The challenge of applying the F-A-C-S pathway from EWGSOP2 for sarcopenia diagnosis in patients with chronic obstructive pulmonary disease: A diagnostic accuracy study

Abstract

Objective

The main objective was to evaluate the performance of the SARC-F questionnaire and muscle function tests used in pulmonary rehabilitation settings following the F-A-C-S (Find cases-Assess-Confirm-Severity) algorithm of the European Working Group on Sarcopenia in Older People (EWGSOP2).

Methods

Diagnostic accuracy study in consecutive patients with chronic obstructive pulmonary disease (COPD) referred to pulmonary rehabilitation.

Results

Of 205 patients (66.8 years; 74.1% men), 29 (14.1%) met the diagnostic criteria for sarcopenia according to EWGSOP2. The sensitivity and specificity of SARC-F were 13% and 92.8%, respectively. Cutoff points with the highest diagnostic accuracy were calculated, with handgrip at 30.3 kg in men and quadriceps maximal voluntary isometric contraction (Q-MVIC) at 17.3 kg in women.

Conclusions

The diagnostic accuracy of the SARC-F questionnaire as a screening tool is low and it did not identify sarcopenia in rehabilitation patients with COPD, suggesting that this population could benefit from a direct approach (A-C-S). Handgrip strength determination provided the best diagnostic accuracy in men, with a cutoff point of 30.3 kg, and in women, Q-MVIC determination showed better performance for sarcopenia diagnosis, with a cutoff point of 17.3 kg.