Prevalence of sarcopenia in acute hip fracture patients and its influence on short-term clinical outcome.
OBJECTIVE
Current international criteria provide standardized procedures to diagnose sarcopenia in older people. However, to date few data exist on patients with acute disease. The present study was carried out to determine the frequency of sarcopenia in acute hip fracture patients, and its association with their baseline characteristics and prognosis during hospitalization.


METHODS
Data were collected from 509 consecutive patients hospitalized for hip fracture. The European Working Group on Sarcopenia in Older People Criteria for sarcopenia were applied in the first 72 h. Muscle mass was measured by electrical bioimpedance and grip strength by hydraulic dynamometer. Clinical, functional and cognitive characteristics were assessed at baseline and hospital discharge, and their association with the presence of sarcopenia was studied.


RESULTS
A total of 479 patients (94%) met the inclusion criteria. The mean age was 85.3 (SD 6.8 years). The frequency of sarcopenia was 17.1% (12.4% in men, 18.3% in women). Sarcopenia was associated with residence in nursing homes (30.5% vs 19.6%, P = 0.030), older age (86.8, SD 6.2 vs 85.1, SD 6.9 years, P = 0.038), and lower body mass index (23.1, SD 3.6 vs 25.6, SD 4.23, P < 0.001). In the multivariate analysis, only low body mass index was predictive of sarcopenia (OR 0.85, 95% CI 0.80-0.91). Sarcopenia was associated with worse functional prognosis at discharge in the crude analysis (OR 1.88, 95% CI 1.15-3.07), but not in the multivariate analysis (OR 1.68, 95% CI 0.99-2.84).


CONCLUSIONS
Sarcopenia was detected in almost one of five acute hip fracture patients and was associated with lower body mass index, but an association with worse prognosis at discharge could not be confirmed. Geriatr Gerontol Int 2016; 16: 1021-1027.
Geriatrics Department, La Paz University Hospital, Madrid, Spain.|Medicine Department, Autonoma University of Madrid, Madrid, Spain.|La Paz University Hospital Research Institute, IdiPAZ, Madrid, Spain.
Juan I
JI
González-Montalvo
Geriatrics Department, La Paz University Hospital, Madrid, Spain.|Medicine Department, Autonoma University of Madrid, Madrid, Spain.|La Paz University Hospital Research Institute, IdiPAZ, Madrid, Spain.
Teresa
T
Alarcón
Geriatrics Department, La Paz University Hospital, Madrid, Spain.|La Paz University Hospital Research Institute, IdiPAZ, Madrid, Spain.
Pilar
P
Gotor
Preventive Medicine Department, Autonoma University of Madrid, Madrid, Spain.|La Paz University Hospital Research Institute, IdiPAZ, Madrid, Spain.
Rocío
R
Queipo
Geriatrics Department, La Paz University Hospital, Madrid, Spain.
Rocío
R
Velasco
Geriatrics Department, La Paz University Hospital, Madrid, Spain.
Rubén
R
Hoyos
Geriatrics Department, La Paz University Hospital, Madrid, Spain.
Armando
A
Pardo
Preventive Medicine Department, Autonoma University of Madrid, Madrid, Spain.|La Paz University Hospital Research Institute, IdiPAZ, Madrid, Spain.
Angel
A
Otero
D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods; D015331:Cohort Studies; D015897:Comorbidity; D016001:Confidence Intervals; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects / Q000379:methods; D015577:Geriatric Assessment; D006620:Hip Fractures / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D053580:Muscle Strength / Q000502:physiology*; D053581:Muscle Strength Dynamometer; D016017:Odds Ratio; D015995:Prevalence; D011379:Prognosis; D020127:Recovery of Function / Q000502:physiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D055948:Sarcopenia / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
cohort; hip fracture; older people; orthogeriatrics; sarcopenia