The high prevalence of sarcopenia and its associated outcomes following hip surgery in Taiwanese geriatric patients with a hip fracture

Chen, Yu Pin; Wong, Poo Kuang; Tsai, Ming Jr; Chang, Wei Chun; Hsieh, Tyng Shiuan; Leu, Tsai Hsueh; Lin, Chien Fu Jeff; Lee, Chian Her; Kuo, Yi Jie; Lin, Chung Ying

doi:10.1016/j.jfma.2020.02.004

Cited by 43 publications

(54 citation statements)

References 37 publications

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“…However, little is known regarding the impact of sarcopenia on hip fracture management. Previous studies have reported that sarcopenia promotes poor functional outcomes after surgery and increases the risk of ve-year mortality in patients with hip fractures (13)(14)(15). Indeed, the present study found that patients with sarcopenia had a lower Barthel index, lower hospital discharge rate, and higher one-year mortality rate, which remains consistent with those presented in previous studies.…”

Section: Discussionsupporting

confidence: 92%

“…The correlation between muscle mass and bone mass has been well known, with combined cases of sarcopenia and osteoporosis being common (12). However, little is known regarding the impact of sarcopenia on hip fracture treatment (13)(14)(15). Therefore, the current study aimed to investigate the characteristics of patients with sarcopenia and determine the impact of sarcopenia on hip fracture treatment outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Impact of Sarcopenia on the Hip Fracture Treatment Outcomes: A Single-institution Case-control Study

Seki¹,

Sakai²,

Watanabe³

et al. 2020

Preprint

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Background: Although sarcopenia has been known as a risk factor for hip fractures, only a few reports have described the impact of sarcopenia on hip fracture treatment outcomes. The current study therefore sought to investigate the effect of sarcopenia on treatment outcomes of patients with hip fractures.Methods: This case–control study involved 337 patients (67 males and 270 females) with hip fractures aged ≥ years (mean age: 84.1 ± 7.1 years) who underwent surgery from January 2013 to June 2019. The mean follow-up period was 17.1 (1–60) months. All patients were assessed for sarcopenia using dual-energy X-ray absorptiometry upon hospitalization. Treatment outcomes and one-year mortality rates were compared between patients with and without sarcopenia. Furthermore, we determined whether sarcopenia was a risk factor for one-year mortality in hip fracture patients using a Cox proportional hazards model.Results: The prevalence of sarcopenia in patients with hip fracture was 231(68.5%). Those with sarcopenia had a lower Barthel index (P < 0.0001) and hospital discharge rate (P = 0.035). Cox proportional hazards regression analysis adjusted for age and sex found that sarcopenia was a risk factor for one-year mortality (hazard ratio, 3.173, 95% confidence interval, 1.095–9.199, P = 0.033).Conclusions: Patients with hip fracture who had sarcopenia had a lower Barthel index, lower hospital discharge rate, and higher one-year mortality. Moreover, sarcopenia was identified as a risk factor for one-year mortality among those with hip fractures. The aforementioned findings may help clinicians better manage those with hip fracture.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Impact of Sarcopenia on the Hip Fracture Treatment Outcomes: A Single-institution Case-control Study

Seki¹,

Sakai²,

Watanabe³

et al. 2020

Preprint

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“…Geriatric patients with FFH are especially prone to sarcopenia, with potential adversity in terms of functional outcome and quality of life following hip surgery. 20 This study showed that sarcopenia following surgery in older South Africans with FFH is common, with a prevalence of 52% based on EWGSOP2 criteria, while different prevalence figures for women and men were documented (62% and 38%, respectively). A low HGS identified all cases with sarcopenia obviating the need for more expensive modalities such as DXA to confirm the diagnosis in our cohort.…”

Section: Discussionmentioning

confidence: 69%

“…Previously published study data on the prevalence of sarcopenia in FFH patients are summarized in Table 3. The prevalence of sarcopenia obtained in European and Asian population groups following FFH 18,[20][21][22][23][24][25][26][27][28][29] varies considerably, with prevalence rates ranging between 14.6% and 67.7% in women and between 12.4% and 95% in men. This variation may be explained in part by inherent differences in muscle strength and muscle quantity among people of different ethnicities.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Sarcopenia in Older South African Patients Following Surgery for Fragility Fractures of the Hip

