TY - JOUR
T1 - Sarcopenia, Low Handgrip Strength, and Low Absolute Muscle Mass Predict Long-Term Mortality in Older Hospitalized Patients: An Observational Inception Cohort Study
T2 - An Observational Inception Cohort Study
AU - Scheerman, Kira
AU - Meskers, Carel G. M.
AU - Verlaan, Sjors
AU - Maier, Andrea B.
N1 - Funding Information: This work was supported by European Union’s Horizon 2020 research and innovation program under the Marie Skłodowska-Curie Grant Agreement No. 675003. Funding Information: This work was supported by European Union's Horizon 2020 research and innovation program under the Marie Sk?odowska-Curie Grant Agreement No. 675003. Publisher Copyright: © 2021 Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/4/1
Y1 - 2021/4/1
N2 - Objective: Sarcopenia is highly prevalent in hospitalized older patients and associated with short-term mortality. This study aimed to investigate whether sarcopenia and its measures handgrip strength (HGS) and muscle mass at hospital admission were associated with long-term mortality in a cohort of hospitalized older patients. Design: Observational, prospective, longitudinal inception cohort study. Setting and Participants: Academic teaching hospital; patients age ≥70 years admitted to the internal medicine, acute admission, trauma, or orthopedic wards. Methods: HGS and muscle mass were measured at admission using a hand dynamometer and bioelectrical impedance analysis. Sarcopenia was determined based on the European Working Group on Sarcopenia in Older People definition. HGS and muscle mass (skeletal muscle mass index, appendicular lean mass, relative skeletal muscle mass) were expressed as sex-specific tertiles. The associations of sarcopenia, HGS, and muscle mass with mortality (during a follow-up of 3.4-4.1 years) were analyzed using Cox regression, adjusted for age, sex, comorbidity, and weight or height. Associations of HGS and muscle mass were stratified by sex. Results: Out of 363 patients [mean age: 79.6 years (standard deviation: 6.4), 49.9% female] 49% died. Probable sarcopenia (prevalence of 53.7%) and sarcopenia (prevalence of 20.8%) were significantly associated with long-term mortality [hazard ratio (HR) 1.53, 95% confidence interval (CI) 1.08‒2.17 and 1.71 95% CI 1.12‒2.61, respectively]. Low HGS, skeletal muscle mass index, and appendicular lean mass were associated with a higher mortality risk (lowest tertile vs highest tertile: HR 2.660, 95% CI 1.40‒5.05; HR 1.95, 95% CI 1.06‒3.58 and HR 1.99 (95% CI 1.12‒3.53) in male patients. No statistically significant associations of relative muscle mass with mortality were found. Conclusions and Implications: Sarcopenia and its measures (low HGS and low absolute muscle mass at admission) predict long-term mortality in older hospitalized patients.
AB - Objective: Sarcopenia is highly prevalent in hospitalized older patients and associated with short-term mortality. This study aimed to investigate whether sarcopenia and its measures handgrip strength (HGS) and muscle mass at hospital admission were associated with long-term mortality in a cohort of hospitalized older patients. Design: Observational, prospective, longitudinal inception cohort study. Setting and Participants: Academic teaching hospital; patients age ≥70 years admitted to the internal medicine, acute admission, trauma, or orthopedic wards. Methods: HGS and muscle mass were measured at admission using a hand dynamometer and bioelectrical impedance analysis. Sarcopenia was determined based on the European Working Group on Sarcopenia in Older People definition. HGS and muscle mass (skeletal muscle mass index, appendicular lean mass, relative skeletal muscle mass) were expressed as sex-specific tertiles. The associations of sarcopenia, HGS, and muscle mass with mortality (during a follow-up of 3.4-4.1 years) were analyzed using Cox regression, adjusted for age, sex, comorbidity, and weight or height. Associations of HGS and muscle mass were stratified by sex. Results: Out of 363 patients [mean age: 79.6 years (standard deviation: 6.4), 49.9% female] 49% died. Probable sarcopenia (prevalence of 53.7%) and sarcopenia (prevalence of 20.8%) were significantly associated with long-term mortality [hazard ratio (HR) 1.53, 95% confidence interval (CI) 1.08‒2.17 and 1.71 95% CI 1.12‒2.61, respectively]. Low HGS, skeletal muscle mass index, and appendicular lean mass were associated with a higher mortality risk (lowest tertile vs highest tertile: HR 2.660, 95% CI 1.40‒5.05; HR 1.95, 95% CI 1.06‒3.58 and HR 1.99 (95% CI 1.12‒3.53) in male patients. No statistically significant associations of relative muscle mass with mortality were found. Conclusions and Implications: Sarcopenia and its measures (low HGS and low absolute muscle mass at admission) predict long-term mortality in older hospitalized patients.
KW - Aged
KW - hospitalization
KW - mortality
KW - muscle mass
KW - muscle strength
KW - sarcopenia
UR - http://www.scopus.com/inward/record.url?scp=85099986674&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jamda.2020.12.016
DO - https://doi.org/10.1016/j.jamda.2020.12.016
M3 - Article
C2 - 33453174
SN - 1525-8610
VL - 22
SP - 816-820.e2
JO - Journal of the American Medical Directors Association
JF - Journal of the American Medical Directors Association
IS - 4
ER -