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SARC-Calf using calf circumference adjusted for BMI predicts six-months readmission and mortality in hospitalized patients: a secondary analysis of a cohort study.

Sarcopenia is a prevalent condition associated with worse clinical outcomes in hospitalized patients. The SARC-Calf is an accurate instrument for its screening; however, it includes the calf circumference (CC) measure as a criterion, which is influenced by adiposity.

An adjustment for CC based on body mass index (BMI) has been proposed, but the literature lacks studies evaluating the SARC-Calf using adjusted CC. This study aimed to evaluate the prognostic value of the SARC-Calf with BMI-adjusted CC and compare it between adult and older hospitalized patients.

This is a secondary analysis of a cohort with prospective data collection, including individuals aged โ‰ฅ18 years, lucid and able to communicate. SARC-Calf was applied using BMI-adjusted CC, obtained by subtracting 3, 7, and 12 cm from CC values when BMI was 25-29.99, 30-39.99, and โ‰ฅ 40kg/m, respectively.

Outcomes of interest included prolonged hospital stay, in-hospital death, hospital readmission, and mortality six months after discharge. Logistic and Cox regression analyses, adjusted for Charlson comorbidity index and sex, were performed.

We analyzed data from 554 patients (mean age 55.2ยฑ14.9 years, 52.9% males). Suggestive signs of sarcopenia by SARC-Calf with BMI-adjusted CC were identified in 40.4% of patients (38.6% in adults and 42.7% in older patients, p=0.380).

Suggestive signs of sarcopenia were associated with hospital readmission in adults (OR=1.8; 95%CI 1.1, 2.9), and six-month death in both adult (OR= 4.0; 95% CI 1.3, 12.1) and older patients (OR=2.8; 95%CI 1.2, 6.6). It was not independently associated with in-hospital outcomes.

SARC-Calf with BMI-adjusted CC identified a high frequency of patients with suggestive signs of sarcopenia, regardless of age, and it was independently associated with worse outcomes six months after discharge. Suggestive signs of sarcopenia cannot be accurately identified by SARC-Calf in individuals with high BMI due to the influence of adiposity on calf circumference (CC) measurements.

In this secondary analysis, we explored the prognostic value of SARC-Calf with BMI-adjusted CC, aiming to correct the influence of adiposity on the CC measurement. We confirmed that this approach identifies a high number of patients with suggestive signs of sarcopenia and showed that it was independently related to worse outcomes six months after hospital discharge in both adults and older patients.

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