (EWGSOP) criteria and compared it with the modified frailty index. All the patients were divided in sarcopenic and non-sarcopenic groups; frailty index was applied, and outcomes were measured in terms of mortality, the need for ventilation, and length of ICU stay.Results: In this study, the mean age of the patients was 68.61 ± 5.88 years in the sarcopenic group and 69.10 ± 6.31 years in the non-sarcopenic group. Eighteen (42.86%) patients in the sarcopenic group were severely frail, whereas eight (28.57%) patients in the non-sarcopenic group (p = 0.532) were not. In the sarcopenic severely frail group, mortality was six (14.29%), and eight (19.05%) required ventilation (p = 0.001), whereas in the non-sarcopenic severely frail group, mortality as well as the need for ventilation were four (14.29%) (p = 0.0001). Total duration of ICU stays was 4.30 ± 1.07 days in the sarcopenic group (n = 42), whereas it was 3.85 ± 1.23 days in the non-sarcopenic group (n = 28) (p = 0.10).Conclusion: Our study found that critically ill patients with sarcopenia had more tendency to become frail, thereby increased risk of mortality. A timely routine assessment for sarcopenia upon ICU admission may provide an important prognostic factor in patient outcomes.

Sarcopenia of Iliopsoas and Abdominal Muscles and Coexistence with Osteoporosis - Case Presentation

“…According to the literature, a patient with a score above 4 has a 42% risk of being sarcopenic [33][34][35]. The total score obtained by the patient was 9 points, which pleads for a definite diagnosis of sarcopenia [36,37].…”

“…This suggestion was adopted by EWGSOP [30]. In the case of the patient under investigation, the detected muscle strength was less than 20 kg, which represents the limit value that advocates for one diagnosis of sarcopenia [31][32][33].…”

Nutritional and Functional Status as a Predictor of Short-Term Mortality in Hospitalized Elderly Patients in a Tertiary Care Hospital

“…We are not sure if the observed prevalence of malnutrition from the study was a cause or a possible consequence of the observed decline in functional status and the three-month all-cause mortality outcomes at follow-up [ 17 ]. This study has not used other indexes that have been used previously in the elderly, such as the Modified Frailty Index [ 18 ]. However, taking into view the results of the current study, stating that both nutritional and functional status are clinically significant parameters to predict mortality outcomes in the elderly age group, there is a need of further exploration in future studies, especially while formulating for some interventional measures.…”

An epigenetic aging analysis of randomized metformin and weight loss interventions in overweight postmenopausal breast cancer survivors

“…One important consideration is the coexistence of sarcopenia in older overweight/obese cancer patients [ 13 ]. Having diminished lean mass compared to fat mass already places these individuals at risk for frailty/disability [ 14 ]. Interventions that focus on weight loss irrespective of the type could potentially lead to further decreases in muscle mass.…”