Usefulness of an early sarcopenia screening in predicting short-term mortality in older patients discharged for acute heart failure .

Abstract

Abstract Purpose Sarcopenia is a potentially reversible syndrome is associated with an increased risk of cardiogenic cachexia and adverse outcomes in older patients with HF. Despite its significance, sarcopenia is often underdiagnosed due to the complexity of a thorough assessment in patients with acute heart failure. The purpose of this study was to evaluate whether early sarcopenia screening can predict the short-term prognostic risk in very old patients recently discharge for Acutely Decompensated Heart Failure (ADHF).Methods We consecutively enrolled patients aged 75 years or older hospitalized with acutely DHF in the Geriatrics Unit of a tertiary care hospital. All patients underwent physical examination, complete blood tests, point-of-care ultrasound, and a comprehensive geriatric assessment, including physical performance through SARC-F and Hand Grip Strength test (HGS). The thirty-day post-discharge mortality rate was assessed by phone interview.Results Out of 184 patients hospitalized with ADHF enrolled in the study (mean [SD], 86.8 [5.9] years, 60.3% female), 47 died within 30 days after discharge. By multivariate logistic analysis, HGS (β = -0.73 ± 0.03, p = 0.008) and SARC-F [adjusted OR = 1.18 (CI95% 1.03–1.33), p = 0.003] resulted independently associated with mortality. Furthermore, two SARC-F sub-items, namely, limitation in rising from a chair and history of falls [aOR: 3.26 (CI95% 1.27–8.34), p = 0.008; aOR: 3.30 (CI95% 1.28–8.49), p = 0.01; respectively] emerged as determinants of 30-days mortality.Conclusion An early sarcopenia assessment comprising SARC-F and HGS test independently predicts 30-day post-discharge mortality in oldest-old patients hospitalized for acute HF.