Sarcopenia with co-existent type 2 diabetes mellitus is associated with worse clinical outcomes among hospitalised cardiac patients.

Abstract

Sarcopenia has been shown associated with functional decline, disability, poorer quality of life and mortality. However, there are limited studies among hospitalised cardiac patients in Malaysia. This study aimed to identify the association of sarcopenia and type 2 diabetes mellitus (T2DM) with clinical outcomes among hospitalised cardiac patients. This prospective observational study assessed 100 patients who were admitted to the general wards at the National Heart Institute. We measured handgrip strength, body composition using bioelectrical impedance analysis (BIA) and recorded the length of stay (LOS), unplanned readmission and incidence of infection within 90 days after discharge. Logistic regression analysis at a significant level p<0.05 was used to identify the association between sarcopenia and clinical outcomes. The prevalence of sarcopenia was 63%, and this was similar in patients with or without T2DM. After adjustment, sarcopenia was significantly associated with 90-day unplanned readmission (adjusted OR 3.5; 95%CI 1.40-8.77; p=0.007) and LOS (AOR 0.4; 95%CI 0.16-0.88; p=0.026). After adjustment, the co-existent of T2DM and sarcopenia was significantly associated with 90-day unplanned readmission (AOR 7.3; 95%CI 1.82-29.66; p=0.005) and 90-day incidence of infection (AOR 4.4; 95%CI 1.12-17.52; p=0.033). Sarcopenia with co-existent T2DM was associated with increased risk for readmission and infection among hospitalised cardiac patients. Early identification of sarcopenia is important for timely intervention to improve prognosis in hospitalised cardiac patients with T2DM.