# Acute‐Phase Interventions and Clinical Implementation Challenges for Hospital‐Associated Sarcopenia: A Narrative Review of a Multifaceted Approach to a Preventable Condition

**Authors:** Yoshinori Yamamoto, Masato Ogawa, Takayuki Okamoto, Marika Tsuboi, Ryo Momosaki

PMC · DOI: 10.1111/ggi.70330 · 2026-01-21

## TL;DR

Hospital-associated sarcopenia is a reversible muscle loss condition that can be managed with timely interventions and improved hospital systems.

## Contribution

The paper proposes multifaceted strategies, including modular protocols and electronic medical record integration, to manage hospital-associated sarcopenia.

## Key findings

- Interventions initiated within 48 hours may preserve muscle function and improve quality of life.
- Modular protocols and electronic medical record-integrated algorithms are suggested to optimize treatment outcomes.
- Standardized evaluations and sustainable post-discharge systems are key for clinical implementation.

## Abstract

Hospital‐associated sarcopenia (HAS) is a preventable and reversible condition characterized by rapid muscle loss during hospitalization. Although its prevalence is higher than that of age‐related sarcopenia, the clinical recognition and structured management of this condition remain limited. In this narrative review, the pathophysiology of HAS is synthesized, the effectiveness of acute‐phase interventions is evaluated, and the implementation challenges are examined to propose multifaceted strategies for optimizing treatment outcomes. The development of HAS involves a vicious cycle of activity limitation, inflammation, malnutrition, and iatrogenic stress. Initiating interventions within 48 h may aid in preserving muscle function and improving the patients' quality of life. However, protocol variability, inadequate patient stratification, fragile transitional care systems, and other challenges persist. The proposed solutions include modular protocols, electronic medical record‐integrated adaptive algorithms, and strengthened team coordination. To prevent HAS progression and improve patient‐centered outcomes, timely, structured multidisciplinary interventions in the acute phase are imperative. Standardized evaluations, scalable protocols, and sustainable post‐discharge systems are key to advancing the clinical implementation of HAS management strategies.

## Full-text entities

- **Genes:** FBXO32 (F-box protein 32) [NCBI Gene 114907] {aka Fbx32, MAFbx}, IL6 (interleukin 6) [NCBI Gene 3569] {aka BSF-2, BSF2, CDF, HGF, HSF, IFN-beta-2}, TNF (tumor necrosis factor) [NCBI Gene 7124] {aka DIF, IMD127, TNF-alpha, TNFA, TNFSF2, TNLG1F}, MTOR (mechanistic target of rapamycin kinase) [NCBI Gene 2475] {aka FRAP, FRAP1, FRAP2, RAFT1, RAPT1, SKS}, FOXO3 (forkhead box O3) [NCBI Gene 2309] {aka AF6q21, FKHRL1, FKHRL1P2, FOXO2, FOXO3A}
- **Diseases:** liver cirrhosis (MESH:D008103), atrophy (MESH:D001284), critical illness (MESH:D016638), muscle atrophy (MESH:D009133), colorectal, abdominal, or hip fracture (MESH:D006620), Muscle loss (MESH:D009135), sepsis (MESH:D018805), dysphagia (MESH:D003680), cancer (MESH:D009369), HAS (MESH:D055948), Anabolic resistance (MESH:D060467), functional loss (MESH:D006315), muscle degradation (MESH:D055959), frailty (MESH:D000073496), infection (MESH:D007239), limitation (MESH:D045745), acute illness (MESH:D000208), hypoalbuminemia (MESH:D034141), impaired oral intake (MESH:D000080146), renal dysfunction (MESH:D007674), decline (MESH:D060825), pneumonia (MESH:D011014), Inflammation (MESH:D007249), Nutritional Impairment (MESH:D009748), cognitive overload (MESH:D003072), Malnutrition (MESH:D044342), heart failure (MESH:D006333), liver disease (MESH:D008107), inactivity (MESH:C564765), Comorbidity (MESH:D004194), diabetes (MESH:D003920), Muscle Metabolic Dysregulation (MESH:D024821), systemic infection (MESH:D012141), muscle (MESH:D019042), COVID-19 (MESH:D000086382), weakness (MESH:D018908)
- **Chemicals:** BCAA (MESH:D000597), omega-3 fatty acids (MESH:D015525), leucine-rich protein (-), HMB (MESH:C004961), vitamin D (MESH:D014807)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12824560/full.md

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Source: https://tomesphere.com/paper/PMC12824560