Malnutrition-sarcopenia syndrome predicts mortality in hospitalized older patients

Xiaoyi Hu,Haozhong Wang,Ming Yang,Qiukui Hao,Lei Zhang,Birong Dong

doi:10.1038/s41598-017-03388-3

Xiaoyi Hu, Haozhong Wang + Show 4 more

Open Access

https://doi.org/10.1038/s41598-017-03388-3

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Abstract

A new term, malnutrition-sarcopenia syndrome (MSS), was recently coined to describe the clinical presentation of both malnutrition and sarcopenia. The aim of this study was to investigate the association between MSS and long-term mortality in older inpatients. We conducted a prospective study in acute geriatric wards of two local hospitals in China. Muscle mass and malnutrition were estimated by anthropometric measures and the Mini Nutritional Assessment (MNA). Of the 453 participants, 14 (3.1%) had sarcopenia with normal nutrition, 139 (30.7%) had malnutrition risk without sarcopenia, 48 (10.6%) had malnutrition risk with sarcopenia, 25 (5.5%) had malnutrition without sarcopenia, and 22 (4.9%) had MSS at baseline. Compared with non-sarcopenic subjects with normal nutrition, subjects with MSS and subjects with malnutrition risk and sarcopenia were more than four times more likely to die (hazard ratio [HR], 4.78; 95% confidence interval [CI], 2.09–10.97; and HR, 4.25; 95% CI, 2.22–8.12, respectively); non-sarcopenic subjects with malnutrition risk were more than two times more likely to die (HR, 2.41; 95% CI, 1.32–4.39). In conclusion, MSS may serve as a prognostic factor in the management of hospitalized older patients.

Highlights

Malnutrition is common in different populations, but especially in older adults[1]
Compared with normally-nourished subjects without sarcopenia, subjects with malnutrition-sarcopenia syndrome (MSS) were more than four times more likely to die (HR, 4.78; 95% confidence intervals (CI), 2.09–10.97); subjects with both malnutrition risk and sarcopenia were more than four times more likely to die (HR, 4.25; 95% CI, 2.22–8.12); non-sarcopenic subjects with malnutrition risk were more than two times more likely to die (HR, 2.41; 95% CI, 1.32–4.39); non-sarcopenic subjects with malnutrition were more than two times more likely to die, but the measure of effect was not statistically significant (HR, 2.62; 95% CI 0.98–7.04); and sarcopenic subjects with normal nutritional status had no significantly higher risk of death (HR, 1.66; 95% CI, 0.48–5.72)
Our study demonstrated that malnutrition/ malnutrition risk and sarcopenia were prevalent in the study population of older inpatients, and there was an overlap between these two syndromes

Summary

Introduction

Malnutrition is common in different populations, but especially in older adults[1]. Older people with malnutrition (or malnutrition risk) are at increased risk of adverse clinical outcomes, such as prolonged length of hospital stay, increased health costs, poor quality of life, and mortality[2]. Malnutrition and sarcopenia may share some clinical features, such as abnormal body weight or inactivity[6], the fundamental mechanisms of the two conditions differ[7]. Based on these facts, Vandewoude and colleagues recently suggested using a new term, “malnutrition-sarcopenia syndrome (MSS)”, to describe the clinical presentation of both malnutrition and sarcopenia[7]. Vandewoude and colleagues recently suggested using a new term, “malnutrition-sarcopenia syndrome (MSS)”, to describe the clinical presentation of both malnutrition and sarcopenia[7] This concept has not yet been widely accepted, and its value for clinical practices and research remains unclear. We conducted a prospective study with the following objectives: 1) to identify the prevalence of malnutrition, sarcopenia, and MSS in a study population of hospitalized older patients; and 2) to investigate the association between MSS and long-term mortality in this population

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