Correlation of Sarcopenia With Modified Frailty Index as a Predictor of Outcome in Critically III Elderly Patients: A Cross-Sectional Study

Introduction: Frailty phenotype represents weight loss, decreased functional and physical capacity and activity, falls, slow gait, and memory impairment. Sarcopenia is a generalized and progressive loss of skeletal muscle mass, strength, and function, which occurs due to primary effects of aging and secondary effects of other causes including diseases, malnutrition, and inactivity. Materials and Methods: This prospective cross-sectional study was performed on 70 critically ill geriatric patients (of age > 60 years) admitted in Medicine ICU (MICU) from December 2020 to May 2021 at a rural medical school at Wardha in central rural India. We assessed sarcopenia in all the patients by the European Working Group on Sarcopenia in Older People (EWGSOP) criteria and compared it with the modified frailty index. All the patients were divided in sarcopenic and non-sarcopenic groups; frailty index was applied, and outcomes were measured in terms of mortality, the need for ventilation, and length of ICU stay. Results: In this study, the mean age of the patients was 68.61 +/- 5.88 years in the sarcopenic group and 69.10 +/- 6.31 years in the non-sarcopenic group. Eighteen (42.86%) patients in the sarcopenic group were severely frail, whereas eight (28.57%) patients in the non-sarcopenic group (p = 0.532) were not. In the sarcopenic severely frail group, mortality was six (14.29%), and eight (19.05%) required ventilation (p = 0.001), whereas in the non .sarcopenic severely frail group, mortality as well as the need for ventilation were four (14.29%) (p = 0.0001). lbtal duration of ICU stays was 4.30 +/- 1.07 days in the sarcopenic group (n = 42), whereas it was 3.85 +/- 1.23 days in the non-sarcopenic group (n = 28) (p = 0.10). Conclusion: Our study found that critically ill patients with sarcopenia had more tendency to become frail, thereby increased risk of mortality. A timely routine assessment for sarcopenia upon ICU admission may provide an important prognostic factor in patient outcomes.