journal article·2026-01-19Open access

The Impact of Sarcopenia on the Clinical Profile of Hospitalized Pulmonary Embolism Patients: A Longitudinal Cohort Study

Julia Raya-Benítez, Ana Belén Gámiz-Molina, Marie Carmen Valenza, Alejandro Heredia-Ciuró, María Granados-Santiago, Laura López-López, Maria del Carmen García-Rios

Applied Sciences· Volume 16· Issue 2

Abstract

Pulmonary embolism (PE) is a potentially life-threatening cardiopulmonary condition that frequently requires hospitalization and is often accompanied by reduced mobility, systemic inflammation, and nutritional impairment. These factors may contribute to the development or worsening of sarcopenia, a condition associated with adverse outcomes in hospitalized patients. However, its clinical relevance in patients with PE has not been sufficiently explored. This longitudinal observational cohort study evaluated the association between sarcopenia and clinical outcomes in patients hospitalized with confirmed PE. Participants were classified according to the presence of sarcopenia based on muscle mass and muscle strength criteria. Symptom severity, functional status, and health-related quality of life were assessed at hospital admission, at discharge, and three months after discharge. A total of 162 patients were included. Patients with sarcopenia exhibited a greater symptom burden, poorer functional status, and worse self-perceived health compared with non-sarcopenic patients. At discharge, sarcopenic patients reported higher levels of dyspnea and fatigue, poorer health-related quality of life, and experienced longer hospital stays. At the three-month follow-up, these patients continued to show significantly worse symptoms, reduced functionality, and lower quality of life. Sarcopenia was therefore associated with a persistently worse clinical and functional profile in patients hospitalized for PE. Early identification of sarcopenia may help identify patients at higher risk of poor recovery and support the implementation of targeted interventions aimed at improving functional outcomes and quality of life.
Source: crossref · Quality: baseline

Research context

OpenAlex topics: Nutrition and Health in Aging · Venous Thromboembolism Diagnosis and Management · Body Composition Measurement Techniques

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Department of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain

Pulmonology Service, San Cecilio University Hospital, 18016 Granada, Spain

Department of Physiotherapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain

References (50)

