Ab0889 sarcopenia and Hip Fracture in Geriatric Population

Abstract

Background:Sarcopenia is a loss of skeletal muscle mass, muscle strength, and function, with an impact on the quality of life, increased risk of bone loss and fracture, which is associated with normal aging.Objectives:To determine the effect of sarcopenia on the recovery of patients after hip fracture, their fitness, functionality, and quality of lifeMethods:A prospective study had 60 patients with hip fractures of both sexes,> 65 years of age (70.8), in the experimental group of patients with sarcopenia and the control group without sarcopenia. All anthropometric measurements were performed: BMI (kg / m2), waist circumference, the volume of the upper arm and lower leg muscle mass, handgrip force (kg) - dynamometry. The following questionnaires were used to assess functionality, mobility, and quality of life: Health assessment questionnaire (HAQ), Harrison hip score (HHS), Sarcopenia and Quality of life (SarQol)Results:Muscle mass (BMI) was significantly lower in the experimental group patients (p <0.005) compared to the control group. The clamp strength measured by the dynamometer was significantly lower in patients with hip fractures (p <0.005) compared to the control group. About 2/3 of the subjects with sarcopenia and hip fracture have a severe and complete physical disability. There was a significant difference in all domains of quality of life between subjects with hip fractures and the control group due to the presence of sarcopenia (p <0.005).Conclusion:The presence of sarcopenia indicates consequently reduced functionality and a degree of disability in patients with hip fractures, slows recovery and increases the need for mobility aids, thus extending hospital stay and patient recovery.References:[1]He H, Liu Y, Tian Q, Papasian CJ, Hu T, Deng HW. Relationship of sarcopenia and body composition with osteoporosis. Osteoporos Int. 2016 Feb; 27(2):473–82.https://doi.org/10.1007/s00198-015-3241-8PMID: 26243357[2]Oliveira A, Vaz C. The role of sarcopenia in the risk of osteoporotic hip fracture. Clin Rheumatol. 2015 Oct; 34(10):1673–80.https://doi.org/10.1007/s10067-015-2943-9PMID: 25912213[3]Tarantino U, Piccirilli E, Fantini M, Baldi J, Gasbarra E, Bei R. Sarcopenia and fragility fractures: molecular and clinical evidence of the bone-muscle interaction. J Bone Joint Surg Am. 2015 Mar 4; 97(5):429–37.https://doi.org/10.2106/JBJS.N.00648PMID: 25740034 Benichou O, Lord SR. Rationale for Strengthening Muscle to Prevent Falls and Fractures: A Review of the Evidence. Calcif Tissue Int. 2016 Jun; 98(6):531–45.https://doi.org/10.1007/s00223-016-0107-9PMID: 26847435[4]Hirschfeld HP, Kinsella R, Duque G. Osteosarcopenia: where bone, muscle, and fat collide. Osteoporos Int. 2017 Oct; 28(10):2781–2790.https://doi.org/10.1007/s00198-017-4151-8PMID: 28733716[5]Rantanen T, Volpato S, Ferrucci L, Heikkinen E, Fried LP, Guralnik JM. Handgrip strength and causespecific and total mortality in older disabled women: exploring the mechanism. J Am Geriatr Soc. 2003 May; 51(5):636–41.https://doi.org/10.1034/j.1600-0579.2003.00207.xPMID: 12752838[6]Syddall H, Cooper C, Martin F, Briggs R, Aihie Sayer A. Is grip strength a useful single marker of frailty? Age Ageing. 2003 Nov; 32(6):650–6.https://doi.org/10.1093/ageing/afg111PMID: 14600007[7]Chen LK, Liu LK, Woo J, Assantachai P, Auyeung TW, Bahyah KS, et al. Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. J Am Med Dir Assoc. 2014 Feb; 15(2):95–101.https://doi.org/10.1016/j.jamda.2013.11.025PMID: 24461239[8]Wehren LE, Hawkes WG, Hebel JR, Orwig DL, Magaziner J. Bone mineral density, soft tissue body composition, strength, and functioning after hip fracture. J Gerontol A Biol Sci Med Sci. 2005 Jan; 60 (1):80–4.https://doi.org/10.1093/gerona/60.1.80PMID: 15741287Disclosure of Interests:None declared

The Association Between Sarcopenia and Postoperative Outcomes Among Older Adults With Hip Fracture: A Systematic Review

“…Fourteen studies were excluded for the following reasons: use of inappropriate sarcopenia diagnostic method (n = 7), lack of the minimum age requirements in the methodology (n = 5), duplicate publication (n = 1), and assessment of only the association between handgrip strength and functional prognosis instead of sarcopenia and its respective outcomes (n = 1). Thus, 10 studies and one scientific abstract were subjected to meta-analysis: nine prospective observational studies (Boskovic et al, 2020;González-Montalvo et al, 2016;Ho et al, 2016;Lang et al, 2018;Lim et al, 2018Lim et al, , 2020Malafarina et al, 2019;Steihaug et al, 2018), one cross-sectional study (Hida et al, 2013), and one retrospective study (Yoo et al, 2018; Figure 1). No randomized controlled trials were identified.…”

“…An observational study conducted by Chen et al demonstrated that patients with a hip fracture and sarcopenia had significantly poorer BI scores and Euro Qol-5D scores (for assessing quality of life) than patients without sarcopenia before a hip fracture and at 6 months after surgery (Y. P. . Similarly, Boskovic et al noted a significant difference in all domains of quality of life between older adults with hip fractures and sarcopenia and the control group by using Sarcopenia and Quality of Life (SarQol) questionnaires (p < .005; Boskovic et al, 2020). A prospective study included 181 consecutive patients with femoral neck fracture with 6 months of follow-up, using Harris hip scores for functional evaluation (odds ratio: 2.887, p = .008; Lang et al, 2018).…”

“…Online Table 1 summarizes the risk of bias of the included studies. Briefly, three studies were graded as high risk: one lacked adjustment of confounding factors for all clinical outcomes (Lim et al, 2018), one measured muscle mass by using anthropometry and the dual-energy X-ray absorptiometry (DXA) performing time was unknown (Steihaug et al, 2018), and one was only a scientific abstract and lacked detailed study design information (Boskovic et al, 2020). The remaining five studies were graded to have a low bias risk.…”