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Calf Circumference: A Marker of Muscle Mass as a Predictor of Hospital Readmission
Author(s) -
Real Gustavo Gonzales,
Frühauf Inara Regina,
Sedrez José Henrique Koth,
Dall'Aqua Eduarda Jaine Fachinello,
Gonzalez Maria Cristina
Publication year - 2018
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1002/jpen.1170
Subject(s) - medicine , interquartile range , bioelectrical impedance analysis , odds ratio , confidence interval , prospective cohort study , body mass index , sarcopenia
Hospital readmissions (HRs) are common, potentially preventable, and a marker of poor quality in health services. This study aimed to identify risk factors for HR in clinical patients, with an emphasis on nutrition aspects, especially calf circumference (CC), as a marker of muscle mass. A prospective cohort study of patients admitted to the internal medicine ward was conducted. The short form of the Patient‐Generated Subjective Global Assessment was performed in the first 24 hours of hospitalization. In addition, single‐frequency bioelectrical impedance analysis was used to estimate the phase angle, CC as a surrogate of muscle mass, and handgrip strength as a marker of strength. The Charlson Comorbidity Index (CCI) was used to assess the severity of the comorbidities. Reassessments were performed every 7 days during hospitalization. HR was evaluated 30 days after discharge by phone contact. A sample of 161 patients was assessed; 54.6% were male, with a mean age of 59.2 ± 17.8 years. The median CCI was 2.76 (interquartile range: 1–4), and nutrition risk and low CC were present in 77.6% and 46% of the patients, respectively. The readmission rate was 16.8% after 30 days. After controlling for sex and age, a CCI > 2 (odds ratio [OR]: 3.29; 95% confidence interval [CI]: 1.21–8.97), the presence of cancer (OR: 4.52; 95% CI: 1.11–18.42), nutrition risk (OR: 9.53; 95% CI: 1.16–77.9), and a low CC (OR: 3.89; 95% CI: 1.34–11.31) were significantly associated with 30 day HR. In conclusion, muscle mass loss, identified by CC, can be a good predictor of 30‐day HR, even after controlling for other well‐known risk factors.