{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T16:57:07Z","timestamp":1787331427955,"version":"build-2736575974"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,7,31]],"date-time":"2020-07-31T00:00:00Z","timestamp":1596153600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,7,31]],"date-time":"2020-07-31T00:00:00Z","timestamp":1596153600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["P30AR072581"],"award-info":[{"award-number":["P30AR072581"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["R01AR077273"],"award-info":[{"award-number":["R01AR077273"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["K23DK102824"],"award-info":[{"award-number":["K23DK102824"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Musculoskelet Disord"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Sarcopenia, cachexia and frailty have overlapping features and clinical consequences, but often go unrecognized. The objective was to detect patients described by clinicians as having sarcopenia, cachexia or frailty within electronic health records (EHR) and compare clinical variables between cases and matched controls.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>We conducted a case-control study using retrospective data from the Indiana Network for Patient Care multi-health system database from 2016 to 2017. The computable phenotype combined ICD codes for sarcopenia, cachexia and frailty, with clinical note text terms for sarcopenia, cachexia and frailty detected using natural language processing. Cases with these codes or text terms were matched to controls without these codes or text terms matched on birth year, sex and race. Two physicians reviewed EHR for all cases and a subset of controls. Comorbidity codes, laboratory values, and other coded clinical variables were compared between groups using Wilcoxon matched-pair sign-rank test for continuous variables and conditional logistic regression for binary variables.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Cohorts of 9594 cases and 9594 matched controls were generated. Cases were 59% female, 69% white, and a median (1st, 3rd quartiles) age 74.9 (62.2, 84.8) years. Most cases were detected by text terms without ICD codes <jats:italic>n<\/jats:italic>\u00a0=\u20098285 (86.4%). All cases detected by ICD codes (total <jats:italic>n<\/jats:italic>\u00a0=\u20091309) also had supportive text terms. Overall 1496 (15.6%) had concurrent terms or codes for two or more of the three conditions (sarcopenia, cachexia or frailty). Of text term occurrence, 97% were used positively for sarcopenia, 90% for cachexia, and 95% for frailty. The remaining occurrences were negative uses of the terms or applied to someone other than the patient. Cases had lower body mass index, albumin and prealbumin, and significantly higher odds ratios for diabetes, hypertension, cardiovascular and peripheral vascular diseases, chronic kidney disease, liver disease, malignancy, osteoporosis and fractures (all <jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.05). Cases were more likely to be prescribed appetite stimulants and caloric supplements.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Patients detected with a computable phenotype for sarcopenia, cachexia and frailty differed from controls in several important clinical variables. Potential uses include detection among clinical cohorts for targeting recruitment for research and interventions.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12891-020-03522-9","type":"journal-article","created":{"date-parts":[[2020,7,31]],"date-time":"2020-07-31T16:02:59Z","timestamp":1596211379000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Sarcopenia, frailty and cachexia patients detected in a multisystem electronic health record database"],"prefix":"10.1186","volume":"21","author":[{"given":"Ranjani N.","family":"Moorthi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziyue","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah A.","family":"El-Azab","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren R.","family":"Lembcke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew R.","family":"Miller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea A.","family":"Broyles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7284-3467","authenticated-orcid":false,"given":"Erik A.","family":"Imel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,7,31]]},"reference":[{"issue":"3","key":"3522_CR1","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1097\/MNH.0000000000000318","volume":"26","author":"RN Moorthi","year":"2017","unstructured":"Moorthi RN, Avin KG. Clinical relevance of sarcopenia in chronic kidney disease. Curr Opin Nephrol Hypertens. 