Assessing Muscle Mass in the Orthopedic Clinical Setting: Application of the Ultrasound Sarcopenia Index in Elderly Subjects with a Recent Femoral Fracture

Abstract

Background: Sarcopenia poses a risk factor for falls, disability, mortality, and unfavorable postoperative outcomes. Recently, the Ultrasound Sarcopenia Index (USI) has been validated to assess muscle mass, and this study aimed to apply the USI in the clinical setting. Methods: This prospective observational study included 108 patients aged >65 years, hospitalized for proximal femoral traumatic fracture. Patients were divided into two groups based on anamnestic data: patients with independent walking (IW) and patients requiring walking aid (WA) before admission. All the participants received an ultrasound examination. Other parameters evaluated were handgrip strength, limb circumferences, nutrition (MNA), and activity of daily living (ADL) scores. Results: Fifty-six IW patients (83 ± 6 y; 38 females) and 52 WA patients (87 ± 7 y; 44 females) were recruited. The USI was significantly higher in the IW group compared to the WA group (p = 0.013, Cohen’s d = 0.489). Significant correlations were found between the USI and other sarcopenia-associated parameters, such as handgrip strength, MNA, ADLs, other muscle ultrasound parameters, and limb circumferences. Conclusion: The application of the USI in the orthopedic surgery setting is feasible and might support the diagnosis of sarcopenia when combined with other measures of strength and function.

New Perspectives for Low Muscle Mass Quantity/Quality Assessment in Probable Sarcopenic Older Adults: An Exploratory Analysis Study

“…The present study determined that the upper leg pennation angle muscle mass quality parameter assessed by ultrasound has a great diagnostic accuracy of sarcopenia only in men with probable sarcopenia and provided a possible cut-off point (10.11 • ) to confirm sarcopenia diagnosis. Additionally, the scientific evidence also proposed the ultrasound measurement of vastus lateralis as a useful measure to assess the aging effects on muscle, in particular, the ultrasound sarcopenia index, which is the ratio between the muscle thickness of the vastus lateralis and the fascicles length [24,25].…”

Prognostic Value of New Sarcopenia Screening Tool in the Elderly—SARC-GLOBAL

“…However, the proposed methods for sarcopenia diagnosis are onerous, which makes it unlikely to be reproduced in clinical practice and sarcopenia can be underdiagnosed, especially in places with low resources. Alternatives such as ultrasound have become scientific and can offer a viable diagnostic option due to their good association with other parameters related to sarcopenia, such as grip strength and skills [ 14 ]. This fact encourages the use of screening tools, such as the sarcopenia screening tool SARC-F and SARC-CalF questionnaires, however both tools have a low capacity to predict adverse outcomes that are consequences of sarcopenia in the elderly population [ 15 , 16 ].…”