The Journal of Nutrition, Health and Aging (Jul 2024)

Exploring the role of body mass index-adjusted calf circumference within the SARC-CalF screening tool among older patients with cancer

  • Maria Karolainy do Nascimento,
  • Jarson Pedro da Costa Pereira,
  • Janaína Oliveira de Araújo,
  • M. Cristina Gonzalez,
  • Ana Paula Trussardi Fayh

Journal volume & issue
Vol. 28, no. 7
p. 100251

Abstract

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Objectives: This study aimed to assess and compare the frequency of positive scores using unadjusted SARC-CalF with the scores derived from SARC-CalF after adjusting calf circumference (CC) for body mass index (BMI). The secondary aim was to assess the prognostic value of SARC-CalF after BMI adjustment, for length of hospital stay (LOS) and mortality. Design, Setting, and Participants: This secondary analysis of a prospective cohort study, included both outpatients and inpatients of an oncology unit hospital in Brazil. Measurements: BMI and CC were measured. Patients with excess weight had their CC adjusted for BMI by subtracting 3 cm, 7 cm, and 12 cm from the unadjusted CC values for respective BMI categories. SARC-CalF was used to screen for sarcopenia. Scores ≥11 were indicative of sarcopenia, considering both unadjusted and BMI-adjusted CC values. Clinical outcomes included prolonged LOS and both short- and long-term mortality. Results: Our study included 206 subjects, with a median age of 69 years, and the majority were males (52.1%). The prevalence of low CC increased from 65% to 84% after BMI adjustment. Positive unadjusted SARC-CalF scores (≥11) were observed in 51% of the population and this prevalence increased to 65% using BMI-adjusted SARC-CalF criteria (≥11). Higher scores on BMI-adjusted SARC-CalF but not unadjusted SARC-CalF were independently associated with prolonged LOS [adjusted HR: 1.26 (1.03–1.53)], and 6-month mortality [adjusted HR: 1.42 (1.07–1.87)]. Both unadjusted and BMI-adjusted SARC-CalF were independently associated with 12-month mortality. Conclusion: BMI-adjusted SARC-CalF may be a promising strategy to enhance the detection of older patients with cancer and excess weight at risk of sarcopenia, and it may serve a dual role as a prognostic tool, as it was independently associated with prolonged LOS and mortality.

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