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Sarcopenia Is Poorly Documented in Geriatric Rehabilitation Inpatients: Restoring Health of Acutely Unwell Adults
Thang Dao1,2, Cheng Hwee Soh3,4, Esmee M Reijnierse3,5
1Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia, thang.dao.email@gmail.com.
Introduction:
Sarcopenia is highly prevalent in older inpatients. However, it is unclear if sarcopenia is documented routinely in geriatric rehabilitation. This study aimed to investigate the documentation of sarcopenia in medical records among geriatric rehabilitation patients.
Methods:
Geriatric rehabilitation inpatients in a statewide hospital in VIC, Australia, were included. Patient characteristics, muscle measurements, and medical records at admission and discharge were collected. Sarcopenia was defined using the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). Patient characteristics were compared between the groups with documented and non-documented sarcopenia using the Wilcoxon rank-sum or chi-square test.
Results:
Of 1,890 geriatric rehabilitation inpatients (aged 83.4 [interquartile range: 77.6-88.4] years, 56.3% female), muscle measurements were available in 1,334 patients at admission. The prevalence of sarcopenia was 20.8% (n = 278). Sarcopenia was documented in 68 out of 1,890 patients; 23 of them did not have muscle mass or muscle strength measured. Forty-five patients with muscle measurements available were documented with sarcopenia either at discharge from acute admissions (n = 9), on rehabilitation admission (n = 25), or at discharge from rehabilitation (n = 26). Of these 45 patients, 8 patients had sarcopenia following the EWGSOP2 criteria. Compared with patients without sarcopenia documented, patients documented with sarcopenia had lower body mass index and sarcopenia screening (Strength, Assistance in Walking, Rise from a Chair, Climb Stairs, Falls History [SARC-F]) scores and higher Clinical Frailty Scale (CFS) scores and were likely to come from nursing homes.
Conclusions:
Documentation of sarcopenia was lower than the prevalence of sarcopenia in geriatric rehabilitation inpatients. Sarcopenia was incorrectly documented as data on muscle measurement were missing to define sarcopenia. Practitioners likely used clinical impressions to document sarcopenia, rather than the formal diagnostic criteria.
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