Diagnostic accuracy and prognostic ability of SARC-F during acute exacerbations of COPD

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Introduction Sarcopenia is linked to adverse outcomes, including hospitalisation and all-cause mortality. The SARC-F questionnaire presents a cost-effective screening tool for sarcopenia. We investigated the diagnostic accuracy of the SARC-F for identifying probable sarcopenia during acute exacerbations of COPD (AECOPD) and impact on hospital readmissions. Methods Individuals hospitalised with AECOPD were recruited to the study in Leicester, UK. SARC-F score, hand grip strength (HGS), ultrasound quadriceps muscle thickness (Q-T), and four-metre gait speed (FMGS) were assessed during admission. Probable sarcopenia was identified as HGS <27 kg in males or <16 kg in females. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for SARC-F ≥4 were calculated, as well as the area under the curve (AUC) for both continuous and binary scores. Results Among 83 participants (57% female; mean age 71 ± 11 years), 22 (27%) had probable sarcopenia. SARC-F ≥4 had moderate sensitivity (68.2%) but poor specificity (52.5%) for detecting probable sarcopenia, with low PPV (34.1%) and high NPV (82.1%). SARC-F as a continuous score did not significantly enhance discriminative ability (AUC = 0.652 vs. 0.603, p = 0.165). Readmission rates were higher in SARC-F ≥4 at 30 days (29% vs. 18%), 90 days (56% vs. 39%), and 1 year (76% vs. 73%), but differences were not significant (p> 0.05). SARC-F ≥4 was associated with lower Q-T in males (p= 0.036) and slower FMGS (p<.001). Conclusion SARC-F ≥4 demonstrated limited diagnostic accuracy in identifying probable sarcopenia during AECOPD but was associated with lower functional performance and a trend toward a higher rate of readmission.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.