Point-of-Care Ultrasound-Based Assessment of Sarcopenia to Predict Revisits or Mortality in Older Adults at the...

Older patients visiting the emergency department (ED) are at increased risk of adverse outcomes, including ED revisits and mortality. Sarcopenia quantification by point-of-care ultrasound (POCUS) may be a useful bedside screening tool, especially when traditional frailty screening instruments, reliant on history taking, cannot be used. This study evaluated whether POCUS measurement of rectus femoris cross-sectional area (RFcsa) can predict adverse outcomes in older patients visiting the ED.

In this single-centre prospective study, patients aged ≥70 years presenting to the ED of a Dutch university hospital and enrolled in the Acutelines data and biobank were included. RFcsa was measured using POCUS. ROC-analysis assessed the overall accuracy of RFcsa for prediction of the primary outcome, which was defined as the composite of ED revisit or death within 3 months. Logistic regression determined the added value of RFcsa to Karnofsky Performance Score (KPS).

During the study period, a total of 68 patients were included. Twenty-six patients (38%) met the primary endpoint. RFcsa showed excellent intra-rater reliability (interclass correlation coefficient=0.98). However, the accuracy to predict the composite endpoint was low, with an area under the curves of 0.53 (0.39-0.66) for unadjusted RFcsa and 0.51 (0.36-0.66) for sex-adjusted RFcsa. The addition of RFcsa in a multivariate logistic regression model with KPS did not increase the overall explained variance in the primary endpoint.

In older patients presenting in the ED, POCUS-measured RFcsa does not predict ED revisits or death within 3 months. (Trial Registration No. NCT05369962 at ClinicalTrials.gov).