Implications of low muscle mass across the continuum of care: a narrative review

Abstract

Abnormalities in body composition can occur at any body weight. Low muscle mass is a predictor of poor morbidity and mortality and occurs in several populations. This narrative review provides an overview of the importance of low muscle mass on health outcomes for patients in inpatient, outpatient and long-term care clinical settings. A one-year glimpse at publications that showcases the rapidly growing research of body composition in clinical settings is included. Low muscle mass is associated with outcomes such as higher surgical and post-operative complications, longer length of hospital stay, lower physical function, poorer quality of life and shorter survival. As such, the potential clinical benefits of preventing and reversing this condition are likely to impact patient outcomes and resource utilization/health care costs. Clinically viable tools to measure body composition are needed for routine screening and intervention. Future research studies should elucidate the effectiveness of multimodal interventions to counteract low muscle mass for optimal patient outcomes across the healthcare continuum. Key messages Low muscle mass is associated with several negative outcomes across the healthcare continuum. Techniques to identify and counteract low muscle mass in clinical settings are needed.

Cancer‐Associated Malnutrition and CT‐Defined Sarcopenia and Myosteatosis Are Endemic in Overweight and Obese Patients

“…It is not known how to best screen for sarcopenia or myosteatosis in the oncology setting, and no tools have been developed specifically for use in cancer patient populations. 27 A single screening tool, the Strength, Assistance with walking, Rise from a chair, Climb stairs, and Falls (SARC-F), has been developed for use in community-dwelling elders, but it has not been validated against CT measures of muscle mass or for use in the oncology setting. 28 Additionally, myosteatosis can only be identified with CT, although other methods (ie, sonography) are being explored.…”

The Predictive Value of Low Muscle Mass as Measured on CT Scans for Postoperative Complications and Mortality in Gastric Cancer Patients: A Systematic Review and Meta-Analysis

“…However, some studies only used the area of the psoas muscle instead of the full musculature. The full cross-sectional muscle area at the third lumbar vertebra is known to be a better estimate of the total body musculature than the psoas muscle area alone [42]. This indicates that there is a need for a universal definition of low muscle mass for CT-based measurements, as heterogeneity in the applied definitions hampers comparability of the results obtained by published studies.…”

The Underappreciated Role of Low Muscle Mass in the Management of Malnutrition

“…However, more accurately, malnutrition leads to an altered body composition with reduced fat and fat-free body cell mass, leading to diminished physical and mental function and impaired clinical outcome from disease. 1 Specifically, low muscle mass is associated with several negative outcomes across health care settings 8 such as poor respiratory function in chronic obstructive pulmonary disease 9 and poor wound healing after surgery. 10 Furthermore, low muscle mass results in an increased risk of readmission, falls and fractures, longer hospital stays, disability, reduced functional capacity, loss of independence, and higher risk of mortality in hospitalized patients.…”

“…10 Furthermore, low muscle mass results in an increased risk of readmission, falls and fractures, longer hospital stays, disability, reduced functional capacity, loss of independence, and higher risk of mortality in hospitalized patients. 8,11 This suggests that loss of muscle mass is one of the most critical consequences of malnutrition. Additionally, certain measures of muscle function have been correlated with muscle mass and can be used to identify patients at nutritional risk and to monitor progress (Table 1).…”