2017;26(3):219\u201328.","journal-title":"Curr Opin Nephrol Hypertens"},{"issue":"6","key":"3522_CR2","doi-asserted-by":"publisher","first-page":"793","DOI":"10.1016\/j.clnu.2008.06.013","volume":"27","author":"WJ Evans","year":"2008","unstructured":"Evans WJ, Morley JE, Argiles J, Bales C, Baracos V, Guttridge D, et al. Cachexia: a new definition. Clin Nutr. 2008;27(6):793\u20139.","journal-title":"Clin Nutr"},{"issue":"1","key":"3522_CR3","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1093\/ageing\/afy169","volume":"48","author":"AJ Cruz-Jentoft","year":"2019","unstructured":"Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyere O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16\u201331.","journal-title":"Age Ageing"},{"issue":"5","key":"3522_CR4","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1093\/gerona\/glu010","volume":"69","author":"SA Studenski","year":"2014","unstructured":"Studenski SA, Peters KW, Alley DE, Cawthon PM, McLean RR, Harris TB, et al. The FNIH sarcopenia project: rationale, study description, conference recommendations, and final estimates. J Gerontol A Biol Sci Med Sci. 2014;69(5):547\u201358.","journal-title":"J Gerontol A Biol Sci Med Sci"},{"issue":"2","key":"3522_CR5","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1016\/j.clnu.2009.12.004","volume":"29","author":"M Muscaritoli","year":"2010","unstructured":"Muscaritoli M, Anker SD, Argiles J, Aversa Z, Bauer JM, Biolo G, et al. Consensus definition of sarcopenia, cachexia and pre-cachexia: joint document elaborated by special interest groups (SIG) \u201ccachexia-anorexia in chronic wasting diseases\" and \"nutrition in geriatrics\u201d. Clin Nutr. 2010;29(2):154\u20139.","journal-title":"Clin Nutr"},{"issue":"5","key":"3522_CR6","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1016\/j.mad.2006.01.002","volume":"127","author":"K Rockwood","year":"2006","unstructured":"Rockwood K, Mitnitski A. Limits to deficit accumulation in elderly people. Mech Ageing Dev. 2006;127(5):494\u20136.","journal-title":"Mech Ageing Dev"},{"issue":"6","key":"3522_CR7","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1016\/j.jamda.2013.03.022","volume":"14","author":"JE Morley","year":"2013","unstructured":"Morley JE, Vellas B, van Kan GA, Anker SD, Bauer JM, Bernabei R, et al. Frailty consensus: a call to action. J Am Med Dir Assoc. 2013;14(6):392\u20137.","journal-title":"J Am Med Dir Assoc"},{"issue":"3","key":"3522_CR8","doi-asserted-by":"publisher","first-page":"M146","DOI":"10.1093\/gerona\/56.3.M146","volume":"56","author":"LP Fried","year":"2001","unstructured":"Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146\u201356.","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"3522_CR9","first-page":"192","volume":"6","author":"M Cesari","year":"2014","unstructured":"Cesari M, Landi F, Vellas B, Bernabei R, Marzetti E. Sarcopenia and physical frailty: two sides of the same coin. Front Aging Neurosci. 2014;6:192.","journal-title":"Front Aging Neurosci"},{"issue":"2","key":"3522_CR10","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1007\/s10522-017-9677-9","volume":"18","author":"YY Ding","year":"2017","unstructured":"Ding YY, Kuha J, Murphy M. Multidimensional predictors of physical frailty in older people: identifying how and for whom they exert their effects. Biogerontology. 2017;18(2):237\u201352.","journal-title":"Biogerontology."},{"issue":"2","key":"3522_CR11","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/j.berh.2017.11.002","volume":"31","author":"FE McGuigan","year":"2017","unstructured":"McGuigan FE, Bartosch P, Akesson KE. Musculoskeletal health and frailty. Best Pract Res Clin Rheumatol. 