PD990 - SURVIVAL PREDICTIONS OF ARM CIRCUMFERENCE-DERIVED MUSCLE-SPECIFIC STRENGTH IN HOSPITALIZED OLDER PATIENTS

PD990

SURVIVAL PREDICTIONS OF ARM CIRCUMFERENCE-DERIVED MUSCLE-SPECIFIC STRENGTH IN HOSPITALIZED OLDER PATIENTS

J. P. Costa-Pereira¹, P. P. Dal Bello^2,*, K. P. Zucatti³, C. M. Prado⁴, C. P. S. Pinho Ramiro⁵, A. P. T. Fayh³, M. C. Gonzalez⁶

¹Nutrition, UFPE, Recife, ²Division of Nutrology, HCFMUSP, São Paulo, ³Nutrition, UFCSPA, Porto Alegre, ⁴HNRU, University of Alberta, Edmonton, ⁵Clinical Nutrition, HCUFPE, Recife, ⁶Nutrition, UFPEL, Pelotas, Brazil

Rationale: Muscle-specific strength (MSS) reflects the ability to generate strength per unit of muscle mass and is calculated as the ratio of muscle strength to muscle mass. Considering mid-upper arm circumference (MUAC) as a potential surrogate marker of muscle mass, we aimed to evaluate the ability of MUAC-based MSS to predict survival in a cohort of hospitalized older adults, and to determine which criterion most strongly augments mortality risk.

Methods: Single-center secondary analysis of a prospective cohort including older patients hospitalized for diverse causes. MUAC (cm) and handgrip strength (HGS, kg) were assessed. MUAC-based MSS was calculated as the ratio of HGS to MUAC (HGS/MUAC). The maximum log-rank statistic identified the MUAC-based MSS point most strongly associated with 6-mo mortality. Cox regression, adjusted for age, sex, comorbidities, and diagnoses, evaluated the independent associations of the individual (MUAC and HGS) and combined (adapted MUAC-based MSS) predictors with mortality. C-index evaluated the prediction ability.

Results: A total of 226 patients were included (57.5% males, mean age: 70 ± 8 years, 37.6% cancer). The 6-mo mortality rate was 14.2%. The MUAC-based MSS values most strongly associated with higher mortality were <0.53 kg/cm in males and <0.30 kg/cm in females. As continuous variables, MUAC alone was not associated with mortality (HR 1.07, 95% CI 0.92-1.25, p = .14), whereas decreases in HGS increased the risk by 13% (HR 1.13, 95% CI 1.06-1.25, p < .001). However, low MUAC-based MSS showed significant prognostic value, increasing mortality risk by 4-fold (HR 4.00; 95% CI 1.85-8.66, p < .001), demonstrating satisfactory prediction ability (C-index: 0.74).

Conclusion: Our findings describe the prognostic value of a simple MSS adaptation using MUAC in a sample of hospitalized older patients.

Disclosure of Interest: J. P. Costa-Pereira Speakers Bureau of: Fresenius Kabi Br; Danone Nutricia Br; Prodiet Medical Nutrition Br, P. Dal Bello Speakers Bureau of: Fresenius Kabi Br; Danone Nutricia Br; Nestlé Health Science, K. Zucatti: None declared, C. Prado Consultant for: Abbott Nutrition; Nutricia; Nestlé Health Science; Novo Nordisk. , Speakers Bureau of: Abbott Nutrition; Nutricia; Nestlé Health Science; Novo Nordisk. , C. Pinho Ramiro: None declared, A. Fayh Grant / Research Support from: Prodiet Medical Nutrition, M. C. Gonzalez Consultant for: Nestlé Health Science; Nutricia, Speakers Bureau of: Nestlé Health Science; Nutricia