SARC-F questionnaire identifies physical limitations and predicts post discharge outcomes in elderly patients with cardiovascular disease

2018 ◽  
Vol 3 (1) ◽  
Author(s):  
Shinya Tanaka ◽  
Kentaro Kamiya ◽  
Nobuaki Hamazaki ◽  
Ryota Matsuzawa ◽  
Kohei Nozaki ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Physical Function ◽  
Handgrip Strength ◽  
Japanese Patients ◽  
Walking Distance ◽  
Study Endpoint ◽  
Post Discharge ◽  
Discharge Outcomes ◽  
Physical Limitations ◽  
Discharge From Hospital

Background A simple and inexpensive sarcopenia screening tool would be beneficial in clinical practice. This study was performed to determine whether SARC-F questionnaire can be used to identify physical limitations and poor prognosis in elderly cardiovascular disease (CVD) patients.Methods The study population consisted of 257 Japanese patients ≥65 years old admitted to our hospital for CVD. Prior to discharge from hospital, SARC-F, handgrip strength, usual gait speed, short physical performance battery score, and 6-minute walking distance were measured in all patients. The patients were divided into two groups according to SARC-F score: SARC-F <4 and SARC-F ≥4. The study endpoint was the first occurrence of all-cause emergency readmission or all-cause mortality.Results The prevalence rate of SARC-F ≥4 was 26.8%, and increased with age and number of comorbidities. Even after adjusting for covariates, physical function was significantly poorer and the risks of physical function measurements below the critical cut-off values were higher in the SARC-F ≥4 group compared to the SARC-F <4 group. Sixty (23.3%) patients were readmitted and 17 (6.6%) died over a median follow-up period of 11 months (interquartile range: 6–13 months). SARC-F score was a significant predictor of adverse events after discharge. Patients with SARC-F ≥4 showed higher event risk than those with SARC-F <4 (adjusted hazard ratio: 1.78; 95% confidence interval: 1.03–3.07; P = 0.040).Conclusions SARC-F questionnaire is useful to identify patients at high risk of physical limitations and to predict post-discharge outcomes in elderly CVD patients.

scholarly journals Physical function assessment of older adults with lower body fractures at 3 months post-discharge from hospital

2019 ◽  
Vol Volume 15 ◽  
pp. 201-210
Author(s):  
Nurul 'Izzah Ibrahim ◽  
Mohd Sharkawi Ahmad ◽  
Mohamed S Zulfarina ◽  
Sharifah Nurul Aqilah Sayed Mohd Zaris ◽  
Zainal Abidin Nor Azlin ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Function ◽  
Lower Body ◽  
Post Discharge ◽  
Discharge From Hospital ◽  
Function Assessment

scholarly journals SARC-F Questionnaire: Rapid and Easy Tool for Identifying Physical Limitations in Hemodialysis Patients

2019 ◽  
Vol 4 (1) ◽  
Author(s):  
Shohei Yamamoto ◽  
Ryota Matsuzawa ◽  
Manae Harada ◽  
Takaaki Watanabe ◽  
Takahiro Shimoda ◽  
...  
Keyword(s):  
Physical Function ◽  
Gait Speed ◽  
Handgrip Strength ◽  
Characteristic Curve ◽  
Hemodialysis Patients ◽  
Cross Sectional ◽  
Standing Time ◽  
Leg Strength ◽  
Physical Limitations ◽  
Usual Gait Speed

