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. 2021 Aug 25;13(9):2937.
doi: 10.3390/nu13092937.

Disease-Related Malnutrition and Sarcopenia Predict Worse Outcome in Medical Inpatients: A Cohort Study

María D Ballesteros-Pomar  1 , Luisa Mercedes Gajete-Martín  1 , Begoña Pintor-de-la-Maza  1 , Elena González-Arnáiz  1 , Lucía González-Roza  1 , María Pilar García-Pérez  1 , Verónica González-Alonso  2 , María Ascensión García-González  2 , Rocío de Prado-Espinosa  2 , María José Cuevas  3 , Esther Fernández-Perez  2 , José Luis Mostaza-Fernández  2 , Isidoro Cano-Rodríguez  1
Affiliations

Disease-Related Malnutrition and Sarcopenia Predict Worse Outcome in Medical Inpatients: A Cohort Study

María D Ballesteros-Pomar et al. Nutrients. .

Abstract

(1) Background: Both sarcopenia and disease-related malnutrition (DRM) are unfortunately underdiagnosed and undertreated in our Western hospitals, which could lead to worse clinical outcomes. Our objectives included to determine the impact of low muscle mass (MM) and strength, and also DRM and sarcopenia, on clinical outcomes (length of stay, death, readmissions at three months, and quality of life). (2) Methodology: Prospective cohort study in medical inpatients. On admission, MM and hand grip strength (HGS) were assessed. The Global Leadership Initiative on Malnutrition (GLIM) criteria were used to diagnose DRM and EWGSOP2 for sarcopenia. Assessment was repeated after one week and at discharge. Quality of life (EuroQoL-5D), length of stay (LoS), readmissions and mortality are reported. (3) Results: Two hundred medical inpatients, median 76.0 years-old and 68% with high comorbidity. 27.5% met GLIM criteria and 33% sarcopenia on admission, increasing to 38.1% and 52.3% on discharge. Both DRM and sarcopenia were associated with worse QoL. 6.5% died and 32% readmission in 3 months. The odds ratio (OR) of mortality for DRM was 4.36 and for sarcopenia 8.16. Readmissions were significantly associated with sarcopenia (OR = 2.25) but not with DRM. A higher HGS, but not MM, was related to better QoL, less readmissions (OR = 0.947) and lower mortality (OR = 0.848) after adjusting for age, sex, and comorbidity. (4) Conclusions: In medical inpatients, mostly polymorbid, both DRM but specially sarcopenia are associated with poorer quality of life, more readmissions, and higher mortality. Low HGS proved to be a stronger predictor of worse outcomes than MM.

Keywords: EWGSOP2; GLIM criteria; appendicular lean mass; disease-related malnutrition; hand grip strength; sarcopenia.

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Conflict of interest statement

MDBP has received speaker or consulting fees from Abbott Nutrition, Fresenius Kabi, Nestlé Healthcare, Nutricia, Vegenat and Novo Nordisk. The rest of the authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Selection of patients included in the study.
Figure 2
Figure 2
Screening and diagnosis of disease-related malnutrition and sarcopenia at admission. The phenotypic criterion in the GLIM consensus defined the severity of malnutrition, according to the cut-off points [1]. For sarcopenia diagnosed by EWGSOP2, low muscle function implies probable sarcopenia and low muscle mass confirmed sarcopenia [2]. MUST = malnutrition universal screening tool; a score > 2 indicates high risk of malnutrition. SARC-F = sarcopenia screening tool; a score > 4 indicates high risk of sarcopenia.
See this image and copyright information in PMC

References

    1. Cederholm T., Jensen G., Correia M., Gonzalez M.C., Fukushima R., Higashiguchi T., Baptista G., Barazzoni R., Blaauw R., Coats A., et al. GLIM criteria for the diagnosis of malnutrition—A consensus report from the global clinical nutrition community. Clin. Nutr. 2018;38:1–9. doi: 10.1016/j.clnu.2018.08.002. - DOI - PubMed
    1. Cruz-Jentoft A.J., Bahat G., Bauer J., Boirie Y., Bruyère O., Cederholm T., Cooper C., Landi F., Rolland Y., Sayer A.A., et al. Sarcopenia: Revised European consensus on definition and diagnosis. Age Ageing. 2018;48:16–31. doi: 10.1093/ageing/afy169. - DOI - PMC - PubMed
    1. Deutz N.E., Ashurst I., Ballesteros M.D., Bear D.E., Cruz-Jentoft A.J., Genton L., Landi F., Laviano A., Norman K., Prado C.M. The Underappreciated Role of Low Muscle Mass in the Management of Malnutrition. J. Am. Med. Dir. Assoc. 2019;20:22–27. doi: 10.1016/j.jamda.2018.11.021. - DOI - PubMed
    1. Landi F., Camprubi-Robles M., Bear D., Cederholm T., Malafarina V., Welch A., Cruz-Jentoft A. Muscle loss: The new malnutrition challenge in clinical practice. Clin. Nutr. 2018;38:2113–2120. doi: 10.1016/j.clnu.2018.11.021. - DOI - PubMed
    1. Caccialanza R., Cereda E., Klersy C., Bonardi C., Cappello S., Quarleri L., Turri A., Montagna E., Iacona I., Valentino F., et al. Phase Angle and Handgrip Strength Are Sensitive Early Markers of Energy Intake in Hypophagic, Non-Surgical Patients at Nutritional Risk, with Contraindications to Enteral Nutrition. Nutrients. 2015;7:1828–1840. doi: 10.3390/nu7031828. - DOI - PMC - PubMed