Abstract
BackgroundAlthough sarcopenia has been known as a risk factor for hip fracture, only a few reports have described the impact of muscle mass on hip fracture treatment outcomes. The current study aimed to investigate the impact of muscle mass on hip fracture treatment outcomes.MethodsThis case–control study involved 337 patients (67 males and 270 females) with hip fracture aged ≥65 years (mean age: 84.1 ± 7.1 years) who underwent orthopedic surgery from January 2013 to June 2019. The mean follow-up period was 17.1 (1–60) months. Upon admission, all patients were assessed for low muscle mass according to the Asian Working Group for Sarcopenia criteria (male, SMI < 7.00 kg/m2; female, SMI < 5.40 kg/m2) using dual-energy X-ray absorptiometry. Treatment outcomes (stays at acute care institutions, hospital mortality, the Barthel index at discharge, and home discharge rates, and one-year mortality) were compared between patients with and without low muscle mass by Student’s t-test, Mann-Whitney U test and the Pearson Chi-Square test. A multivariate logistic regression model was used to calculate adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for factors related to low muscle mass. Kaplan–Meier survival curves on one-year mortality of hip fracture patients for those with and without low muscle mass were prepared, and log-rank tests were performed. Furthermore, we determined whether low muscle mass was a risk factor for one-year mortality in hip fracture patients using a Cox proportional hazards model.ResultsThe prevalence of low muscle mass in patients with hip fracture was 231(68.5%). Those with low muscle mass had a lower Barthel index (P < 0.0001), hospital discharge rate (P = 0.035) and higher one-year mortality (P = 0.010). Cox proportional hazards regression analysis adjusted for age and sex found that low muscle mass was a risk factor for one-year mortality (hazard ratio, 3.182, 95% confidence interval, 1.097–9.226, P = 0.033).ConclusionsPatients with hip fracture who had low muscle mass had a lower Barthel index, lower home discharge rate, and higher one-year mortality. Moreover, low muscle mass was identified as a risk factor for one-year mortality among those with hip fracture. The aforementioned findings may help clinicians better manage those with hip fracture.
Highlights
Age-related loss of muscle mass, called sarcopenia, a term proposed by Rosenberg et al in 1989 [1], has been recognized as an independent condition by the International Classification of Disease, Tenth Revision [2]
Low muscle mass was defined as the loss of appendicular skeletal muscle mass (ASM), with the skeletal muscle mass index (SMI) being calculated as ASM/height2 according to the consensus of the Asian Working Group for Sarcopenia criteria [16]
Male sex, low body mass index (BMI), low geriatric nutritional risk index (GNRI), femoral neck fractures were associated with low muscle mass (Table 2)
Summary
Age-related loss of muscle mass, called sarcopenia, a term proposed by Rosenberg et al in 1989 [1], has been recognized as an independent condition by the International Classification of Disease, Tenth Revision [2]. Another study found that half of the patients with hip fracture develop permanent disability and mobility and are at high risk of institutionalization [7]. Mortality rates among those suffering from hip fracture had been reported to exceed 10% [8, 9], with increases rates observed within the first year after injury [10, 11]. Sarcopenia has been known as a risk factor for hip fracture, only a few reports have described the impact of muscle mass on hip fracture treatment outcomes. The current study aimed to investigate the impact of muscle mass on hip fracture treatment outcomes
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
