Association of SARC-F Questionnaire and Mortality in Prevalent Hemodialysis Patients

Diagnostics (Basel). 2020 Oct 31;10(11):890. doi: 10.3390/diagnostics10110890.

Abstract

Sarcopenia is common in patients undergoing chronic hemodialysis, which leads to poor outcomes. SARC-F (sluggishness, assistance in walking, rising from a chair, climb stairs, falls), a self-report questionnaire, is recommended as an easily applied tool for screening sarcopenia in older people. However, there are limited data regarding its use in patients undergoing chronic hemodialysis. Therefore, we aimed to evaluate the association between SARC-F and mortality in these patients. SARC-F questionnaire was applied in 271 hemodialysis patients (mean age 64.4 ± 14.3 years) at baseline. The association between SARC-F and mortality during a 24-month follow-up was analyzed. During this follow-up period, 40 patients (14.8%) died. The discriminative power of SARC-F score for predicting mortality was 0.716 (95% confidence interval (CI) = 0.659-0.769; p < 0.001). The best cut-off was a score ≥ 1, which provided 85.0% sensitivity, 47.2% specificity, 21.8% positive predictive value, and 94.8% negative predictive value. Kaplan-Meier curves showed that patients with SARC-F ≥ 1 exhibited a higher risk of mortality than those with SARC-F < 1 (p < 0.001). Moreover, a stepwise decline in survival with higher SARC-F scores was also observed. After full adjustments, SARC-F ≥ 1 was independently associated with increased mortality (hazard ratio = 2.87, 95% CI = 1.11-7.38; p = 0.029). In conclusion, SARC-F applied for sarcopenia screening predicted mortality in patients undergoing chronic hemodialysis.

Keywords: SARC-F; hemodialysis; mortality; sarcopenia.