Laubscher

Burger

Conradie

et al. 2020

Geriatr Orthop Surg Rehabil

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Introduction: Geriatric patients with a fragility fracture of the hip (FFH) are especially prone to sarcopenia with poor functional outcomes and quality of life. We assessed the prevalence of sarcopenia in older South African patients with FFH. Risk factors for sarcopenia were also investigated. Materials and Methods: From August 1 to November 30, 2018, all older patients with FFH were invited to participate. Sarcopenia was diagnosed based on the revised criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2). Handgrip strength (HGS) and muscle strength were assessed. Muscle quantity was determined by dual-energy X-ray absorptiometry. Demographic information was collected, and 25-hydroxyvitamin D (25[OH]D) status was determined. Results: Of the 100 hip fracture cases, 65 were enrolled, and 52% (34/65) were sarcopenic (women: 62%; men: 38%). HGS accurately identified sarcopenia (sensitivity and specificity: 100%). Patients >80 years of age had a prevalence of sarcopenia twice (18/21 [83%]) that of younger patients (18/44 [36%]). Women with sarcopenia were smaller than those without (weight: p < 0.001; height: p < 0.001; body mass index: p = 0.018). Low 25(OH)D was almost universally present, with median 25(OH)D levels significantly lower in the patients with sarcopenia (27 nmol/L [interquartile range {IQR}: 20–39] vs. 40 nmol/L [IQR: 29–53]). Several risk factors, including advanced age; female sex; a smaller body size, especially among women; limited physical activity; and low 25(OH)D levels, were identified. Discussion: The accuracy of HGS testing in this cohort underscores EWGSOP2’s recommendation that muscle strength is key to sarcopenia. Further study and follow-up are required to determine the clinical relevance of sarcopenia among FFH patients. Conclusion: The prevalence of sarcopenia in our FFH population is high. Sarcopenia is associated with poor patient outcomes following surgical intervention. Orthopaedic surgeons should therefore be cognizant of the presentation and associated risk of sarcopenia as our patient populations age.

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“…Still, results of the present study should be interpreted with caution, and especially for HGS, due to the small sample of men ( n = 10) evaluated in the HGS group. In comparison, a Taiwan study reported about 50% of their patients with hip fracture as sarcopenic, but with about 20% more men compared to women [ 28 ]. A Norwegian study by Steihaug et al [ 29 ], with similar inclusion criterion as the present study, and using the New Mobility Score for identifying patients with an independent pre-fracture walking status, reported 52% of patients with low HGS.…”

Section: Discussionmentioning

confidence: 99%

Knee Extension Strength Measures Indicating Probable Sarcopenia Is Associated with Health-Related Outcomes and a Strong Predictor of 1-Year Mortality in Patients Following Hip Fracture Surgery

et al. 2021

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To examine if knee-extension strength (KES) measures indicating probable sarcopenia are associated with health-related outcomes and if KES and hand grip strength (HGS) measures are associated with 1-year mortality after hip fracture. Two groups of older patients with hip fracture had either HGS (n = 32) or KES (n = 150) assessed during their acute hospital stay. Cut-points for HGS (<27 kg for men and <16 kg for women), and cut-points for maximal isometric KES (non-fractured limb), being the lowest sex-specific quintile (<23.64 kg for men and <15.24 kg for women), were used to examine association with health-related outcomes and 1-year mortality. Overall, 1-year mortality was 12.6% in the two strength groups, of which 47% (HGS) and 46% (KES) respectively, were classified as probable sarcopenia. Probable sarcopenia patients (KES) had lower prefracture function, performed poorly in mobility measures and expressed a greater concern of falling compared to their stronger counterparts. Hazard ratio for 1-year mortality was 2.7 (95%CI = 0.49–14.7, p = 0.3) for HGS and 9.8 (95%CI = 2.2–43.0, p = 0.002) for KES for probable sarcopenia patients compared to those not. Sex-specific KES measures indicating sarcopenia is associated with health-related outcomes and a strong predictor of 1-year mortality after hip fracture.

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The high prevalence of sarcopenia and its associated outcomes following hip surgery in Taiwanese geriatric patients with a hip fracture

Cited by 43 publications

References 37 publications

Impact of Sarcopenia on the Hip Fracture Treatment Outcomes: A Single-institution Case-control Study

Impact of Sarcopenia on the Hip Fracture Treatment Outcomes: A Single-institution Case-control Study

Prevalence of Sarcopenia in Older South African Patients Following Surgery for Fragility Fractures of the Hip

Knee Extension Strength Measures Indicating Probable Sarcopenia Is Associated with Health-Related Outcomes and a Strong Predictor of 1-Year Mortality in Patients Following Hip Fracture Surgery

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