Frailty and Sarcopenia Assessment upon Hospital Admission to Internal Medicine Predicts Length of Hospital Stay and Re-Admission: A Prospective Study of 980 Patients
Background: Frailty and sarcopenia are associated with frequent hospitalizations and poor clinical outcomes in geriatric patients. Ascertaining this association for younger patients hospitalized in internal medicine departments could help better prognosticate patients in the realm of internal medici...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-08-01
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| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/9/8/2659 |
| _version_ | 1797557605052186624 |
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| author | Sapir Anani Gal Goldhaber Adi Brom Nir Lasman Natia Turpashvili Gilat Shenhav-saltzman Chen Avaky Liat Negru Muhamad Agbaria Sigalit Ariam Doron Portal Yishay Wasserstrum Gad Segal |
| author_facet | Sapir Anani Gal Goldhaber Adi Brom Nir Lasman Natia Turpashvili Gilat Shenhav-saltzman Chen Avaky Liat Negru Muhamad Agbaria Sigalit Ariam Doron Portal Yishay Wasserstrum Gad Segal |
| author_sort | Sapir Anani |
| collection | DOAJ |
| description | Background: Frailty and sarcopenia are associated with frequent hospitalizations and poor clinical outcomes in geriatric patients. Ascertaining this association for younger patients hospitalized in internal medicine departments could help better prognosticate patients in the realm of internal medicine. Methods: During a 1-year prospective study in an internal medicine department, we evaluated patients upon admission for sarcopenia and frailty. We used the FRAIL questionnaire, blood alanine-amino transferase (ALT) activity, and mid-arm muscle circumference (MAMC) measurements. Results: We recruited 980 consecutive patients upon hospital admission (median age 72 years (IQR 65–79); 56.8% males). According to the FRAIL questionnaire, 106 (10.8%) patients were robust, 368 (37.5%) pre-frail, and 506 (51.7%) were frail. The median ALT value was 19IU/L (IQR 14–28). The median MAMC value was 27.8 (IQR 25.7–30.2). Patients with low ALT activity level (<17IU/L) were frailer according to their FRAIL score (3 (IQR 2–4) vs. 2 (IQR 1–3); <i>p</i> < 0.001). Higher MAMC values were associated with higher ALT activity, both representing robustness. The rate of 30 days readmission in the whole cohort was 17.4%. Frail patients, according to the FRAIL score (FS), had a higher risk for 30 days readmission (for FS > 2, HR = 1.99; 95CI = 1.29–3.08; <i>p</i> = 0.002). Frail patients, according to low ALT activity, also had a significantly higher risk for 30 days readmission (HR = 2.22; 95CI = 1.26–3.91; <i>p</i> = 0.006). After excluding patients whose length of stay (LOS) was ≥10 days, 252 (27.5%) stayed in-hospital for 4 days or longer. Frail patients according to FS had a higher risk for LOS ≥4 days (for FS > 2, HR = 1.87; 95CI = 1.39–2.52; <i>p</i> < 0.001). Frail patients, according to low ALT activity, were also at higher risk for LOS ≥4 days (HR = 1.87; 95CI = 1.39–2.52; <i>p</i> < 0.001). MAMC values were not correlated with patients’ LOS or risk for re-admission. Conclusion: Frailty and sarcopenia upon admission to internal medicine departments are associated with longer hospitalization and increased risk for re-admission. |
| first_indexed | 2024-03-10T17:19:12Z |
| format | Article |
| id | doaj.art-5cd721cf891a43abb0f2f5270114f3e3 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T17:19:12Z |
| publishDate | 2020-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-5cd721cf891a43abb0f2f5270114f3e32023-11-20T10:23:07ZengMDPI AGJournal of Clinical Medicine2077-03832020-08-0198265910.3390/jcm9082659Frailty and Sarcopenia Assessment upon Hospital Admission to Internal Medicine Predicts Length of Hospital Stay and Re-Admission: A Prospective Study of 980 PatientsSapir Anani0Gal Goldhaber1Adi Brom2Nir Lasman3Natia Turpashvili4Gilat Shenhav-saltzman5Chen Avaky6Liat Negru7Muhamad Agbaria8Sigalit Ariam9Doron Portal10Yishay Wasserstrum11Gad Segal12Internal Medicine Department “T”, Chaim Sheba Medical Center. Sackler faculty of medicine, Tel-Aviv University, Tel Aviv P.O. Box 39040, Tel Aviv 6997801, IsraelInternal Medicine Department “T”, Chaim Sheba Medical Center. Sackler faculty of medicine, Tel-Aviv University, Tel Aviv P.O. Box 39040, Tel Aviv 6997801, IsraelInternal Medicine Department “T”, Chaim Sheba Medical Center. Sackler faculty of medicine, Tel-Aviv University, Tel Aviv P.O. Box 39040, Tel Aviv 6997801, IsraelInternal Medicine Department “T”, Chaim Sheba Medical Center. Sackler faculty of medicine, Tel-Aviv University, Tel Aviv P.O. Box 39040, Tel Aviv 6997801, IsraelInternal Medicine Department “T”, Chaim Sheba Medical Center. Sackler faculty of medicine, Tel-Aviv University, Tel Aviv P.O. Box 39040, Tel Aviv 6997801, IsraelInternal Medicine Department “T”, Chaim Sheba Medical Center. Sackler faculty of medicine, Tel-Aviv University, Tel Aviv P.O. Box 39040, Tel Aviv 6997801, IsraelInternal