Abstract
The prevalence, relationships and outcomes of sarcopenia and frailty in polypathological patients remain unknown. We performed a multicenter prospective observational study in six hospitals in order to assess prevalence, clinical features, outcome and associated risk factors of sarcopenia and frailty in a hospital-based population of polypathological patients. The cohort was recruited by performing prevalence surveys every 14 days during the inclusion period (March 2012–June 2016). Sarcopenia was assessed by means of EWGSOP criteria and frailty by means of Fried’s criteria. Skeletal muscle mass was measured by tetrapolar bioimpedanciometry. All patients were followed for 12 months. Factors associated with sarcopenia, frailty and mortality were analyzed by multivariate logistic regression, and Kaplan–Meier curves. A total of 444 patients (77.3 ± 8.4 years, 55% males) were included. Sarcopenia was present in 97 patients (21.8%), this being moderate in 54 (12.2%), and severe in 43 (9.6%); frailty was present in 278 patients (62.6%), and 140 (31.6%) were pre-frail; combined sarcopenia and frailty were present in the same patient in 80 (18%) patients. Factors independently associated to the presence of both, sarcopenia and frailty were female gender, older age, different chronic conditions, poor functional status, low body mass index, asthenia and depressive disorders, and low leucocytes and lymphocytes count. Mortality in the 12-months follow-up period was 40%. Patients with sarcopenia, frailty or both survived significantly less than those without these conditions. Sarcopenia and frailty are frequent and interrelated conditions in polypathological patients, shadowing their survival. Their early recognition and management could improve health-related outcomes in this population.
Highlights
The improvement in life conditions, as well as in the social and health systems, has led to an increase in life expectancy in most of the world
In the area of chronic conditions, polypathological patients (PP) are nowadays the clinical paradigm of the emergence of multimorbidity in our societies. They meet all criteria of the so-called ’populations with complex chronic diseases’: they are prevalent in most clinical arenas, they are advanced-aged, complex, clinically vulnerable, they are prone towards functional decline, and suffer high mortality rates [3,4,5]
We have developed a multicenter cohort study in order to assess the prevalence, the main features, and the factors associated with sarcopenia, frailty and 12-month mortality in hospital-based PP
Summary
The improvement in life conditions, as well as in the social and health systems, has led to an increase in life expectancy in most of the world. Survive to many diseases, but the cost we are paying is the increase of chronic conditions, which accompany us in the last years of life. This new social and epidemiological trend is becoming of nuclear importance in establishing medium- and long-term strategies in most healthcare systems. In the area of chronic conditions, polypathological patients (PP) are nowadays the clinical paradigm of the emergence of multimorbidity in our societies They meet all criteria of the so-called ’populations with complex chronic diseases’: they are prevalent in most clinical arenas, they are advanced-aged (mean age of PP in multicenter cohorts rounded 75–80 years), complex, clinically vulnerable, they are prone towards functional decline, and suffer high mortality rates [3,4,5]
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