Background:SARC-F is a simple questionnaire for rapidly assessing physical function and screening for sarcopenia. This study aimed to determine whether the SARC-F questionnaire is useful for identifying impaired physical function and the risk of physical limitations in hemodialysis patients.Methods:This cross-sectional study included 281 patients undergoing hemodialysis at two dialysis units.SARC-F, handgrip strength, leg strength, one-leg standing time, usual gait speed, and short physical performance battery (SPPB) score were measured. Patients were classified according to the SARC-F score (SARC-F <4 and SARC-F ≥4), indicating the risk of sarcopenia. Furthermore, we defined physical limitations as handgrip strength of <26 kg for men and <18 kg for women, leg strength of <40%, usual gait speed of ≤0.8 m/s, and SPPB score of ≤8 points. To calculate the areas under the curves (AUCs) of the SARC-F score for physical limitations, receiver-operating characteristic curve analysis was performed.Results:SARC-F ≥4 was observed in 75 (26.7 %) hemodialysis patients. The SARC-F ≥4 group had a significantly lower handgrip and leg strength, shorter one-leg standing time, slower usual gait speed, and lower SPPB score than the SARC-F <4 group, even after adjusting for potential confounders (all P<0.001). Further, SARC-F demonstrated good accuracy in identifying the risk of physical limitations (all AUCs > 0.75).Conclusions:The SARC-F questionnaire is useful for screening impaired physical function and for identifying the risk of physical limitations in hemodialysis patients and can be easily and rapidly administered to this patient group in clinical practice.

P1583UTILITY OF THE GLOBAL LEADERSHIP INITIATIVE ON MALNUTRITION CRITERIA FOR THE DETECTION OF MALNUTRITION AND DECLINE IN PHYSICAL FUNCTION AND ADL IN JAPANESE AMBULATORY HEMODIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Haruka Ito ◽  
Shohei Yamamoto ◽  
Manae Harada ◽  
Takaaki Watanabe ◽  
Yuta Suzuki ◽  
...  
Keyword(s):  
Physical Function ◽  
Phase Angle ◽  
Handgrip Strength ◽  
Hemodialysis Patients ◽  
Global Leadership ◽  
Analysis Of Covariance ◽  
Nutritional Risk ◽  
Calf Circumference ◽  
Risk Of Death ◽  
Cumulative Score

Abstract Background and Aims In patients who undergo hemodialysis (HD), malnutrition is a frequent complication associated with higher risk of death, extended hospital stay, physical limitation, and decline of activities of daily living (ADL). Therefore, proper assessment for malnutrition in this population is important for effective disease management. The Global Leadership Initiative on Malnutrition (GLIM) released new criteria for diagnosing and grading malnutrition. Nevertheless, only very few studies have investigated malnutrition prevalence on the basis of the GLIM criteria in hemodialysis patients. Hence, the usefulness of the GLIM criteria’s application in hemodialysis patients remains unclear. The aims of this study were (1) to examine whether malnutrition diagnosed on the basis of the GLIM criteria will produce equivalent results with that diagnosed with the use of existing nutritional indicators and (2) to evaluate the association between the GLIM criteria and decline of physical function and ADL in Japanese patients on HD. Method This cross-sectional study included a total of 185 outpatients who undergo HD three times a week. We measured the existing nutritional indicators (GNRI, MNA-SF, phase angle, mid-arm muscle circumference, and calf circumference), physical function (Fried Scale, handgrip strength, usual gait speed, Short Physical Performance Battery, and physical activity), and ADL status (cumulative score of Barthel Index and instrumental ADL). On the basis of the GLIM criteria, the patients were classified into two groups (no malnutrition and malnutrition). In addition, in case of nutritional risk, nutritional assessment was performed by evaluation of the phenotypic (unintentional weight loss, low BMI, and/or reduced muscle mass) and etiologic (reduced intake or assimilation and/or inflammatory response) factors. Malnutrition was diagnosed if a patient has one or more of these items. The analysis of covariance (ANCOVA) was performed to examine the association between the GLIM criteria and existing nutritional indicators, physical function, and ADL status. Results Malnutrition was diagnosed in 41.1% of the participants based on the GLIM criteria. In contrast, on the basis of the existing nutritional indicators (GNRI, MNA-SF, phase angle, mid-arm muscle circumference, and calf circumference), malnutrition was diagnosed in 22.2%, 58.3%, 48.6%, 57.9%, and 54.6%, respectively. The ANCOVA results, adjusted for the patient’s characteristics, revealed that the malnutrition group had significantly lower score than the non-malnutrition group in the existing nutritional indicators (all P &lt; 0.001) (Figure). Furthermore, the malnutrition group had significantly higher Fried Scale scores, lower handgrip strength results, and lower ADL status than the non-malnutrition group, even after potential confounder adjustment (all P &lt; 0.05). Conclusion The GLIM criteria could be one of the useful tools for screening the risk of malnutrition, frailty, lower handgrip strength, and lower ADL status in patients who undergo HD.

