Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Protein, malnutrition and wasting disorders

Sarcopenia and length of hospital stay

European Journal of Clinical Nutrition volume 70, pages 595–601 (2016)Cite this article

Subjects

Abstract

Background/objectives:

We aimed to quantify the association of sarcopenia with length of hospital stay (LOS) and to identify factors associated with sarcopenia among hospitalized patients.

Subjects/methods:

A total of 655 patients composed the study sample. A longitudinal study was conducted in a University Hospital. Sarcopenia was defined, according to European Consensus criteria, as low muscle mass (bioelectrical impedance analysis) and low muscle function (handgrip strength). Logistic regression, Kaplan–Meier and Cox adjusted proportional hazards methods were used. LOS was determined from the date of hospital admission and discharge home (event of interest).

Results:

Participants were aged 18 to 90 years (24.3% sarcopenic). Factors associated with sarcopenia were male gender, age ⩾65 years, moderate or severe dependence, undernutrition and being admitted to a medical ward. Sarcopenic patients presented a lower probability of being discharged home (hazard ratio (HR), 95% confidence interval (CI)=0.71, 0.58–0.86). However, after stratifying for age groups, this effect was visible only in patients aged <65 years (HR, 95% CI= 0.66, 0.51–0.86). Moreover, sarcopenic overweight or obese patients presented a higher probability of being discharged home (HR, 95% CI=0.78, 0.61–0.99) than nonoverweight sarcopenic patients (HR, 95% CI=0.63, 0.48–0.83).

Conclusions:

Being male, age ⩾65 years, presenting dependence, being undernourished and admitted to a medical ward were factors associated with sarcopenia among hospitalized adult patients. Sarcopenia is independently associated with longer LOS, although this association is stronger for patients aged <65 years. Moreover, sarcopenic overweight was associated with a higher probability of discharge home than nonoverweight sarcopenia.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F et al. Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on sarcopenia in older people. Age Ageing 2010; 39: 412–423.

    Article  Google Scholar 

  2. Landi F, Liperoti R, Russo A, Giovannini S, Tosato M, Capoluongo E et al. Sarcopenia as a risk factor for falls in elderly individuals: results from the ilSIRENTE study. Clin Nutr 2012; 31: 652–658.

    Article  Google Scholar 

  3. Abellan van Kan G . Epidemiology and consequences of sarcopenia. J Nutr Health Aging 2009; 13: 708–712.

    Article  CAS  Google Scholar 

  4. Volpato S, Bianchi L, Cherubini A, Landi F, Maggio M, Savino E et al. Prevalence and clinical correlates of sarcopenia in community-dwelling older people: application of the EWGSOP definition and diagnostic algorithm. J Gerontol A Biol Sci Med Sci 2014; 69: 438–446.

    Article  CAS  Google Scholar 

  5. Cherin P, Voronska E, Fraoucene N, de Jaeger C . Prevalence of sarcopenia among healthy ambulatory subjects: the sarcopenia begins from 45 years. Aging Clin Exp Res 2014; 26: 137–146.

    Article  Google Scholar 

  6. Gariballa S, Alessa A . Sarcopenia: prevalence and prognostic significance in hospitalized patients. Clin Nutr 2013; 32: 772–776.

    Article  Google Scholar 

  7. Smoliner C, Sieber CC, Wirth R . Prevalence of sarcopenia in geriatric hospitalized patients. J Am Med Dir Assoc 2014; 15: 267–272.

    Article  Google Scholar 

  8. Cerri AP, Bellelli G, Mazzone A, Pittella F, Landi F, Zambon A et al. Sarcopenia and malnutrition in acutely ill hospitalized elderly: prevalence and outcomes. Clin Nutr 2014; 34: 745–751.

    Article  Google Scholar 

  9. Sousa AS, Guerra RS, Fonseca I, Pichel F, Amaral TF . Sarcopenia among hospitalized patients - a cross-sectional study. Clin Nutr 2015; 34: 1239–1244.

    Article  Google Scholar 

  10. Rossi AP, Fantin F, Micciolo R, Bertocchi M, Bertassello P, Zanandrea V et al. Identifying sarcopenia in acute care setting patients. J Am Med Dir Assoc 2014; 15: 303 e7–303 12.

    Article  Google Scholar 

  11. Vetrano DL, Landi F, Volpato S, Corsonello A, Meloni E, Bernabei R et al. Association of sarcopenia with short- and long-term mortality in older adults admitted to acute care wards: results from the CRIME study. J Gerontol A Biol Sci Med Sci 2014; 69: 1154–1161.

