title: Sarcopenia, physical rehabilitation and functional outcomes of patients in a subacute geriatric care unit.
abstract: Sarcopenia is the loss of muscle mass and strength, which in the elderly can result in disability and affect functional outcomes after hospitalization. The aim of this study was to evaluate the functional outcomes and mortality during hospitalization and at three months post-discharge, according to the presence of sarcopenia. Prospective study of 99 patients (38.4% men, aged 84.6) admitted in a subacute geriatric care unit who underwent a rehabilitation intervention. Main outcomes were mortality and functional improvement at discharge and at three-month follow-up. Sarcopenia was assessed by handgrip strength (hydraulic dynamometer) and by body composition bioimpedance. Forty-six (46.5%) patients met diagnostic criteria of sarcopenia. Patients with sarcopenia had a worse prior functional status than those without the condition (Barthel Index: 64.2±22.8 vs 73.3±21.8; p=0.04) but both groups had similar functional decline at admission (Barthel Index: 24±15.1 vs 28.5±15.2; p=0.1) and achieved similar functional improvement at discharge (20.4±18.3 vs 27.4±21; p=0.08). Barthel Index at discharge remained comparatively worse in patients with sarcopenia (44.2±26.6 vs 55.9±26.7; p=0.03). After completing a 3-month at-home rehabilitation program, no changes in functional capacity were observed in patients with sarcopenia; their peers improved their Barthel Index scores (45.5±24.8 vs 61.6±26.6; p=0.007). Mortality rates at 3-month follow-up did not differ between groups. In conclusion, patients with sarcopenia had a worse functional status, similar functional improvement during hospitalization and a lack of recovery after returning home. Further studies are needed to establish long-terms effects on mortality.
authors.affiliation: Geriatrics Department, Parc de Salut Mar (Hospital de ĺEsperança, Centro Fòrum de ĺHospital del Mar), Barcelona, Catalonia, Spain; School of Medicine, Universitat Autònoma de Barcelona, Catalonia, Spain. Electronic address: 97662@parcdesalutmar.cat.
authors.forename: Dolores
authors.initials: D
authors.lastname: Sánchez-Rodríguez
authors.affiliation: Physical Medicine and Rehabilitation Department, Parc de Salut Mar (Hospital de ĺEsperança), Barcelona, Catalonia, Spain; School of Medicine, Universitat Autònoma de Barcelona, Catalonia, Spain; School of Medicine, Universitat Internacional de Catalunya, Catalonia, Spain.
authors.forename: Ester
authors.initials: E
authors.lastname: Marco
authors.affiliation: Geriatrics Department, Parc de Salut Mar (Hospital de ĺEsperança, Centro Fòrum de ĺHospital del Mar), Barcelona, Catalonia, Spain; School of Medicine, Universitat Autònoma de Barcelona, Catalonia, Spain.
authors.forename: Ramon
authors.initials: R
authors.lastname: Miralles
authors.affiliation: Physical Medicine and Rehabilitation Department, Parc de Salut Mar (Hospital de ĺEsperança), Barcelona, Catalonia, Spain.
authors.forename: Mónica
authors.initials: M
authors.lastname: Fayos
authors.affiliation: Institut Hospital del Mar d́Investigacions Mèdiques, Barcelona, Catalonia, Spain.
authors.forename: Sergio
authors.initials: S
authors.lastname: Mojal
authors.affiliation: Physical Medicine and Rehabilitation Department, Parc de Salut Mar (Hospital de ĺEsperança), Barcelona, Catalonia, Spain.
authors.forename: Martha
authors.initials: M
authors.lastname: Alvarado
authors.affiliation: Geriatrics Department, Parc de Salut Mar (Hospital de ĺEsperança, Centro Fòrum de ĺHospital del Mar), Barcelona, Catalonia, Spain; School of Medicine, Universitat Autònoma de Barcelona, Catalonia, Spain.
authors.forename: Olga
authors.initials: O
authors.lastname: Vázquez-Ibar
authors.affiliation: Physical Medicine and Rehabilitation Department, Parc de Salut Mar (Hospital de ĺEsperança), Barcelona, Catalonia, Spain; Institut Hospital del Mar d́Investigacions Mèdiques, Barcelona, Catalonia, Spain; School of Medicine, Universitat Autònoma de Barcelona, Catalonia, Spain.
authors.forename: Ferran
authors.initials: F
authors.lastname: Escalada
authors.affiliation: Physical Medicine and Rehabilitation Department, Parc de Salut Mar (Hospital de ĺEsperança), Barcelona, Catalonia, Spain; Institut Hospital del Mar d́Investigacions Mèdiques, Barcelona, Catalonia, Spain; School of Medicine, Universitat Autònoma de Barcelona, Catalonia, Spain.
authors.forename: Josep M
authors.initials: JM
authors.lastname: Muniesa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D010349:Patient Compliance; D011446:Prospective Studies; D020127:Recovery of Function; D055948:Sarcopenia / Q000401:mortality / Q000503:physiopathology* / Q000534:rehabilitation; D013030:Spain; D019467:Subacute Care
keywords: Elderly; Geriatric rehabilitation; In-patient; Intermediate care; Sarcopenia