{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T16:07:16Z","timestamp":1762445236402,"version":"3.37.3"},"reference-count":43,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2021,9,23]],"date-time":"2021-09-23T00:00:00Z","timestamp":1632355200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100013238","name":"faculty of medicine siriraj hospital, mahidol university","doi-asserted-by":"publisher","award":["R016034004"],"award-info":[{"award-number":["R016034004"]}],"id":[{"id":"10.13039\/501100013238","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Sarcopenia is defined as decreased skeletal muscle mass and muscle functions (strength and physical performance). Muscle mass is measured by specific methods, such as bioelectrical impedance analysis and dual-energy X-ray absorptiometry. However, the devices used for these methods are costly and are usually not portable. A simple tool to screen for sarcopenia without measuring muscle mass might be practical, especially in developing countries. The aim of this study was to design a simple screening tool and to validate its performance in screening for sarcopenia in older adult cancer patients scheduled for elective surgery.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Cancer surgical patients aged &gt;60 years were enrolled. Their nutritional statuses were evaluated using the Mini Nutrition Assessment-Short Form. Sarcopenia was assessed using Asian Working Group for Sarcopenia (AWGS) criteria. Appendicular skeletal muscle mass was measured by bioelectrical impedance analysis. Four screening formulas with differing combinations of factors (muscle strength, physical performance, and nutritional status) were assessed. The validities of the formulas, compared with the AWGS definition, are presented as sensitivity, specificity, accuracy, and area under a receiver operating characteristic curve.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Of 251 enrolled surgical patients, 84 (34%) were diagnosed with sarcopenia. Malnutrition (odds ratio [OR]: 2.89, 95% CI: 1.40\u20135.93); underweight status (OR: 2.80, 95% CI: 1.06\u20137.43); and age increments of 5 years (OR: 1.78, 95% CI: 1.41\u20132.24) were independent predictors of preoperative sarcopenia. The combination of low muscle strength and\/or abnormal physical performance, plus malnutrition\/risk of malnutrition had the highest sensitivity, specificity, and accuracy (81.0%, 78.4%, and 79.3%, respectively). This screening formula estimated the probability of sarcopenia with a positive predictive value of 65.4% and a negative predictive value of 89.1%.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Sarcopenia screening can be performed using a simple tool. The combination of low muscle strength and\/or abnormal physical performance, plus malnutrition\/risk of malnutrition, has the highest screening performance.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0257672","type":"journal-article","created":{"date-parts":[[2021,9,23]],"date-time":"2021-09-23T17:51:05Z","timestamp":1632419465000},"page":"e0257672","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["A simpler screening tool for sarcopenia in surgical patients"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5407-306X","authenticated-orcid":true,"given":"Onuma","family":"Chaiwat","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mingkwan","family":"Wongyingsinn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weerasak","family":"Muangpaisan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chalobol","family":"Chalermsri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arunotai","family":"Siriussawakul","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pornpoj","family":"Pramyothin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6542-2034","authenticated-orcid":true,"given":"Poungkaew","family":"Thitisakulchai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Panita","family":"Limpawattana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chayanan","family":"Thanakiattiwibun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,9,23]]},"reference":[{"issue":"2014","key":"pone.0257672.ref001","first-page":"1","article-title":"Summary health statistics for U.S. adults: national health interview survey, 2012","volume":"10","author":"DL Blackwell","journal-title":"Vital Health Stat"},{"key":"pone.0257672.ref002","unstructured":"Office of the National Econimic and Social Development Board. Population projections for Thailand 2010\u20132040. Bangkok, Thailand; 2013."},{"key":"pone.0257672.ref003","doi-asserted-by":"crossref","first-page":"27","DOI":"10.4240\/wjgs.v8.i1.27","article-title":"Role of frailty and sarcopenia in predicting outcomes among patients undergoing gastrointestinal surgery","volume":"8","author":"D Wagner","year":"2016","journal-title":"World J Gastrointest Surg"},{"key":"pone.0257672.ref004","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.cger.2011.09.002","article-title":"Principles of surgical oncology in the elderly","volume":"28","author":"AP Zbar","year":"2012","journal-title":"Clin Geriatr Med"},{"key":"pone.0257672.ref005","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1093\/ageing\/afq034","article-title":"Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People","volume":"39","author":"AJ Cruz-Jentoft","year":"2010","journal-title":"Age Ageing"},{"key":"pone.0257672.ref006","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/j.clnu.2009.12.004","article-title":"Consensus definition of sarcopenia, cachexia and pre-cachexia: joint document elaborated by Special Interest Groups (SIG) \"cachexia-anorexia in chronic wasting diseases\" and \"nutrition in geriatrics\"","volume":"29","author":"M Muscaritoli","year":"2010","journal-title":"Clin Nutr"},{"key":"pone.0257672.ref007","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/j.jamda.2011.01.003","article-title":"Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia","volume":"12","author":"RA Fielding","year":"2011","journal-title":"J Am Med Dir Assoc"},{"key":"pone.0257672.ref008","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/j.jamda.2011.04.014","article-title":"Sarcopenia with limited mobility: an international consensus","volume":"12","author":"JE Morley","year":"2011","journal-title":"J Am Med Dir Assoc"},{"key":"pone.0257672.ref009","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.jamda.2013.11.025","article-title":"Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia","volume":"15","author":"LK Chen","year":"2014","journal-title":"J Am Med Dir Assoc"},{"key":"pone.0257672.ref010","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1093\/gerona\/glu012","article-title":"Criteria for clinically relevant weakness and low lean mass and their longitudinal association with incident mobility impairment and mortality: the foundation for the National Institutes of Health (FNIH) sarcopenia project","volume":"69","author":"RR McLean","year":"2014","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"pone.0257672.ref011","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1111\/hepr.12774","article-title":"Japan Society of Hepatology guidelines for sarcopenia in liver disease (1st edition): Recommendation from the working group for creation of sarcopenia assessment criteria.","volume":"46","author":"H Nishikawa","year":"2016","journal-title":"Hepatol Res"},{"issue":"Suppl 1","key":"pone.0257672.ref012","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1111\/ggi.13311","article-title":"Chapter 1 Definitions and diagnosis of sarcopenia","volume":"18","author":"M Akishita","year":"2018","journal-title":"Geriatr Gerontol Int"},{"key":"pone.0257672.ref013","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1093\/ageing\/afy169","article-title":"Sarcopenia: revised European consensus on definition and diagnosis","volume":"48","author":"AJ Cruz-Jentoft","year":"2019","journal-title":"Age Ageing"},{"key":"pone.0257672.ref014","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/j.jamda.2019.12.012","article-title":"Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment","volume":"21","author":"LK Chen","year":"2020","journal-title":"J Am Med Dir Assoc"},{"key":"pone.0257672.ref015","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1016\/j.jamda.2012.10.009","article-title":"Validity and reliability of tools to measure muscle mass, strength, and physical performance in community-dwelling older people: a systematic review.","volume":"14","author":"DM Mijnarends","year":"2013","journal-title":"J Am Med Dir Assoc"},{"key":"pone.0257672.ref016","first-page":"168","article-title":"Suggestions for assessment of muscle mass in primary care setting","volume":"20","author":"O Yilmaz","year":"2017","journal-title":"Aging Male"},{"key":"pone.0257672.ref017","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1038\/sj.ijo.0803417","article-title":"Dual energy X-ray absorptiometry body composition and aging in a population-based older cohort","volume":"31","author":"KA Shaw","year":"2007","journal-title":"Int J Obes (Lond)"},{"key":"pone.0257672.ref018","first-page":"181","article-title":"Techniques for the diagnosis of sarcopenia","volume":"11","author":"G Rubbieri","year":"2014","journal-title":"Clin Cases Miner Bone Metab"},{"key":"pone.0257672.ref019","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/S0261-5614(99)80003-X","article-title":"Prevalence of malnutrition in surgical patients: evaluation of nutritional support and documentation","volume":"18","author":"LI Bruun","year":"1999","journal-title":"Clin Nutr"},{"key":"pone.0257672.ref020","first-page":"359","article-title":"Nutritional support for wound healing","volume":"8","author":"D MacKay","year":"2003","journal-title":"Altern Med Rev"},{"key":"pone.0257672.ref021","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1016\/j.clnu.2008.03.002","article-title":"Is malnutrition still a risk factor of postoperative complications in gastric cancer surgery?","volume":"27","author":"F Pacelli","year":"2008","journal-title":"Clin Nutr"},{"key":"pone.0257672.ref022","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1080\/07315724.2004.10719365","article-title":"The influence of nutritional status on complications after major intraabdominal surgery","volume":"23","author":"H Sungurtekin","year":"2004","journal-title":"J Am Coll Nutr"},{"key":"pone.0257672.ref023","first-page":"191","article-title":"Prevalence of malnutrition on admission to four hospitals in England","volume":"19","author":"J Edington","year":"2000","journal-title":"The Malnutrition Prevalence Group. Clin Nutr"},{"key":"pone.0257672.ref024","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/S0261-5614(02)00215-7","article-title":"The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis","volume":"22","author":"MI Correia","year":"2003","journal-title":"Clin Nutr"},{"key":"pone.0257672.ref025","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.1007\/s12603-018-1072-y","article-title":"Comparing SARC-F with SARC-CalF to Screen Sarcopenia in Community Living Older Adults","volume":"22","author":"G Bahat","year":"2018","journal-title":"J Nutr Health Aging"},{"key":"pone.0257672.ref026","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1016\/j.jamda.2016.08.004","article-title":"Enhancing SARC-F: Improving Sarcopenia