• Am J Emerg Med · Aug 2021

    Observational Study

    A pilot study examining the use of ultrasound to measure sarcopenia, frailty and fall in older patients.

    • Emily Benton, Andrew S Liteplo, Hamid Shokoohi, Michael A Loesche, Sarah Yacoub, Phraewa Thatphet, Thiti Wongtangman, and Shan W Liu.
    • NewYork-Presbyterian Hospital, Department of Emergency Medicine, 525 East 68th Street, New York, NY 10065, United States of America. Electronic address: eab9022@nyp.org.
    • Am J Emerg Med. 2021 Aug 1; 46: 310-316.

    IntroductionThe importance of this study is to devise an efficient tool for assessing frailty in the ED. The goals of this study are 1) to correlate ultrasonographic (US) measurements of muscle thickness in older ED patients with frailty and 2) to correlate US-measured sarcopenia with falls, subsequent hospitalizations and ED revisits.MethodsParticipants were conveniently sampled from a single ED in this prospective cohort pilot study of patients aged 65 or older. Participants completed a Fatigue, Resistance, Ambulation, Illness and Loss of Weight (FRAIL) scale assessment and US measurements of their upper arm muscles, quadricep muscles, and abdominal wall muscles thickness. We conducted one-month follow-up phone calls to assess for falls, ED revisits, and subsequent hospital visits.ResultsWe enrolled 43 patients (mean age of 78.5). Ultrasound measurements of the three muscle groups were not significantly different between frail and non-frail groups. Frail participants had greater bicep asymmetry (a difference of 0.47 cm vs 0.24 cm, p < .01). A predictive logistic regression model using average quadriceps thickness and biceps asymmetry was found to identify frail patients (AUC of 0.816). Participants with subsequent falls had smaller quadriceps (1.18 cm smaller, p < .01). Subsequently hospitalized patients were found to have smaller quadriceps muscles (0.54 cm smaller, p = .03) and abdominal wall muscles (0.25 cm smaller, p = .01).ConclusionUS measurements of sarcopenia in older patients had mild to moderate associations with frailty, falls and subsequent hospitalizations. Further investigation is needed to confirm these findings.Copyright © 2020. Published by Elsevier Inc.

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