2017;31(2):145\u201359.","journal-title":"Best Pract Res Clin Rheumatol"},{"key":"3522_CR12","doi-asserted-by":"publisher","first-page":"2003","DOI":"10.2147\/CIA.S150826","volume":"12","author":"M Steffl","year":"2017","unstructured":"Steffl M, Sima J, Shiells K, Holmerova I. The increase in health care costs associated with muscle weakness in older people without long-term illnesses in the Czech Republic: results from the survey of health, ageing and retirement in Europe (SHARE). Clin Interv Aging. 2017;12:2003\u20137.","journal-title":"Clin Interv Aging"},{"issue":"1","key":"3522_CR13","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1111\/1747-0080.12287","volume":"74","author":"AC Antunes","year":"2017","unstructured":"Antunes AC, Araujo DA, Verissimo MT, Amaral TF. Sarcopenia and hospitalisation costs in older adults: a cross-sectional study. Nutr Diet. 2017;74(1):46\u201350.","journal-title":"Nutr Diet"},{"issue":"3","key":"3522_CR14","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1007\/s12603-012-0434-0","volume":"17","author":"VE Arango-Lopera","year":"2013","unstructured":"Arango-Lopera VE, Arroyo P, Gutierrez-Robledo LM, Perez-Zepeda MU, Cesari M. Mortality as an adverse outcome of sarcopenia. J Nutr Health Aging. 2013;17(3):259\u201362.","journal-title":"J Nutr Health Aging"},{"issue":"2","key":"3522_CR15","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1093\/ageing\/afs194","volume":"42","author":"F Landi","year":"2013","unstructured":"Landi F, Cruz-Jentoft AJ, Liperoti R, Russo A, Giovannini S, Tosato M, et al. Sarcopenia and mortality risk in frail older persons aged 80 years and older: results from ilSIRENTE study. Age Ageing. 2013;42(2):203\u20139.","journal-title":"Age Ageing"},{"issue":"1","key":"3522_CR16","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1186\/s12877-018-0878-0","volume":"18","author":"X Zhang","year":"2018","unstructured":"Zhang X, Zhang W, Wang C, Tao W, Dou Q, Yang Y. Sarcopenia as a predictor of hospitalization among older people: a systematic review and meta-analysis. BMC Geriatr. 2018;18(1):188.","journal-title":"BMC Geriatr"},{"issue":"2","key":"3522_CR17","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1016\/j.pan.2019.01.006","volume":"19","author":"SS Olesen","year":"2019","unstructured":"Olesen SS, Buyukuslu A, Kohler M, Rasmussen HH, Drewes AM. Sarcopenia associates with increased hospitalization rates and reduced survival in patients with chronic pancreatitis. Pancreatology. 2019;19(2):245\u201351.","journal-title":"Pancreatology."},{"issue":"1","key":"3522_CR18","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1111\/j.1532-5415.2004.52014.x","volume":"52","author":"I Janssen","year":"2004","unstructured":"Janssen I, Shepard DS, Katzmarzyk PT, Roubenoff R. The healthcare costs of sarcopenia in the United States. J Am Geriatr Soc. 2004;52(1):80\u20135.","journal-title":"J Am Geriatr Soc"},{"issue":"6","key":"3522_CR19","doi-asserted-by":"publisher","first-page":"748","DOI":"10.1093\/ageing\/afu115","volume":"43","author":"AJ Cruz-Jentoft","year":"2014","unstructured":"Cruz-Jentoft AJ, Landi F, Schneider SM, Zuniga C, Arai H, Boirie Y, et al. Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the international sarcopenia initiative (EWGSOP and IWGS). Age Ageing. 2014;43(6):748\u201359.","journal-title":"Age Ageing"},{"issue":"4","key":"3522_CR20","first-page":"194","volume":"5","author":"B Vellas","year":"2016","unstructured":"Vellas B, Fielding R, Bhasin S, Cerreta F, Goodpaster B, Guralnik JM, et al. Sarcopenia trials in specific diseases: report by the international conference on frailty and sarcopenia research task force. J Frailty Aging. 2016;5(4):194\u2013200.","journal-title":"J Frailty Aging."},{"key":"3522_CR21","doi-asserted-by":"publisher","first-page":"569194","DOI":"10.4061\/2011\/569194","volume":"2011","author":"O Theou","year":"2011","unstructured":"Theou O, Stathokostas L, Roland KP, Jakobi JM, Patterson C, Vandervoort AA, et al. The effectiveness of exercise interventions for the management of frailty: a systematic review. J Aging Res. 2011;2011:569194.","journal-title":"J Aging Res"},{"key":"3522_CR22","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1016\/j.coph.2015.04.003","volume":"22","author":"JM Argiles","year":"2015","unstructured":"Argiles JM, Busquets S, Stemmler B, Lopez-Soriano FJ. Cachexia and sarcopenia: mechanisms and potential targets for intervention. Curr Opin Pharmacol. 