Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2025 Feb;16(1):e13662.
doi: 10.1002/jcsm.13662. Epub 2024 Dec 17.

Acute Sarcopenia: Systematic Review and Meta-Analysis on Its Incidence and Muscle Parameter Shifts During Hospitalisation

Affiliations
Meta-Analysis

Acute Sarcopenia: Systematic Review and Meta-Analysis on Its Incidence and Muscle Parameter Shifts During Hospitalisation

Luke Aldrich et al. J Cachexia Sarcopenia Muscle. 2025 Feb.

Abstract

Background: Acute sarcopenia is sarcopenia lasting less than 6 months, typically following acute illness or injury. It may impact patient recovery and quality of life, advancing to chronic sarcopenia. However, its development and assessment remain poorly understood, particularly during hospitalisation. This systematic review aimed to elucidate the incidence of acute sarcopenia and examine changes in muscle parameters during hospitalisation.

Methods: Eighty-eight papers were included in the narrative synthesis; 33 provided data for meta-analyses on the effects of hospitalisation on handgrip strength (HGS), rectus femoris cross-sectional area (RFCSA) and various muscle function tests. Meta-regressions were performed for length of hospital stay (LoS) and age for all meta-analyses; sex was also considered for HGS.

Results: Acute sarcopenia development was assessed in four studies with a pooled incidence of 18% during hospitalisation. Incidence was highest among trauma patients in intensive care (59%), whereas it was lower among medical and surgical patients (15%-20%). Time of development ranged from 4 to 44 days. HGS remained stable during hospitalisation (SMD = 0.05, 95% CI = -0.18:0.28, p = 0.67) as did knee extensor strength. LoS affected HGS performance (θ = 0.04, 95% CI = 0.001:0.09, p = 0.045) but age (p = 0.903) and sex (p = 0.434) did not. RFCSA, reduced by 16.5% over 3-21 days (SMD = -0.67, 95% CI = -0.92:-0.43, p < 0.001); LoS or time between scans did significantly predict the reduction (θ = -0.04, 95% CI = -0.077:-0.011, p = 0.012). Indices of muscle quality also reduced. Muscle function improved when assessed by the short physical performance battery (SMD = 0.86, 95% CI = 0.03:1.69, p = 0.046); there was no change in 6-min walk (p = 0.22), timed up-and-go (p = 0.46) or gait speed tests (p = 0.98). The only significant predictor of timed up-and-go performance was age (θ = -0.11, 95% CI = -0.018:-0.005, p = 0.009).

Conclusions: Assessment and understanding of acute sarcopenia in clinical settings are limited. Incidence varies between clinical conditions, and muscle parameters are affected differently. HGS and muscle function tests may not be sensitive enough to identify acute changes during hospitalisation. Currently, muscle health deterioration may be underdiagnosed impacting recovery, quality of life and overall health following hospitalisation. Further evaluation is necessary to determine the suitability of existing diagnostic criteria of acute sarcopenia. Muscle mass and quality indices might need to become the primary determinants for muscle health assessment in hospitalised populations.

Keywords: atrophy; cachexia; disuse; wasting; weakness.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Flow diagram outlining the identification and screening process according to PRISMA [18] guidelines.
FIGURE 2
FIGURE 2
Meta‐analysis illustrating changes in HGS during hospitalisation (F = Female; M = Male; mal. = malnourished; non‐mal. = non‐malnourished).
FIGURE 3
FIGURE 3
Meta‐analysis illustrating changes in RFCSA during hospitalisation.
FIGURE 4
FIGURE 4
Meta‐analysis illustrating changes in muscle function during hospitalisation.

Similar articles

Cited by

References

    1. Cruz‐Jentoft A. J., Bahat G., Bauer J., et al., “Sarcopenia: Revised European Consensus on Definition and Diagnosis,” Age and Ageing 48 (2019): 16–31. - PMC - PubMed
    1. Kemp P. R., Paul R., Hinken A. C., Neil D., Russell A., and Griffiths M. J., “Metabolic Profiling Shows Pre‐Existing Mitochondrial Dysfunction Contributes to Muscle Loss in a Model of ICU‐Acquired Weakness,” Journal of Cachexia, Sarcopenia and Muscle 11 (2020): 1321–1335. - PMC - PubMed
    1. Dimopoulos S., Raidou V., Elaiopoulos D., et al., “Sonographic Muscle Mass Assessment in Patients After Cardiac Surgery,” World Journal of Cardiology. 12 (2020): 351–361. - PMC - PubMed
    1. Lee Z. Y., Ong S. P., Ng C. C., et al., “Association Between Ultrasound Quadriceps Muscle Status With Premorbid Functional Status and 60‐Day Mortality in Mechanically Ventilated Critically Ill Patient: A Single‐Center Prospective Observational Study,” Clinical Nutrition 40 (2021): 1338–1347. - PubMed
    1. Srikanthan P., Horwich T. B., and Tseng C. H., “Relation of Muscle Mass and Fat Mass to Cardiovascular Disease Mortality,” American Journal of Cardiology 117 (2016): 1355–1360. - PubMed

Grants and funding

LinkOut - more resources