A simpler screening tool for sarcopenia in surgical patients

Abstract

Background Sarcopenia is defined as decreased skeletal muscle mass and muscle functions (strength and physical performance). Muscle mass is measured by specific methods, such as bioelectrical impedance analysis and dual-energy X-ray absorptiometry. However, the devices used for these methods are costly and are usually not portable. A simple tool to screen for sarcopenia without measuring muscle mass might be practical, especially in developing countries. The aim of this study was to design a simple screening tool and to validate its performance in screening for sarcopenia in older adult cancer patients scheduled for elective surgery. Methods Cancer surgical patients aged >60 years were enrolled. Their nutritional statuses were evaluated using the Mini Nutrition Assessment-Short Form. Sarcopenia was assessed using Asian Working Group for Sarcopenia (AWGS) criteria. Appendicular skeletal muscle mass was measured by bioelectrical impedance analysis. Four screening formulas with differing combinations of factors (muscle strength, physical performance, and nutritional status) were assessed. The validities of the formulas, compared with the AWGS definition, are presented as sensitivity, specificity, accuracy, and area under a receiver operating characteristic curve. Results Of 251 enrolled surgical patients, 84 (34%) were diagnosed with sarcopenia. Malnutrition (odds ratio [OR]: 2.89, 95% CI: 1.40–5.93); underweight status (OR: 2.80, 95% CI: 1.06–7.43); and age increments of 5 years (OR: 1.78, 95% CI: 1.41–2.24) were independent predictors of preoperative sarcopenia. The combination of low muscle strength and/or abnormal physical performance, plus malnutrition/risk of malnutrition had the highest sensitivity, specificity, and accuracy (81.0%, 78.4%, and 79.3%, respectively). This screening formula estimated the probability of sarcopenia with a positive predictive value of 65.4% and a negative predictive value of 89.1%. Conclusion Sarcopenia screening can be performed using a simple tool. The combination of low muscle strength and/or abnormal physical performance, plus malnutrition/risk of malnutrition, has the highest screening performance.

The association between sarcopenia, defined by a simplified screening tool, and long‐term outcomes

“…Probable sarcopenia was screened using the C3 formula 16 . Chaiwat et al 16 developed a simplified diagnostic tool for sarcopenia (Table S1).…”

“…Probable sarcopenia was screened using the C3 formula 16 . Chaiwat et al 16 developed a simplified diagnostic tool for sarcopenia (Table S1). The C3 formula evaluates the presence of low muscle strength and/or abnormal physical performance, coupled with malnutrition or the risk of malnutrition.…”

“…The data set in this study was from a previous study. 16 Descriptive statistics were used to summarize demographic and clinical factors. Mean values with SD or medians with interquartile range (IQR) were used for continuous variables, based on data distribution.…”

“…When validated against the AWGS consensus, this formula exhibited notable sensitivity, specificity, and predictive capability in diagnosing sarcopenia. 16 The objective of this research was to determine the association between sarcopenia, as defined by the simplified C3 formula screening tool, and long-term outcomes in older adult cancer patients after surgery.…”

“…Their “C3 formula” assessed the combination of low muscle strength and/or abnormal physical performance, plus malnutrition/risk of malnutrition. When validated against the AWGS consensus, this formula exhibited notable sensitivity, specificity, and predictive capability in diagnosing sarcopenia 16 …”