Low Calf Circumference is Associated with Prolonged Hospital Stay in Older Patients with Solid Tumors: A Secondary Analysis of a Cohort Study

Abstract

Background

Older patients with cancer present intense loss of muscle mass (MM). Calf circumference (CC) is a simple measurement that assesses MM. This study analyzed the accuracy and association between low CC and negative outcomes in older patients with solid tumors.

Methods

A secondary analysis of a prospective cohort study of inpatients with cancer was conducted. Low CC was defined as CC ≤34 cm in males and ≤33 cm in females. The CC was adjusted for body mass index by reducing 3 or 7 cm for BMI (in kg/m²) of 25–29.9 and 30–39.9, respectively. Accuracy tests and regression analyses were performed to evaluate the criterion validity of low CC for predicting length of stay (LOS) and readmission.

Results

A total of 248 inpatients were evaluated (69.7 [standard deviation (SD) 7.2]; 59.7% men). Among them, 31% had a low CC. A low CC (crude and adjusted for BMI) showed poor performance in predicting LOS and readmission. In the adjusted analysis, older patients with low CC had a 2.45-fold increased risk of LOS ≥ 4 days.

Conclusion

Low CC did not perform well in predicting negative outcomes in older patients with solid tumors. However, low CC was positively associated with LOS.

Acknowledgements

The authors thank the volunteers and the staff, as well as the Financiamento e Incentivo à Pesquisa (FIPE) program of the Hospital de Clínicas de Porto Alegre (HCPA) for financial support.

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Authors’ Contribution

TS and GPS conceived and designed the study. LMS, MSC, GPS, and CHS contributed to data acquisition. GPS and TS participated in the data analysis and interpretation. LMS and TS drafted the manuscript. All authors critically revised and approved the final version of the manuscript. TS is the guarantor and attests that all listed authors meet the authorship criteria, and that no others meeting the criteria have been omitted.

Data Availability Statement

The participants of this study did not give written consent for their data to be shared publicly. Due to the sensitive nature of the research supporting data, the information was not made available.

Additional information

Funding

This study was supported by the Financiamento e Incentivo à Pesquisa (FIPE) of the Hospital de Clínicas de Porto Alegre (HCPA), Brazil. This study was also financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Brazil (CAPES), Finance Code 001. Giovanna P. Stefani and Mariana S. Crestani received the CAPES scholarship. Laura M. Scott received a scholarship from Universidade Federal do Rio Grande do Sul.