Comparison of SARC-F Score among Gastrointestinal Diseases

Abstract

SARC-F is a screening tool for sarcopenia. We sought to compare the SARC-F scores of patients with different gastrointestinal diseases (n = 1282 (762 males): upper gastrointestinal disease (UGD, n = 326), lower gastrointestinal disease (LGD, n = 357), biliary and pancreatic disease (BPD, n = 416), and liver disease (LD, n = 183)). Factors associated with SARC-F ≥4 points (highly suspicious of sarcopenia) were also examined. The median age was 71 years. Patients with SARC-F ≥4 points were found in 197 (15.4%). Advanced cancer was found in 339 patients (26.4%). The proportion of SARC-F ≥4 points in groups of UGD, LGD, BPD, and LD were 17.5% (57/326) in UGD, 12.0% (43/357) in LGD, 17.3% (72/416) in BPD, and 13.7% (25/183) in LD, respectively (overall p = 0.1235). In patients with and without advanced cancer, similar tendencies were observed. In the multivariate analysis, age (p < 0.0001), gender (p = 0.0011), serum albumin (p < 0.0001), lymphocyte count (p = 0.0019), C reactive protein (p = 0.0197), and the presence of advanced cancer (p = 0.0424) were significant factors linked to SARC-F ≥4 points. In patients with advanced cancer, SARC-F scores correlated well with their Glasgow prognostic scores. In conclusion, sarcopenia in gastrointestinal diseases may be affected not by disease type (i.e., the primary origin of the disease) but by aging, nutritional condition, inflammatory condition, and cancer burden.

Screening Tools for Sarcopenia

“…The SARC-F is also closely correlated with lower limb muscle weakness in acute stroke patients (62). In our study of 1,282 patients with gastrointestinal diseases using the SARC-F, the percentage of patients with SARC-F score of 4 or higher was 17.5% (57/326) in upper gastrointestinal diseases, 12.0% (43/357) in lower gastrointestinal diseases, 17.3% (72/416) in biliary and pancreatic diseases, and 13.7% (25/183) in liver diseases, and there was no significant difference among the four groups (p=0.1235) (63). In our multivariate analysis of SARC-F 4 or higher, age, gender, albumin level, lymphocyte count, C reactive protein, and presence of advanced cancer were independent factors (63).…”

SARC-F Is a Predictor of Longer LOS and Hospital Readmission in Hospitalized Patients after a Cardiovascular Event

“…SARC-F was developed based on the elderly population, and its applications in other populations may not be appropriate. However, in recent years, studies using SARC-F as screening of sarcopenia in different populations have been published, such as orthopedic [ 16 ], cancer [ 30 , 31 ], gastrointestinal [ 32 ] and type 2 diabetes patients [ 33 ], regardless of age or hospitalization status. Kurita et al [ 30 ] examined the accuracy of SARC-F ≥ 4 in orthopedic patients and reported a sensitivity and specificity of 41.7% and 68.5%, respectively, indicating that the specificity was comparable to that of the SARC-F ≥ 4 for community-dwelling older adults.…”

“…In this context, Barbosa-Silva et al [ 34 ] proposed a modified version of the SARC-F, including an anthropometric measurement as a marker of muscle mass (CC) with the aim of improving the performance of the original for screening (SARC-CalF score). Some studies have already shown that both versions have acceptable agreement for screening sarcopenia in different populations [ 18 , 32 , 35 ].…”

Review article: Putting some muscle into sarcopenia—the pathogenesis, assessment and clinical impact of muscle loss in patients with inflammatory bowel disease

“…Finally, the SARC‐F is a validated patient‐reported questionnaire to assess physical function and possible sarcopenia; this tool has 5 questions about physical function including a history of falls as well as difficulty walking, rising from a chair and carrying 10 pounds. Ushiro et al 71 evaluated the SARC‐F across gastrointestinal diseases and concluded that those at greatest risk of sarcopenia as predicted by this tool were older patients with lower serum albumin and an elevated lymphocyte count as well as C‐reactive protein, perhaps serving as a surrogate for active inflammation. There are no studies validating the use of this patient‐reported screening tool, however, future studies may further elucidate its role in sarcopenia evaluation.…”