Comparison of SARC-F, MRSA-5, and MRSA-7 questionnaires in detecting sarcopenia among Egyptian chronic heart failure patients

Abstract Background Sarcopenia is a significant comorbidity in patients with chronic heart failure (CHF), contributing to poor outcomes and increased healthcare utilization. Early and accurate detection using simple clinical tools is essential. This study compares the diagnostic performance of three commonly used sarcopenia screening questionnaires—SARC-F, MRSA-5, and MRSA-7—in Egyptian patients with CHF. Methods A cross-sectional study was conducted involving 90 Egyptian CHF (EF < 50%) patients. Participants were assessed for sarcopenia using European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria as the reference standard. Demographic, clinical, and echocardiographic parameters were collected. SARC-F, MRSA-5, and MRSA-7 scores were calculated. Diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the ROC curve (AUC) were compared. Results Of the 90 participants, 56 (62.2%) were classified as sarcopenic patients. The SARC-F score demonstrated the highest specificity (97.1%) and PPV (96.9%) but had a sensitivity of only 55.4%. The MRSA-5 score exhibited the highest sensitivity (89.3%) and accuracy (74.4%), while the MRSA-7 score showed a balance between sensitivity (75%) and specificity (67.6%). The AUCs for all three tools were comparable: SARC-F (0.754), MRSA-5 (0.753), and MRSA-7 (0.754). Conclusion Among CHF patients, MRSA-5 offers the best sensitivity for detecting sarcopenia and is suitable for initial screening. The SARC-F score, with its high specificity, is valuable for confirming the diagnosis. MRSA-7 provides balanced diagnostic performance. A tiered approach using MRSA-5 followed by SARC-F may optimize sarcopenia screening in clinical practice.