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

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.