Sarcopenia predicts readmission and mortality in elderly patients in acute care wards: a prospective study

Abstract

BackgroundThe aim of this study is to assess the prevalence of sarcopenia and investigate the associations between sarcopenia and long‐term mortality and readmission in a population of elderly inpatients in acute care wards.MethodsWe conducted a prospective observational study in the acute care wards of a teaching hospital in western China. The muscle mass was estimated according to a previously validated anthropometric equation. Handgrip strength was measured with a handheld dynamometer, and physical performance was measured via a 4 m walking test. Sarcopenia was defined according to the recommended diagnostic algorithm of the Asia Working Group for Sarcopenia. The survival status and readmission information were obtained via telephone interviews at 12, 24, and 36 months during the 3 year follow‐up period following the baseline investigation.ResultsTwo hundred and eighty‐eight participants (mean age: 81.1 ± 6.6 years) were included. Forty‐nine participants (17.0%) were identified as having sarcopenia. This condition was similar in men and women (16.9% vs. 17.5%, respectively, P = 0.915). During the 3 year follow‐up period, 49 men (22.7%) and 9 women (16.4%) died (P = 0.307). The mortality of sarcopenic participants was significantly increased compared with non‐sarcopenic participants (40.8% vs. 17.1%, respectively, P < 0.001). After adjusting for age, sex and other confounders, sarcopenia was an independent predictor of 3 year mortality (adjusted hazard ratio: 2.49; 95% confidential interval: 1.25–4.95) and readmission (adjusted hazard ratio: 1.81; 95% confidential interval: 1.17–2.80).ConclusionsSarcopenia, which is evaluated by a combination of anthropometric measures, gait speed, and handgrip strength, is valuable to predict hospital readmission and long‐term mortality in elderly patients in acute care wards.

Sarcopenia: Prevalence and Prognostic Implications in Elderly Patients with Cardiovascular Disease

“…A recent study demonstrated that sarcopenia evaluated by a combination of anthropometric measures, gait speed, and handgrip strength, is valuable for predicting hospital readmission and long-term mortality in elderly patients in acute care wards [4]. This study confirmed these findings in an elderly inpatient population with CVD.…”

“…These results were confirmed in a recent systematic review and meta-analysis [41]; they examined the prognostic influence of sarcopenia defined by the EWGSOP criteria in older people, in a meta-analysis including 12 cohort studies, and found a higher mortality rate among sarcopenic subjects (pooled odds ratio = 3.60; 95% CI = 2.96 -4.37) [41]. Although the prognostic value of sarcopenia is controversial in general Asian populations [10,42], it is robust in hospitalized elderly patients [4].…”

“…Therefore, DEXA and BIA were not appropriate for patients hospitalized in an acute care setting [4,14]. A recent study demonstrated that sarcopenia evaluated by a combination of anthropometric measures, gait speed, and handgrip strength, is valuable for predicting hospital readmission and long-term mortality in elderly patients in acute care wards [4].…”

“…Sarcopenia is becoming a major health issue with the aging of the world's population [1][2][3][4][5][6][7].…”

Skeletal muscle wasting in chronic heart failure

“…37 The effects of sarcopenia are not only restricted to the loss of skeletal muscle mass but are also associated with muscle dysfunction and impaired physical performance, which may be exacerbated by chronic diseases. 39 Therefore, patients are in dire needs for a specialized sarcopenia therapy. 39 Therefore, patients are in dire needs for a specialized sarcopenia therapy.…”