    Article  Google Scholar 

  12. Kyle UG, Genton L, Pichard C . Hospital length of stay and nutritional status. Curr Opin Clin Nutr Metab Care 2005; 8: 397–402.

    Article  Google Scholar 

  13. Omachonu VK, Suthummanon S, Akcin M, Asfour S . Predicting length of stay for Medicare patients at a teaching hospital. Health Serv Manage Res 2004; 17: 1–12.

    Article  CAS  Google Scholar 

  14. ASPEN Board of Directors and the Clinical Guidelines Task Force. Guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients. J Parenter Enteral Nutr 2002; 26: 1SA–138SA.

    Article  Google Scholar 

  15. Hodkinson HM . Evaluation of a mental test score for assessment of mental impairment in the elderly. Age Ageing 1972; 1: 233–238.

    Article  CAS  Google Scholar 

  16. Katz S . Assessing self-maintenance: activities of daily living, mobility, and instrumental activities of daily living. J Am Geriatr Soc 1983; 31: 721–727.

    Article  CAS  Google Scholar 

  17. Charlson ME, Pompei P, Ales KL, MacKenzie CR . A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987; 40: 373–383.

    Article  CAS  Google Scholar 

  18. Ottery F . Patient-generated subjective global assessment. In: Polisena PMC (ed). The Clinical Guide to Oncology Nutrition. The American Dietetic Association: Chicago, IL, USA, 2000, pp 11–23.

    Google Scholar 

  19. Marfell-Jones MOT, Stewart A, Carter L . International Standards for Anthropometric Assessement. ISAK: Potchefstroom, South Africa, 2006.

    Google Scholar 

  20. Pederson D, Gore C . Anthropometry Measurement Error. University of New South Wales Press: Sydney, Australia, 1996.

    Google Scholar 

  21. WHO Expert Committee on Physical Status. Physical status: the use and interpretation of anthropometry, Report of a WHO Expert Committee. World Health Organ Tech Rep Ser 1995; 854: 1–452.

  22. Janssen I, Heymsfield SB, Baumgartner RN, Ross R . Estimation of skeletal muscle mass by bioelectrical impedance analysis. J Appl Physiol (1985) 2000; 89: 465–471.

    Article  CAS  Google Scholar 

  23. Fess E . Grip Strength, 2nd edn. American Society of Hand Therapists: Chicago, 1992.

    Google Scholar 

  24. Vaz M, Thangam S, Prabhu A, Shetty PS . Maximal voluntary contraction as a functional indicator of adult chronic undernutrition. Br J Nutr 1996; 76: 9–15.

    Article  CAS  Google Scholar 

  25. Matos L, Teixeira MA, Henriques A, Tavares MM, Alvares L, Antunes A et al. [Nutritional status recording in hospitalized patient notes]. Acta Med Port 2007; 20: 503–510.

    CAS  PubMed  Google Scholar 

  26. Hillman TE, Nunes QM, Hornby ST, Stanga Z, Neal KR, Rowlands BJ et al. A practical posture for hand grip dynamometry in the clinical setting. Clin Nutr 2005; 24: 224–228.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We thank Centro Hospitalar do Porto and all ward directors for facilitating the data collection. RSG received a scholarship from Fundação para a Ciência e a Tecnologia, financing program POPH/FSE, under the project SFRH/BD/61656/2009.

Author information

Authors and Affiliations

  1. Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal

    A S Sousa & T F Amaral

  2. Departamento de Bioquímica da Faculdade de Medicina, Universidade do Porto, Porto, Portugal

    R S Guerra

  3. UISPA-INEGI, Faculdade de Engenharia, Universidade do Porto, Porto, Portugal

    R S Guerra & T F Amaral

  4. Serviço de Nutrição e Alimentação, Centro Hospitalar do Porto, Porto, Portugal

    I Fonseca & F Pichel

Authors
  1. A S Sousa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R S Guerra
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. I Fonseca
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. F Pichel
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. T F Amaral
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A S Sousa.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sousa, A., Guerra, R., Fonseca, I. et al. Sarcopenia and length of hospital stay. Eur J Clin Nutr 70, 595–601 (2016). https://doi.org/10.1038/ejcn.2015.207

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ejcn.2015.207

This article is cited by

Search

Advanced search

Quick links