Systematic review and meta-analysis of prevalence of sarcopenia in post acute inpatient rehabilitation

Abstract

Sarcopenia is associated with poor function and increased risk of falls and disability. This work reports a systematic review and meta-analysis of prevalence of sarcopenia in post acute inpatient rehabilitation. Sarcopenia is found to be present in approximately 50% of rehabilitation patients and its prevalence may vary with admission diagnosis.

Purpose: To conduct a systematic review and meta-analysis of reported prevalence of sarcopenia in post acute inpatient rehabilitation.

Methods: Systematic review conducted according to PRISMA guidelines (PROSPERO registration number CRD42016054135). Databases searched MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Methodology Register, and CINAHL. Studies considered the following: published January 1988-February 2017. Key terms are as follows: "sarcopenia" AND "inpatient rehabilitation" OR "rehabilitation" AND/OR "prevalence". Abstracts and subsequently full studies reporting sarcopenia prevalence in adults admitted to rehabilitation reviewed irrespective of design, provided sarcopenia diagnosis included at least assessment of muscle mass. Random effect meta-analysis was conducted. Methodological quality assessment: Agency for Healthcare Research and Quality, US Department of Health and Human Services tool (MORE tool); Joanna Briggs Institute Prevalence Critical Appraisal Tool.

Results: Four hundred twenty-six studies identified during initial search, 399 excluded after reviewing titles and abstracts, 21 full text articles reviewed, and six studies met inclusion criteria. Patient populations: after hip fracture (five studies), general deconditioning (one study). Identified sarcopenia prevalence ranged from 0.28 to 0.69. Pooled sarcopenia prevalence obtained with random effect meta-analysis: 0.56 (95% CI 0.46-0.65), heterogeneity I2 = 92.9%. Main quality shortcomings: lack of reporting of inter- and intra-rater reliability, lack of generalizability to other rehabilitation populations.

Conclusions: Original research examining sarcopenia prevalence in inpatient rehabilitation is scarce. Patient populations studied to date are not representative of general rehabilitation population with regard to both age and admission diagnoses. Sarcopenia may be present in approximately half of rehabilitation patients and its prevalence may vary with admission diagnosis.

Keywords: Inpatient rehabilitation; Rehabilitation; Sarcopenia; Subacute care.