Screening in the Clinical Practice","volume":"17","author":"TG Barbosa-Silva","year":"2016","journal-title":"J Am Med Dir Assoc"},{"key":"pone.0257672.ref027","first-page":"5978523","article-title":"Clinical Screening Tools for Sarcopenia and Its Management","volume":"2016","author":"SC Yu","year":"2016","journal-title":"Curr Gerontol Geriatr Res"},{"key":"pone.0257672.ref028","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1007\/s12603-009-0214-7","article-title":"Validation of the Mini Nutritional Assessment short-form (MNA-SF): a practical tool for identification of nutritional status","volume":"13","author":"MJ Kaiser","year":"2009","journal-title":"J Nutr Health Aging"},{"key":"pone.0257672.ref029","doi-asserted-by":"crossref","first-page":"M366","DOI":"10.1093\/gerona\/56.6.M366","article-title":"Screening for undernutrition in geriatric practice: developing the short-form mini-nutritional assessment (MNA-SF)","volume":"56","author":"LZ Rubenstein","year":"2001","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"pone.0257672.ref030","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.afos.2015.10.001","article-title":"Sarcopenia in Asia","volume":"1","author":"P Limpawattana","year":"2015","journal-title":"Osteoporosis Sarcopenia"},{"key":"pone.0257672.ref031","first-page":"39","volume-title":"Guidelines for management of Geriatric syndromes: Institute of Geriatric Medicine, Department of Medical Service, Ministry of Public health","author":"P Limpawattana","year":"2015"},{"key":"pone.0257672.ref032","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1093\/ageing\/afu115","article-title":"Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the International Sarcopenia Initiative (EWGSOP and IWGS)","volume":"43","author":"AJ Cruz-Jentoft","year":"2014","journal-title":"Age Ageing"},{"key":"pone.0257672.ref033","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.afos.2016.05.001","article-title":"The prevalence of sarcopenia and related factors in a community-dwelling elders Thai population","volume":"2","author":"N Khongsri","year":"2016","journal-title":"Osteoporosis Sarcopenia"},{"key":"pone.0257672.ref034","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1007\/s10120-015-0546-4","article-title":"Sarcopenia is associated with severe postoperative complications in elderly gastric cancer patients undergoing gastrectomy","volume":"19","author":"Y Fukuda","year":"2016","journal-title":"Gastric Cancer"},{"key":"pone.0257672.ref035","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/j.eurger.2015.12.012","article-title":"Sarcopenia and the cardiometabolic syndrome: A narrative review","volume":"7","author":"G Bahat","year":"2016","journal-title":"Eur Geriatr Med"},{"key":"pone.0257672.ref036","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/j.jamda.2013.05.018","article-title":"SARC-F: a simple questionnaire to rapidly diagnose sarcopenia","volume":"14","author":"TK Malmstrom","year":"2013","journal-title":"J Am Med Dir Assoc"},{"key":"pone.0257672.ref037","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1016\/j.jamda.2014.04.021","article-title":"Validating the SARC-F: a suitable community screening tool for sarcopenia?","volume":"15","author":"J Woo","year":"2014","journal-title":"J Am Med Dir Assoc"},{"issue":"Suppl 1","key":"pone.0257672.ref038","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1111\/ggi.12197","article-title":"Development of a simple screening test for sarcopenia in older adults","volume":"14","author":"S Ishii","year":"2014","journal-title":"Geriatr Gerontol Int"},{"key":"pone.0257672.ref039","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1007\/s13539-013-0107-9","article-title":"Development of a practical screening tool to predict low muscle mass using NHANES 1999\u20132004","volume":"4","author":"MJ Goodman","year":"2013","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"pone.0257672.ref040","first-page":"147","article-title":"Appendicular Skeletal Muscle Mass: Development and Validation of Anthropometric Prediction Equations","volume":"1","author":"R Visvanathan","year":"2012","journal-title":"J Frailty Aging"},{"key":"pone.0257672.ref041","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.jamda.2014.06.018","article-title":"An anthropometric prediction equation for appendicular skeletal muscle mass in combination with a measure of muscle function to screen for sarcopenia in primary and aged care","volume":"16","author":"S Yu","year":"2015","journal-title":"J Am Med Dir Assoc"},{"key":"pone.0257672.ref042","first-page":"177","article-title":"Clinical definition of sarcopenia","volume":"11","author":"V Santilli","year":"2014","journal-title":"Clin Cases Miner Bone Metab"},{"key":"pone.0257672.ref043","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1016\/j.clnu.2004.06.004","article-title":"Bioelectrical impedance analysis\u2014part I: review of principles and methods","volume":"23","author":"UG Kyle","year":"2004","journal-title":"Clin Nutr"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0257672","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,23]],"date-time":"2021-09-23T17:51:50Z","timestamp":1632419510000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0257672"}},"subtitle":[],"editor":[{"given":"Joao Felipe","family":"Mota","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2021,9,23]]},"references-count":43,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2021,9,23]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0257672","relation":{},"ISSN":["1932-6203"],"issn-type":[{"type":"electronic","value":"1932-6203"}],"subject":[],"published":{"date-parts":[[2021,9,23]]}}}