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Background &amp; aims <p>The Strength, Assistance with Walking, Rising from a Chair, and Falls (SARC-F) questionnaire was proposed to screen sarcopenia. However, its limited sensitivity may compromise its prognostic value. Since its introduction, several adapted SARC-F-based approaches have been proposed, although their ability to predict clinical outcomes among older hospitalized individuals remains underexplored. This study aimed to investigate the prognostic value of SARC-F and six modified versions in a cohort of hospitalized individuals.</p> Methods <p>Cohort study with prospective data collection. Older adults (<i>N</i> = 236, 69.8 ± 7.5 years old) hospitalized in medical or surgical wards were included. Outcomes of interest were 1-year mortality and prolonged length of hospital stay (LOS). The original SARC-F was applied. Additional adapted approaches were explored: (1) SARC-CalF (including calf circumference, CC); (2) <sub>BMI−adjusted</sub> SARC-CalF (using BMI-adjusted CC); (3) SARC-F + mid-upper arm circumference (MUAC); (4) SARC-F + age and body mass (SARC-F EBM); (5) SARC-CalF + MUAC; and (6) <sub>BMI−adjusted</sub> SARC-CalF + MUAC. Suggestive signs of sarcopenia were SARC-F scores <i>≥</i> 4, SARC-F EBM scores <i>≥</i> 12, and scores <i>≥</i> 11 for all other SARC-based approaches.</p> Results <p>SARC-F EBM was the approach identifying the lowest rate of suggestive signs of sarcopenia (25.9%), while <sub>BMI−adjusted</sub> SARC-CalF + MUAC identified the highest rate (79.2%). All SARC-F-based approaches were associated with higher odds of prolonged LOS (OR ranged from 2.05 to 3.31). SARC-CalF model had the highest <sub>adjusted</sub> AUC for LOS prediction (0.64). Except for SARC-F and SARC-F + EBM, all approaches were associated with a higher risk of 1-year mortality (HR <sub>adjusted</sub> ranged from 2.07 to 11.34). <sub>BMI−adjusted</sub> SARC-CalF + MUAC exhibited the highest mortality prediction based on the C-index (0.75).</p> Conclusion <p>Our study demonstrates that all SARC-F-based approaches are linked to prolonged LOS, and almost all approaches were also linked to 1-year mortality. We also introduce the novel <sub>BMI−adjusted</sub> SARC-CalF + MUAC version, pending future validation.</p>

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SARC-F and six modified versions: prognostic role for prolonged hospital stay and 1-year mortality in older inpatients

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月22日

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  • Taís G. Nascimento,
  • Ana P. T. Fayh,
  • Flavia M. Silva,
  • Eduardo C. Costa,
  • Jorge Z. Silva-Filho,
  • José F. M. Cintra,
  • Claudia P. S. Pinho Ramiro,
  • Poliana C. Cabral,
  • Rebecca P. Paes-Silva,
  • Vanessa S. Leal,
  • Jarson P. Costa-Pereira

摘要

Background & aims

The Strength, Assistance with Walking, Rising from a Chair, and Falls (SARC-F) questionnaire was proposed to screen sarcopenia. However, its limited sensitivity may compromise its prognostic value. Since its introduction, several adapted SARC-F-based approaches have been proposed, although their ability to predict clinical outcomes among older hospitalized individuals remains underexplored. This study aimed to investigate the prognostic value of SARC-F and six modified versions in a cohort of hospitalized individuals.

Methods

Cohort study with prospective data collection. Older adults (N = 236, 69.8 ± 7.5 years old) hospitalized in medical or surgical wards were included. Outcomes of interest were 1-year mortality and prolonged length of hospital stay (LOS). The original SARC-F was applied. Additional adapted approaches were explored: (1) SARC-CalF (including calf circumference, CC); (2) BMI−adjusted SARC-CalF (using BMI-adjusted CC); (3) SARC-F + mid-upper arm circumference (MUAC); (4) SARC-F + age and body mass (SARC-F EBM); (5) SARC-CalF + MUAC; and (6) BMI−adjusted SARC-CalF + MUAC. Suggestive signs of sarcopenia were SARC-F scores ≥ 4, SARC-F EBM scores ≥ 12, and scores ≥ 11 for all other SARC-based approaches.

Results

SARC-F EBM was the approach identifying the lowest rate of suggestive signs of sarcopenia (25.9%), while BMI−adjusted SARC-CalF + MUAC identified the highest rate (79.2%). All SARC-F-based approaches were associated with higher odds of prolonged LOS (OR ranged from 2.05 to 3.31). SARC-CalF model had the highest adjusted AUC for LOS prediction (0.64). Except for SARC-F and SARC-F + EBM, all approaches were associated with a higher risk of 1-year mortality (HR adjusted ranged from 2.07 to 11.34). BMI−adjusted SARC-CalF + MUAC exhibited the highest mortality prediction based on the C-index (0.75).

Conclusion

Our study demonstrates that all SARC-F-based approaches are linked to prolonged LOS, and almost all approaches were also linked to 1-year mortality. We also introduce the novel BMI−adjusted SARC-CalF + MUAC version, pending future validation.