Exploring the role of body mass index-adjusted calf circumference within the SARC-CalF screening tool among older patients with cancer

Maria Karolainy do Nascimento; Jarson Pedro da Costa Pereira; Janaína Oliveira de Araújo; M Cristina Gonzalez; Ana Paula Trussardi Fayh

doi:10.1016/j.jnha.2024.100251

Exploring the role of body mass index-adjusted calf circumference within the SARC-CalF screening tool among older patients with cancer

J Nutr Health Aging. 2024 Apr 26;28(7):100251. doi: 10.1016/j.jnha.2024.100251. Online ahead of print.

Authors

Maria Karolainy do Nascimento¹, Jarson Pedro da Costa Pereira², Janaína Oliveira de Araújo¹, M Cristina Gonzalez³, Ana Paula Trussardi Fayh⁴

Affiliations

¹ Postgraduate Program in Health Sciences, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, RN, Brazil.
² Postgraduate Program in Nutrition and Public Health, Department of Nutrition, Federal University of Pernambuco, Recife, PE, Brazil.
³ Postgraduate Program in Nutrition and Food, Federal University of Pelotas, Pelotas, RS, Brazil.
⁴ Postgraduate Program in Health Sciences, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, RN, Brazil; PesqClin Lab, Onofre Lopes University Hospital, Brazilian Company of Hospital Services (EBSERH), Federal University of Rio Grande do Norte, Natal, RN, Brazil. Electronic address: ana.fayh@ufrn.br.

PMID: 38677077
DOI: 10.1016/j.jnha.2024.100251

Abstract

Objectives: This study aimed to assess and compare the frequency of positive scores using unadjusted SARC-CalF with the scores derived from SARC-CalF after adjusting calf circumference (CC) for body mass index (BMI). The secondary aim was to assess the prognostic value of SARC-CalF after BMI adjustment, for length of hospital stay (LOS) and mortality.

Design, setting, and participants: This secondary analysis of a prospective cohort study, included both outpatients and inpatients of an oncology unit hospital in Brazil.

Measurements: BMI and CC were measured. Patients with excess weight had their CC adjusted for BMI by subtracting 3 cm, 7 cm, and 12 cm from the unadjusted CC values for respective BMI categories. SARC-CalF was used to screen for sarcopenia. Scores ≥11 were indicative of sarcopenia, considering both unadjusted and BMI-adjusted CC values. Clinical outcomes included prolonged LOS and both short- and long-term mortality.

Results: Our study included 206 subjects, with a median age of 69 years, and the majority were males (52.1%). The prevalence of low CC increased from 65% to 84% after BMI adjustment. Positive unadjusted SARC-CalF scores (≥11) were observed in 51% of the population and this prevalence increased to 65% using BMI-adjusted SARC-CalF criteria (≥11). Higher scores on BMI-adjusted SARC-CalF but not unadjusted SARC-CalF were independently associated with prolonged LOS [_adjusted HR: 1.26 (1.03-1.53)], and 6-month mortality [_adjusted HR: 1.42 (1.07-1.87)]. Both unadjusted and BMI-adjusted SARC-CalF were independently associated with 12-month mortality.

Conclusion: BMI-adjusted SARC-CalF may be a promising strategy to enhance the detection of older patients with cancer and excess weight at risk of sarcopenia, and it may serve a dual role as a prognostic tool, as it was independently associated with prolonged LOS and mortality.

Keywords: Body mass index; Calf circumference; Cancer; Mortality; Sarcopenia screening.