Department of Medicine V - Haematology, Oncology and Rheumatology, University Hospital Heidelberg, Heidelberg, Germany.
Clinic for Urology, University Hospital Augsburg, Augsburg, Germany.
J Cachexia Sarcopenia Muscle. 2022 Feb;13(1):264-275. doi: 10.1002/jcsm.12871. Epub 2021 Dec 12.
The strength, assistance walking, rise from a chair, climb stairs, and falls (SARC-F) questionnaire is a well-established instrument for screening of sarcopenia and sarcopenia-related functional impairments. As it is based on self-reporting, its use precludes patients who are unable to answer the questionnaire as a consequence of severe acute diseases or cognitive impairment. Therefore, we aimed to validate a proxy-reported version of the SARC-F for both ad-hoc as well as retrospective screening for severe sarcopenia-related functional impairments.
Patients aged ≥60 years completed the SARC-F and performed the short physical performance battery (SPPB) at baseline (T1). Proxies in Cohort A gave a simultaneous assessment of the patients' functional status with the proxy-reported SARC-F at T1 and again, retrospectively, after 3 months (T2). Proxies in Cohort B only completed the SARC-F retrospectively at T2. The questionnaires' performances were assessed through sensitivity/specificity analyses and receiver operating characteristic (ROC) curves. For non-inferiority analyses, results of both the patient-reported and proxy-reported SARC-F were correlated with the SPPB total score as well as the results of the chair-rise test subcategory; the respective correlation coefficients were tested against each other.
One hundred and four patients and 135 proxies participated. Using a SPPB score < 9 points as the reference standard, the proxy-reported SARC-F identified patients at high risk for sarcopenia-related functional impairment with a sensitivity of 0.81 (ad-hoc), 0.88 (retrospective Cohort A), and 0.87 (retrospective Cohort B) as well as a specificity of 0.89 (ad-hoc), 0.78 (retrospective Cohort A), and 0.64 (retrospective Cohort B). Areas under the ROC curves were ≥ 0.9 for the ad-hoc proxy-reported SARC-F and the retrospective proxy-reported SARC-F in both cohorts. The proxy-reported SARC-F showed a non-inferior correlation with the SPPB compared with the patient-reported SARC-F for ad-hoc (P = <0.001) as well as retrospective screening for severe sarcopenia-related functional impairment in both Cohorts A (P = 0.007) and B (P = 0.026).
Proxy-reported SARC-F is a valid instrument for both ad-hoc as well as retrospective screening for sarcopenia-related functional impairment and could become the standard tool for evaluating this risk in older adults with severe acute disease, for example, in patients with quickly evolving haematological conditions.
力量、助行、从椅子上起身、爬楼梯和跌倒（SARC-F）问卷是一种用于筛查肌少症和肌少症相关功能障碍的成熟工具。由于它基于自我报告，因此对于因严重急性疾病或认知障碍而无法回答问卷的患者，该工具不适用。因此，我们旨在为严重肌少症相关功能障碍的临时和回顾性筛查验证代理报告版本的 SARC-F。
年龄≥60 岁的患者在基线（T1）时完成 SARC-F 和简短身体表现测试（SPPB）。队列 A 的代理人在 T1 时同时使用代理报告的 SARC-F 对患者的功能状态进行评估，并在 3 个月后（T2）再次进行回顾性评估。队列 B 的代理人仅在 T2 时进行回顾性的 SARC-F 评估。通过敏感性/特异性分析和接收者操作特征（ROC）曲线评估问卷的性能。对于非劣效性分析，将患者报告和代理报告的 SARC-F 的结果与 SPPB 总分以及椅子起身测试子类别进行相关性分析；将各自的相关系数进行相互比较。
共有 104 名患者和 135 名代理人参与。使用 SPPB 评分<9 分作为参考标准，代理报告的 SARC-F 以 0.81（临时）、0.88（回顾性队列 A）和 0.87（回顾性队列 B）的灵敏度以及 0.89（临时）、0.78（回顾性队列 A）和 0.64（回顾性队列 B）的特异性识别出有肌少症相关功能障碍风险的患者。ROC 曲线下面积均≥0.9，适用于临时和回顾性队列 A 和 B 的代理报告的 SARC-F。与患者报告的 SARC-F 相比，代理报告的 SARC-F 对于临时（P<0.001）和回顾性筛查严重肌少症相关功能障碍在两个队列中均具有非劣效相关性（P=0.007）和 B（P=0.026）。
代理报告的 SARC-F 是临时和回顾性筛查肌少症相关功能障碍的有效工具，可能成为评估患有严重急性疾病的老年人（例如快速发展的血液疾病患者）风险的标准工具。