2015;22:100\u20136.","journal-title":"Curr Opin Pharmacol"},{"issue":"10","key":"3522_CR23","doi-asserted-by":"publisher","first-page":"e0185837","DOI":"10.1371\/journal.pone.0185837","volume":"12","author":"EM Reijnierse","year":"2017","unstructured":"Reijnierse EM, de van der Schueren MAE, Trappenburg MC, Doves M, Meskers CGM, Maier AB. Lack of knowledge and availability of diagnostic equipment could hinder the diagnosis of sarcopenia and its management. PLoS One. 2017;12(10):e0185837.","journal-title":"PLoS One"},{"issue":"5","key":"3522_CR24","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","volume":"40","author":"ME Charlson","year":"1987","unstructured":"Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373\u201383.","journal-title":"J Chronic Dis"},{"issue":"1","key":"3522_CR25","first-page":"2","volume":"7","author":"B Vellas","year":"2018","unstructured":"Vellas B, Fielding RA, Bens C, Bernabei R, Cawthon PM, Cederholm T, et al. Implications of ICD-10 for sarcopenia clinical practice and clinical trials: report by the international conference on frailty and sarcopenia research task force. J Frailty Aging. 2018;7(1):2\u20139.","journal-title":"J Frailty Aging"},{"issue":"7","key":"3522_CR26","doi-asserted-by":"publisher","first-page":"1432","DOI":"10.1111\/bcp.13590","volume":"84","author":"M Gutierrez-Valencia","year":"2018","unstructured":"Gutierrez-Valencia M, Izquierdo M, Cesari M, Casas-Herrero A, Inzitari M, Martinez-Velilla N. The relationship between frailty and polypharmacy in older people: a systematic review. Br J Clin Pharmacol. 2018;84(7):1432\u201344.","journal-title":"Br J Clin Pharmacol"},{"issue":"3","key":"3522_CR27","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1002\/jcsm.12292","volume":"9","author":"V Ruiz-Garcia","year":"2018","unstructured":"Ruiz-Garcia V, Lopez-Briz E, Carbonell-Sanchis R, Bort-Marti S, Gonzalvez-Perales JL. Megestrol acetate for cachexia-anorexia syndrome. A systematic review. J Cachexia Sarcopenia Muscle. 2018;9(3):444\u201352.","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"3522_CR28","first-page":"37","volume":"8","author":"ME Badowski","year":"2016","unstructured":"Badowski ME, Perez SE, et al. HIV AIDS (Auckl). 2016;8:37\u201345.","journal-title":"HIV AIDS (Auckl)"},{"issue":"3","key":"3522_CR29","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1002\/jcsm.12291","volume":"9","author":"JW Skinner","year":"2018","unstructured":"Skinner JW, Otzel DM, Bowser A, Nargi D, Agarwal S, Peterson MD, et al. Muscular responses to testosterone replacement vary by administration route: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle. 2018;9(3):465\u201381.","journal-title":"J Cachexia Sarcopenia Muscle"}],"container-title":["BMC Musculoskeletal Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12891-020-03522-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12891-020-03522-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12891-020-03522-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,30]],"date-time":"2021-07-30T23:39:07Z","timestamp":1627688347000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmusculoskeletdisord.biomedcentral.com\/articles\/10.1186\/s12891-020-03522-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,31]]},"references-count":29,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["3522"],"URL":"https:\/\/doi.org\/10.1186\/s12891-020-03522-9","relation":{},"ISSN":["1471-2474"],"issn-type":[{"value":"1471-2474","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,31]]},"assertion":[{"value":"7 November 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 July 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 July 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study was conducted in accordance with the Declaration of Helsinki, and prior to the study the protocol was approved by the Indiana University Institutional Review Board. Patients were not contacted during this retrospective study in a large EHR database, and the Indiana University Institutional Review Board approved waiver of consent.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable; there are not individual patient level data presented.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All authors declare that they have no conflicts of interest.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"508"}}