PD992 - CLINICAL SIGNIFICANCE OF NOVEL ARM CIRCUMFERENCE CUTOFFS WITH BMI ADJUSTMENT FACTORS IN HOSPITALIZED OLDER PATIENTS

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PD992

CLINICAL SIGNIFICANCE OF NOVEL ARM CIRCUMFERENCE CUTOFFS WITH BMI ADJUSTMENT FACTORS IN HOSPITALIZED OLDER PATIENTS

J. Z. Silva-Filho1, J. P. Costa-Pereira2,*, C. M. Prado3, C. P. S. Pinho Ramiro4, A. P. T. Fayh5, M. C. Gonzalez6

1Medical Sciences, UPE, 2Nutrition, UFPE, Recife, Brazil, 3HNRU, University of Alberta, Edmonton, Canada, 4Clinical Nutrition, HCUFPE, Recife, 5Nutrition, UFCSPA, Porto Alegre, 6Nutrition, UFPEL, Pelotas, Brazil

 

Rationale: New cutoff values and body mass index (BMI)-adjusted factors for mid-upper arm circumference (MUAC) have been proposed. However, its clinical relevance requires further exploration across multiple populations, including hospitalized older adults.

Methods: Single-center secondary analysis of a prospective cohort including older hospitalized patients. MUAC was measured using standardized protocols. Unadjusted and BMI-adjusted (MUACBMI-adj) values were compared. BMI adjustment factors were: male (M) -3cm, female (F) -2cm for BMI 25-29.9; M -7cm, F -6cm for BMI 30-39.9; and M -10cm, F -9cm for BMI >40. Low MUAC was defined as <28cm (M) and <25cm (F). Cox and Poisson regression models, adjusted for confounders, evaluated the independent associations of MUAC and MUACBMI-adj with prolonged length of stay (LOS > 8 days) and 12-month mortality. 

Results: A total of 236 patients were included (57.6% males, mean age: 70 ± 7 years, 36.8% cancer). The prevalence of low MUAC was 33.5%, increasing to 53.4% after BMI adjustment. Prolonged LOS rate was 46.1%, and 12-mo mortality was 18.2%. Patients with low MUAC and low MUACBMI-adj had lower 12-mo survival probabilities (MUAC: 86.2% vs 70.6%, log-rank p = 0.005; MUACBMI-adj: 86.9% vs 75.9%, log-rank p = 0.037). Low MUAC was associated with 2.3-fold higher mortality risk (HR 2.30, 95% CI 1.22;4.33, p = 0.010). Low MUACBMI-adj demonstrated similar prognostic value and was associated with 2.1 times higher mortality risk (HR 2.13, 95% CI 1.03;4.39, p=0.041). MUAC and MUACBMI-adj were not associated with prolonged LOS.

Conclusion: Our study demonstrates the clinical relevance of the newly proposed MUAC cutoff points, irrespective of BMI adjustments. Our results support the use of MUAC as a muscle-related prognostic marker in hospitalized older patients.

Disclosure of Interest: J. Silva-Filho: None declared, J. P. Costa-Pereira Speakers Bureau of: Fresenius Kabi Br; Danone Nutricia Br; Prodiet Medical Nutrition Br, 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