Impact of possible sarcopenia on post-discharge adverse outcomes in patients with acute stroke.

Purpose: This study aimed to clarify the effects of possible sarcopenia at admission-defined using calf circumference (CC) and handgrip strength-on adverse events, including recurrence and death, in patients with acute stroke.

Methods: This retrospective cohort study was conducted at two acute care hospitals between November 2020 and March 2022. All patients admitted within 48 h of stroke onset during the study period were included. Possible sarcopenia was defined according to the AWGS 2019 criteria, using CC (men <34 cm, women <33 cm) for case finding and identified by the presence of low handgrip strength (men <28 kg, women <18 kg). The primary outcomes were adverse events after discharge, including recurrence, readmission, and death. After adjusting for confounders, we applied the Cox proportional hazards regression analysis to examine whether possible sarcopenia was associated with outcomes.

Results: Out of the 511 patients included in the study, possible sarcopenia was identified in 229 patients (44.8 %). Possible sarcopenia (hazard ratio [HR] = 3.94; 95 % confidence interval [CI] 1.83-8.50; p < 0.001) were significantly associated with adverse events after adjusting for confounders, whereas low CC (HR = 2.37; 95 % CI 0.99-5.62; p = 0.050) and low handgrip strength (HR = 1.97; 95 % CI 0.85-4.59 p = 0.116) were not.

Conclusion: The findings of the study reveal that possible sarcopenia at the time of admission in patients with stroke is associated with adverse outcomes after discharge. These findings suggest that the identification of sarcopenia may facilitate prognostic prediction.