Frailty and Loss of Rectus Femoris Muscle Thickness in Hospitalized Elderly Patients with Community-Acquired Pneumonia – A Case-Control Study

Frailty is at the core of geriatric syndromes that are characterized by multiple morbidities and mobility limitations. The purpose of this case-control study was to assess the frailty scale and muscle mass on the acute phase in hospitalized elderly patients with community-acquired pneumonia (CAP). Thirty-two elderly patients, aged 75 years or older, who were hospitalized with CAP, and 32 control patients hospitalized without CAP were recruited. Frailty scale and muscle mass were assessed using the Reported Edmonton Frail Scale (REFS) and rectus femoris (RF) thickness by ultrasound, respectively. There was a significant increase in the frequency of frailty among CAP patients (50%), compared with control patients (22%). Frailty scale correlated inversely with RF thickness and activity status. Based upon the piece-wise linear regression analysis between REFS and RF thickness decreased rapidly with the pre-frailty status among CAP patients. Elderly patients with CAP exhibit a significant impairment of activity status with frailty due to decreased thickness of RF prior to admission.