Associations of Sarcopenia With Medical Events and Inpatient Rehabilitation Outcomes in ACC/AHA Stage A, B, and C Heart Failure Individuals With Disabilities

Objective: To assess the associations of sarcopenia with medical events and inpatient rehabilitation outcomes in American College of Cardiology (ACC)/American Heart Association (AHA) stage A, B, and C patients with heart failure (HF) and disabilities. Design: Retrospective cohort study. Setting: Inpatient rehabilitation ward. Participants: ACC/AHA stage A, B, and C patients with HF (N=293) with or without sarcopenia who had disabilities because of neurologic disorders, musculoskeletal disorders, or hospital-associated deconditioning. Interventions: None. Main Outcome Measures: The primary outcomes were medical events such as death and illness requiring interhospital transport for specialized medical care. The secondary outcomes were inpatient rehabilitation outcomes, including improvement efficiency of the FIM (gain in FIM score divided by length of stay) for motor function (FIM-M) and cognitive function (FIM-C). Results: The adjusted hazard ratio indicating risk for medical events in the ACC/AHA stage A, B, and C HF with sarcopenia group relative to those without sarcopenia group was 2.93 (95% CI, 1.12-7.67). The β coefficients of the ACC/AHA stage A, B, and C HF with sarcopenia group relative to those without sarcopenia group for the improvement efficiencies of FIM-M and FIM-C were 0.11 (lower confidence limit: -0.33, upper confidence limit: 0.56) and -0.28 (lower confidence limit: -1.51, upper confidence limit: 0.997), respectively. Conclusions: This study showed that sarcopenia was significantly associated with medical events but not with inpatient rehabilitation outcomes in ACC/AHA stage A, B, and C HF patients with disabilities.