Sarcopenia predicts hospitalization and 30-day mortality in older adults presenting to the emergency department

Sarcopenia, characterized by age-related decline in muscle mass and function, is associated with falls, disability, frailty, and mortality in older adults. However, sarcopenia frequently remains unrecognized in the emergency department (ED). We aimed to determine the prevalence, risk factors, and short-term outcomes of sarcopenia among older adults presenting to the ED.

We conducted a prospective observational study of adults aged ≥65 years presenting to the ED of a tertiary medical center from September 2019 to November 2021. Sarcopenia was defined using the 2019 Asian Working Group for Sarcopenia criteria. Demographics, functional status, nutritional status, frailty, and clinical outcomes were compared between patients with and without sarcopenia.

Among 867 enrolled patients, 420 (48.4%) had sarcopenia. Patients with sarcopenia were older, had lower body mass index, skeletal muscle index, and handgrip strength, and had poorer functional performance. Independent predictors of sarcopenia included age (odds ratio [OR] 1.07; 95% confidence interval (CI), 1.044-1.088; p < 0.001), malnutrition (OR 3.83; 95% CI 2.249-6.530; p < 0.001), and frailty (OR 1.91; 95% CI 1.313-2.766; p = 0.001). Sarcopenia patients had higher hospital admission rates (66.7% vs. 59.1%; p = 0.021) and higher 30-day mortality (5.7% vs. 1.8%; p = 0.002).

Nearly half of older patients presenting to the ED had sarcopenia, which was independently associated with short-term mortality and increased admission risk. Early recognition of sarcopenia in the ED may guide targeted nutritional and functional interventions and inform safe discharge planning and post-acute care referrals.