Association of Sonographic Sarcopenia and Falls in Older Adults Presenting to the Emergency Department

• Published in: Journal of clinical medicine 2023-02, Vol.12 (4), p.1251
• Main Authors: Wongtangman, Thiti, Thatphet, Phraewa, Shokoohi, Hamid, McFadden, Kathleen, Ma, Irene, Al Saud, Ahad, Vivian, Rachel, Hines, Ryan, Gullikson, Jamie, Morone, Christina, Parente, Jason, Perkisas, Stany, Liu, Shan W
• Format: Article
• Language: English
• Subjects: Aged patients; Clinical medicine; Consent; Diagnosis; Diagnosis, Ultrasonic; Emergency medical care; Falls; Falls (Accidents); Geriatrics; Grip strength; Health aspects; Hospital costs; Infections; Measurement; Medical examination; Mortality; Muscle strength; Older people; Point of care testing; Polypharmacy; Risk factors; Sarcopenia; Severe acute respiratory syndrome coronavirus 2; Ultrasonic imaging
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm12041251

To determine the association between point-of-care-ultrasonography (POCUS)-measured sarcopenia and grip strength, as well as the history of prior-year falls among older adults admitted to the emergency department observation unit (EDOU). This cross-sectional observational study was conducted over 8 months at a large urban teaching hospital. A consecutive sample of patients who were 65 years or older and admitted to the EDOU were enrolled in the study. Using standardized techniques, trained research assistants and co-investigators measured patients' biceps brachii and thigh quadriceps muscles via a linear transducer. Grip strength was measured using a Jamar Hydraulic Hand Dynamometer. Participants were surveyed regarding their history of falls in the prior year. Logistic regression analyses assessed the relationship of sarcopenia and grip strength to a history of falls (the primary outcome). Among 199 participants (55% female), 46% reported falling in the prior year. The median biceps thickness was 2.22 cm with an Interquartile range [IQR] of 1.87-2.74, and the median thigh muscle thickness was 2.91 cm with an IQR of 2.40-3.49. A univariate logistic regression analysis demonstrated a correlation between higher thigh muscle thickness, normal grip strength, and history of prior-year falling, with an odds ratio [OR] of 0.67 (95% conference interval [95%CI] 0.47-0.95) and an OR of 0.51 (95%CI 0.29-0.91), respectively. In multivariate logistic regression, only higher thigh muscle thickness was correlated with a history of prior-year falls, with an OR of 0.59 (95% CI 0.38-0.91). POCUS-measured thigh muscle thickness has the potential to identify patients who have fallen and thus are at high risk for future falls.