Point-of-Care Ultrasound-Based Assessment of Sarcopenia to Predict Revisits or Mortality in Older Adults at the Emergency Department: A Prospective Observational Study
10.4235/agmr.25.0106
- Author:
Svenja L. HAAK
;
Lisa GIEZEN
;
Deborah BLANCA
;
Hjalmar R. BOUMA
;
Heleen LAMEIJER
;
Jan C. TER MAATEN
;
Ewoud TER AVEST
- Publication Type:Original Article
- From:
Annals of Geriatric Medicine and Research
2026;30(1):77-84
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:Older patients visiting the emergency department (ED) are at increased risk of adverse outcomes, including ED revisits and mortality. Sarcopenia quantification by point-of-care ultrasound (POCUS) may be a useful bedside screening tool, especially when traditional frailty screening instruments, reliant on history taking, cannot be used. This study evaluated whether POCUS measurement of rectus femoris cross-sectional area (RFcsa) can predict adverse outcomes in older patients visiting the ED.
Methods:In this single-centre prospective study, patients aged ≥70 years presenting to the ED of a Dutch university hospital and enrolled in the Acutelines data and biobank were included. RFcsa was measured using POCUS. ROC-analysis assessed the overall accuracy of RFcsa for prediction of the primary outcome, which was defined as the composite of ED revisit or death within 3 months. Logistic regression determined the added value of RFcsa to Karnofsky Performance Score (KPS).
Results:During the study period, a total of 68 patients were included. Twenty-six patients (38%) met the primary endpoint. RFcsa showed excellent intra-rater reliability (interclass correlation coefficient=0.98). However, the accuracy to predict the composite endpoint was low, with an area under the curves of 0.53 (0.39–0.66) for unadjusted RFcsa and 0.51 (0.36–0.66) for sex-adjusted RFcsa. The addition of RFcsa in a multivariate logistic regression model with KPS did not increase the overall explained variance in the primary endpoint.
Conclusion:In older patients presenting in the ED, POCUS-measured RFcsa does not predict ED revisits or death within 3 months. (Trial Registration No. NCT05369962 at ClinicalTrials.gov)