THE RELATIONSHIP OF OBESITY AND LOW HANDGRIP STRENGTH OR SARCOPENIC OBESITY AS A PREDICTOR OF THE PRESENCE OF CARDIOVASCULAR DISEASE

2020 ◽  
Vol 75 (11) ◽  
pp. 2286
Author(s):  
Jose Patricio Lopez ◽  
Patricio Lopez-Jaramillo ◽  
Paul A. Camacho ◽  
Darryl Leong ◽  
Sumathy Rangarajan ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Handgrip Strength ◽  
Sarcopenic Obesity ◽  
Relationship Of ◽  
The Relationship

Early Diuretic Strategies and the Association With In-Hospital and Post-Discharge Outcomes in Acute Heart Failure

2021 ◽  
Author(s):  
Marat Fudim ◽  
Toi Spates ◽  
Jie-Lena Sun ◽  
Veraprapas Kittipibul ◽  
Jeffrey M. Testani ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Post Discharge ◽  
Discharge Outcomes

scholarly journals Women’s Health Initiative Strong and Healthy Pragmatic Physical Activity Intervention Trial for Cardiovascular Disease Prevention: Design and Baseline Characteristics

2021 ◽  
Author(s):  
Marcia L Stefanick ◽  
Abby C King ◽  
Sally Mackey ◽  
Lesley F Tinker ◽  
Mark A Hlatky ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cardiovascular Disease ◽  
Physical Function ◽  
Women’S Health ◽  
Women's Health ◽  
Physical Activity Intervention ◽  
Women's Health Initiative ◽  
Women’S Health Initiative ◽  
Health Initiative ◽  
Race Ethnicity

Abstract Background National guidelines promote physical activity to prevent cardiovascular disease (CVD), yet no randomized controlled trial has tested whether physical activity reduces CVD. Methods The Women’s Health Initiative (WHI) Strong and Healthy (WHISH) pragmatic trial used a randomized consent design to assign women for whom cardiovascular outcomes were available through WHI data collection (N = 18 985) or linkage to the Centers for Medicare and Medicaid Services (N30 346), to a physical activity intervention or “usual activity” comparison, stratified by ages 68–99 years (in tertiles), U.S. geographic region, and outcomes data source. Women assigned to the intervention could “opt out” after receiving initial physical activity materials. Intervention materials applied evidence-based behavioral science principles to promote current national recommendations for older Americans. The intervention was adapted to participant input regarding preferences, resources, barriers, and motivational drivers and was targeted for 3 categories of women at lower, middle, or higher levels of self-reported physical functioning and physical activity. Physical activity was assessed in both arms through annual questionnaires. The primary outcome is major cardiovascular events, specifically myocardial infarction, stroke, or CVD death; primary safety outcomes are hip fracture and non-CVD death. The trial is monitored annually by an independent Data Safety and Monitoring Board. Final analyses will be based on intention to treat in all randomized participants, regardless of intervention engagement. Results The 49 331 randomized participants had a mean baseline age of 79.7 years; 84.3% were White, 9.2% Black, 3.3% Hispanic, 1.9% Asian/Pacific Islander, 0.3% Native American, and 1% were of unknown race/ethnicity. The mean baseline RAND-36 physical function score was 71.6 (± 25.2 SD). There were no differences between Intervention (N = 24 657) and Control (N = 24 674) at baseline for age, race/ethnicity, current smoking (2.5%), use of blood pressure or lipid-lowering medications, body mass index, physical function, physical activity, or prior CVD (10.1%). Conclusion The WHISH trial is rigorously testing whether a physical activity intervention reduces major CV events in a large, diverse cohort of older women. Clinical Trials Registration Number: NCT02425345

