ABSTRACT Aim Calf circumference (CC) is a simple surrogate marker of muscle mass. Body mass index (BMI) adjustment and age‐specific cutoffs for low CC have been proposed to optimize its use in clinical practice. This study aimed to clarify the association of BMI‐adjusted CC and age‐specific cutoffs with in‐hospital falls among older adults. Methods This study was conducted using data from the Japan Hospital Acquired Complications (J‐HAC) project, a multicenter cohort study. In this analysis, we included adults aged ≥ 65 years. CC was measured on admission, and the occurrence of falls was assessed and recorded by medical personnel throughout the hospitalization. BMI adjustment and age‐specific cutoffs for low CC were applied based on previous studies. Multivariable logistic regression models were developed to examine the association between in‐hospital falls and BMI‐adjusted CC and age‐specific low CC cutoffs, adjusting for age and comorbidities. Results A total of 808 patients (mean age 83.7 ± 6.6 years, 57.2% females) were analyzed. In females, higher BMI‐adjusted CC was significantly associated with a lower risk of in‐hospital falls after adjusting for age and comorbidities (adjusted OR = 0.88, 95% CI: 0.77–0.998). Furthermore, low BMI‐adjusted CC, as defined by age‐specific cutoff values, was independently associated with an increased fall risk in the multivariable model (adjusted OR = 2.39, 95% CI: 1.03–5.54). In contrast, no significant associations were observed in males regardless of CC adjustment or cutoff criteria. Conclusions BMI‐adjusted CC and age‐specific cutoffs showed a stronger association with in‐hospital falls among older females than unadjusted CC. Further validation in diverse populations and outcomes is required to confirm their usefulness.
Miyahara et al. (Thu,) studied this question.