Medicine Department “T”, Chaim Sheba Medical Center. Sackler faculty of medicine, Tel-Aviv University, Tel Aviv P.O. Box 39040, Tel Aviv 6997801, IsraelInternal Medicine Department “T”, Chaim Sheba Medical Center. Sackler faculty of medicine, Tel-Aviv University, Tel Aviv P.O. Box 39040, Tel Aviv 6997801, IsraelInternal Medicine Department “T”, Chaim Sheba Medical Center. Sackler faculty of medicine, Tel-Aviv University, Tel Aviv P.O. Box 39040, Tel Aviv 6997801, IsraelInternal Medicine Department “T”, Chaim Sheba Medical Center. Sackler faculty of medicine, Tel-Aviv University, Tel Aviv P.O. Box 39040, Tel Aviv 6997801, IsraelInternal Medicine Department, Sackler faculty of medicine, Tel-Aviv University, Tel Aviv 6997801, IsraelInternal Medicine Department “T”, Chaim Sheba Medical Center. Sackler faculty of medicine, Tel-Aviv University, Tel Aviv P.O. Box 39040, Tel Aviv 6997801, IsraelInternal Medicine Department “T”, Chaim Sheba Medical Center. Sackler faculty of medicine, Tel-Aviv University, Tel Aviv P.O. Box 39040, Tel Aviv 6997801, IsraelBackground: Frailty and sarcopenia are associated with frequent hospitalizations and poor clinical outcomes in geriatric patients. Ascertaining this association for younger patients hospitalized in internal medicine departments could help better prognosticate patients in the realm of internal medicine. Methods: During a 1-year prospective study in an internal medicine department, we evaluated patients upon admission for sarcopenia and frailty. We used the FRAIL questionnaire, blood alanine-amino transferase (ALT) activity, and mid-arm muscle circumference (MAMC) measurements. Results: We recruited 980 consecutive patients upon hospital admission (median age 72 years (IQR 65–79); 56.8% males). According to the FRAIL questionnaire, 106 (10.8%) patients were robust, 368 (37.5%) pre-frail, and 506 (51.7%) were frail. The median ALT value was 19IU/L (IQR 14–28). The median MAMC value was 27.8 (IQR 25.7–30.2). Patients with low ALT activity level (<17IU/L) were frailer according to their FRAIL score (3 (IQR 2–4) vs. 2 (IQR 1–3); <i>p</i> < 0.001). Higher MAMC values were associated with higher ALT activity, both representing robustness. The rate of 30 days readmission in the whole cohort was 17.4%. Frail patients, according to the FRAIL score (FS), had a higher risk for 30 days readmission (for FS > 2, HR = 1.99; 95CI = 1.29–3.08; <i>p</i> = 0.002). Frail patients, according to low ALT activity, also had a significantly higher risk for 30 days readmission (HR = 2.22; 95CI = 1.26–3.91; <i>p</i> = 0.006). After excluding patients whose length of stay (LOS) was ≥10 days, 252 (27.5%) stayed in-hospital for 4 days or longer. Frail patients according to FS had a higher risk for LOS ≥4 days (for FS > 2, HR = 1.87; 95CI = 1.39–2.52; <i>p</i> < 0.001). Frail patients, according to low ALT activity, were also at higher risk for LOS ≥4 days (HR = 1.87; 95CI = 1.39–2.52; <i>p</i> < 0.001). MAMC values were not correlated with patients’ LOS or risk for re-admission. Conclusion: Frailty and sarcopenia upon admission to internal medicine departments are associated with longer hospitalization and increased risk for re-admission.https://www.mdpi.com/2077-0383/9/8/2659sarcopeniafrailtyALTMAMCfrail questionnaireinternal medicine |
| spellingShingle | Sapir Anani Gal Goldhaber Adi Brom Nir Lasman Natia Turpashvili Gilat Shenhav-saltzman Chen Avaky Liat Negru Muhamad Agbaria Sigalit Ariam Doron Portal Yishay Wasserstrum Gad Segal Frailty and Sarcopenia Assessment upon Hospital Admission to Internal Medicine Predicts Length of Hospital Stay and Re-Admission: A Prospective Study of 980 Patients Journal of Clinical Medicine sarcopenia frailty ALT MAMC frail questionnaire internal medicine |
| title | Frailty and Sarcopenia Assessment upon Hospital
Admission to Internal Medicine Predicts Length of
Hospital Stay and Re-Admission: A Prospective
Study of 980 Patients |
| title_full | Frailty and Sarcopenia Assessment upon Hospital
Admission to Internal Medicine Predicts Length of
Hospital Stay and Re-Admission: A Prospective
Study of 980 Patients |
| title_fullStr | Frailty and Sarcopenia Assessment upon Hospital
Admission to Internal Medicine Predicts Length of
Hospital Stay and Re-Admission: A Prospective
Study of 980 Patients |
| title_full_unstemmed | Frailty and Sarcopenia Assessment upon Hospital
Admission to Internal Medicine Predicts Length of
Hospital Stay and Re-Admission: A Prospective
Study of 980 Patients |
| title_short | Frailty and Sarcopenia Assessment upon Hospital
Admission to Internal Medicine Predicts Length of
Hospital Stay and Re-Admission: A Prospective
Study of 980 Patients |
| title_sort | frailty and sarcopenia assessment upon hospital admission to internal medicine predicts length of hospital stay and re admission a prospective study of 980 patients |
| topic | sarcopenia frailty ALT MAMC frail questionnaire internal medicine |
| url | https://www.mdpi.com/2077-0383/9/8/2659 |
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