Show source-provided references
1. Effective Management of Acute Pulmonary Embolism and Deep Vein Thrombosis: Insights from a Case Series on Procedure Benefits
2. Thrombosis: A major contributor to global disease burden10.1161/ATVBAHA.114.304488 ↗
3. Acute Pulmonary Embolism: A Review10.1001/jama.2022.16815 ↗
4. Pulmonary embolism, part I: Epidemiology, risk factors and risk stratification, pathophysiology, clinical presentation, diagnosis and nonthrombotic pulmonary embolism
5. Etiology, Predisposing Factors, Clinical Profile, Diagnosis, Management, Outcome, and Way Forward in Pulmonary Embolism at a Tertiary Care Center in East India
6. Rate and duration of hospitalization for deep vein thrombosis and pulmonary embolism in real-world clinical practice10.3109/07853890.2015.1085127 ↗
7. Rommersbach, N., Wirth, R., Lueg, G., Klimek, C., Schnatmann, M., Liermann, D., Janssen, G., Müller, M.J., and Pourhassan, M. (2020). The impact of disease-related immobilization on thigh muscle mass and strength in older hospitalized patients. BMC Geriatr., 20.10.1186/s12877-020-01873-5 ↗
8. Malnutrition in Relation to Muscle Mass, Muscle Quality, and Muscle Strength in Hospitalized Older Adults10.1016/j.jamda.2021.11.025 ↗
9. Brugliera, L., Giordani, A., D’Angelo, G., Trimarchi, C., Villa, G., Yen, T.Y., Bosica, F., Malatino, L., Zweiker, D., and Negro, A. (2023). Prevalence of Sarcopenia in Older Patients in Rehabilitation Wards. J. Pers. Med., 13.10.3390/jpm13060960 ↗
10. Branchford, B.R., and Carpenter, S.L. (2018). The Role of Inflammation in Venous Thromboembolism. Front. Pediatr., 6.10.3389/fped.2018.00142 ↗
11. Evidence for the Interplay between Inflammation and Clotting System in the Pathogenetic Chain of Pulmonary Embolism10.2174/0115701611390778250321130817 ↗
12. Acute Pulmonary Embolism: Focus on the Clinical Picture10.4070/kcj.2017.0314 ↗
13. CT-defined pectoralis muscle mass and muscle density are associated with mortality in acute pulmonary embolism: A multicenter analysis10.1016/j.clnu.2023.04.022 ↗
15. Diagnostic accuracy of sarcopenia by “possible sarcopenia” premiered by the Asian Working Group for Sarcopenia 2019 definition10.1016/j.archger.2021.104484 ↗
16. Circumstances of Hospitalization Impact Outcomes of Pulmonary Embolism10.1016/j.cpcardiol.2023.101773 ↗
17. Functional status before and during acute hospitalization and readmission risk identification10.1002/jhm.2595 ↗
18. Prevalence, associated factors, and prognostic value of sarcopenia in patients with acute exacerbated chronic obstructive pulmonary disease10.1016/j.clnesp.2021.01.042 ↗
19. Prevalence of sarcopenia and malnutrition during acute exacerbation of COPD and after 6 months recovery10.1038/s41430-020-0623-6 ↗
20. Sarcopenia Associated with Chronic Obstructive Pulmonary Disease10.11005/jbm.2019.26.2.65 ↗
21. The STROBE guidelines10.4103/sja.SJA_543_18 ↗
22. Sarcopenia: Revised European consensus on definition and diagnosis10.1093/ageing/afy169 ↗
23. Sarcopenia, calf circumference, and physical function of elderly women10.1046/j.1532-5415.2003.51362.x ↗
24. A new method of classifying prognostic comorbidity in longitudinal studies10.1016/0021-9681(87)90171-8 ↗
25. Derivation and validation of a prognostic model for pulmonary embolism10.1164/rccm.200506-862OC ↗
26. Developing the World Health Organization Disability Assessment Schedule 2.010.2471/BLT.09.067231 ↗
27. The Spanish version of EuroQol: Description and applications
28. Sarcopenia as Prognostic Factor in Lung Cancer Patients: A Systematic Review and Meta-Analysis10.21873/anticanres.13640 ↗
29. Martínez-Luna, N., Orea-Tejeda, A., González-Islas, D., Flores-Cisneros, L., Keirns-Davis, C., Sánchez-Santillán, R., Pérez-García, I., Gastelum-Ayala, Y., Martínez-Vázquez, V., and Martínez-Reyna, Ó. (2022). Association between body composition, sarcopenia and pulmonary function in chronic obstructive pulmonary disease. BMC Pulm. Med., 22.10.1186/s12890-022-01907-1 ↗
30. Respiratory sarcopenia: A position paper by four professional organizations10.1111/ggi.14519 ↗
31. The Effects of Exercise Training in Patients with Persistent Dyspnea Following Pulmonary Embolism10.1016/j.chest.2023.04.042 ↗
32. Sarcopenia and length of hospital stay10.1038/ejcn.2015.207 ↗
33. De Lorenzo, R., Palmisano, A., Esposito, A., Gnasso, C., Nicoletti, V., Leone, R., Vignale, D., Falbo, E., Ferrante, M., and Cilla, M. (2022). Myosteatosis Significantly Predicts Persistent Dyspnea and Mobility Problems in COVID-19 Survivors. Front. Nutr., 9.10.3389/fnut.2022.846901 ↗
34. The contribution of immobility risk factors to the incidence of venous thrombosis in an older population10.1111/jth.12480 ↗
35. Protecting muscle mass and function in older adults during bed rest
36. Impact of Sarcopenia on the Quality of Life and Mobility in Elderly Patients with Chronic Obstructive Pulmonary Disease10.1080/02703181.2024.2430215 ↗
37. Risk of community-acquired pneumonia in older adults with sarcopenia
38. Quality of life and physical components linked to sarcopenia: The SarcoPhAge study10.1016/j.exger.2015.05.003 ↗
39. Quality of life, physical performance and nutritional status in older patients hospitalized in a cardiology department
40. Sarcopenia and health-related quality of life: A systematic review and meta-analysis10.1002/jcsm.13243 ↗
41. Beaudart, C., Zaaria, M., Pasleau, F., Reginster, J.Y., and Bruyère, O. (2017). Health Outcomes of Sarcopenia: A Systematic Review and Meta-Analysis. PLoS ONE, 12.10.1371/journal.pone.0169548 ↗
42. Sarcopenia and health-related outcomes: An umbrella review of observational studies10.1007/s41999-019-00233-w ↗
43. The Role of Nutrition and Nutritional Supplements in the Prevention and Treatment of Malnutrition in Chronic Obstructive Pulmonary Disease10.1007/s13668-025-00613-8 ↗
44. Assyov, Y., Nedeva, I., Spassov, B., Gerganova, A., Velikov, T., Kamenov, Z., and Velikova, T. (2024). Nutritional Management and Physical Activity in the Treatment of Sarcopenic Obesity. Nutrients, 16.10.3390/nu16152560 ↗
45. Zhang, X.M., Chen, D., Xie, X.H., Zhang, J.E., Zeng, Y., and Cheng, A.S. (2021). Sarcopenia as a predictor of mortality among the critically ill in an intensive care unit: A systematic review and meta-analysis. BMC Geriatr., 21.10.1186/s12877-021-02276-w ↗
46. Sarcopenia Is Associated with Mortality in Adults: A Systematic Review and Meta-Analysis10.1159/000517099 ↗
47. Sarcopenia and adverse health-related outcomes: An umbrella review of meta-analyses of observational studies10.1002/cam4.3428 ↗
48. The prognostic value of blood cellular indices in pulmonary embolism10.1002/ajh.27379 ↗
49. SARC-F: A Simple Questionnaire to Rapidly Diagnose Sarcopenia10.1016/j.jamda.2013.05.018 ↗
50. Calf circumference, frailty and physical performance among older adults living in the community10.1016/j.clnu.2013.07.013 ↗