Paediatric post-discharge pain and parent perceptions of support from an Australian nurse practitioner led acute pain service

2021 ◽  
pp. 136749352110147
Author(s):  
Elizabeth M. Forster ◽  
Catherine Kotzur ◽  
Julianne Richards ◽  
John Gilmour
Keyword(s):  
Pain Management ◽  
Acute Pain ◽  
Nurse Practitioner ◽  
Parental Support ◽  
Transition Period ◽  
Short Form ◽  
Acute Pain Service ◽  
Cross Sectional Survey ◽  
Post Discharge ◽  
Discharge From Hospital

Poorly managed post-operative pain remains an issue for paediatric patients. Post-discharge telephone follow-up is used by an Australian Nurse Practitioner Acute Pain Service (NpAPS) to provide access to effective pain management post-discharge from hospital. This cross-sectional survey design study aimed to determine the pain levels of children following discharge and parent views on participation in their child’s pain management and perceptions of support from the NpAPS. Parents completed the Parents’ Postoperative Pain Measure–Short Form (PPPM-SF) and factors affecting parents’ participation in children’s pain management questionnaire (FPMQ). Results indicated that pain score was high, especially on the day of discharge and 24 hours post-discharge. Parents, despite feeling supported by the NpAPS, experienced uncertainty, emotional responses and expressed concerns about communication and coordination of care. The clinically significant pain levels of the majority of children on the day of discharge and day post-discharge from hospital are a concern. Worry and uncertainty among parents, particularly on the day and first night of discharge, suggest this transition period where responsibility of clinical management of pain is handed over to parents may require greater focus for parental support.

scholarly journals Prognostic value of cardio-hepatic-skeletal muscle syndrome in patients with heart failure

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Takumi Noda ◽  
Kentaro Kamiya ◽  
Nobuaki Hamazaki ◽  
Kohei Nozaki ◽  
Takafumi Ichikawa ◽  
...  
Keyword(s):  
Heart Failure ◽  
Physical Function ◽  
Grip Strength ◽  
Liver Dysfunction ◽  
Gait Speed ◽  
International Normalized Ratio ◽  
Walking Distance ◽  
Leg Strength ◽  
Function Test ◽  
End Stage

AbstractAlthough heart failure (HF) and liver dysfunction often coexist because of complex cardiohepatic interactions, the association between liver dysfunction and physical dysfunction, and between coexistence of both and prognosis in HF patients remains unclear. We reviewed 895 patients with HF (mean age, 69.4 ± 14.2 years) who underwent liver function test using model for end-stage liver disease excluding international normalized ratio (MELD-XI) score and physical function test (grip strength, leg strength, gait speed, and 6-min walking distance [6MWD]). In the multiple regression analysis, MELD-XI score was independently associated with lower grip strength, leg strength, gait speed, and 6MWD (all P < 0.001). One hundred thirty deaths occurred over a median follow-up period of 1.67 years (interquartile range: 0.62–3.04). For all-cause mortality, patients with high MELD-XI scores and reduced physical functions were found to have a significantly higher mortality risk even after adjusting for several covariates (grip strength, hazard ratio [HR]: 3.80, P < 0.001; leg strength, HR: 4.65, P < 0.001; gait speed, HR: 2.49, P = 0.001, and 6MWD, HR: 5.48, P < 0.001). Liver dysfunction was correlated with reduced physical function. Moreover, the coexistence of lower physical function and liver dysfunction considerably affected prognosis in patients with HF.

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