A novel combination of SARC-F, GLIM criteria, and calcium levels to predict short-term mortality in hospitalized older adults with advanced-stage cancer.

BACKGROUND AND OBJECTIVES: Sarcopenia and malnutrition are highly prevalent among older adults with advanced-stage cancers. Although the SARC-F is a simple and widely used screening tool for sarcopenia, its extended prognostic value remains under investigation. This study aimed to evaluate the relationship between SARC-F scores, nutritional status, inflammatory biomarkers, and short-term mortality in hospitalized older adults with advanced solid organ malignancies. METHODS AND STUDY DESIGN: We conducted a retrospective cross-sectional analysis on 72 patients with advanced-stage solid tumors and 52 age and sex matched controls. Nutritional status was evaluated using the Mini Nutritional Assessment Short Form (MNA-SF), Nutrition Risk Screening (NRS-2002), and the Global Leadership Initiative on Malnutrition (GLIM) criteria. Functional and frailty assessments included Activities of Daily Living (ADL), Instrumental ADL (IADL), and the FRAIL scale. Laboratory markers of inflammation were also collected. Multivariate logistic regression and receiver operating characteristic (ROC) analyses were used to identify predictors of mortality. RESULTS: A total of 124 participants were included (72 patients with advanced-stage cancer and 52 controls). The mean age was 74.3±9.4 years, and 58.1% were male. Mortality rates at 1, 3, and 6 months were 41.9%, 59.7%, and 65.3%, respectively. In multivariate analysis, calcium levels were independently associated with increased mortality risk (OR: 4.59, p <0.001). The SARC-F score demonstrated moderate discriminative ability for mortality prediction (AUC: 0.675), with high specificity (96.2%) but low sensitivity (30.6%) at a cut-off of ≥4. CONCLUSIONS: The SARC-F score serves as a multidimensional indicator reflecting sarcopenia risk, nutritional deficits, functional impairment, and short-term mortality. Its prognostic utility improves when combined with clinical and laboratory markers. This study proposes a novel prognostic model incorporating SARC-F, GLIM criteria, and serum calcium to enhance short-term mortality prediction in older adults with advanced cancer.