Effect of Osteosarcopenia on Postoperative Functional Outcomes and Subsequent Fracture in Elderly Hip Fracture Patients

Bae, Gi Cheol; Moon, Kyoung Ho

doi:10.1177/2151459320940568

Cited by 8 publications

(25 citation statements)

References 16 publications

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“…In patients who underwent surgery for trauma, Deren et al 32 reported a one-year mortality rate of 28.6% in the sarcopenic group compared with 12.3% in the control group (p = 0.042), whereas Bae and Moon 19 reported no significant difference in one-year mortality (p = 0.512). Kim et al 28 reported no significant difference in the one-year mortality rate between sarcopenic and non-sarcopenic groups (p = 0.793), but there was a significant difference in the five-year mortality rate (p = 0.028).…”

Section: Resultsmentioning

confidence: 99%

The effect of sarcopenia on outcomes following orthopaedic surgery

Brzeszczyński

Brzeszczyńska

Duckworth

et al. 2022

The Bone & Joint Journal

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Aims Sarcopenia is characterized by a generalized progressive loss of skeletal muscle mass, strength, and physical performance. This systematic review primarily evaluated the effects of sarcopenia on postoperative functional recovery and mortality in patients undergoing orthopaedic surgery, and secondarily assessed the methods used to diagnose and define sarcopenia in the orthopaedic literature. Methods A systematic search was conducted in MEDLINE, EMBASE, and Google Scholar databases according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Studies involving sarcopenic patients who underwent defined orthopaedic surgery and recorded postoperative outcomes were included. The quality of the criteria by which a diagnosis of sarcopenia was made was evaluated. The quality of the publication was assessed using Newcastle-Ottawa Scale. Results A total of 365 studies were identified and screened, 26 full-texts were reviewed, and 19 studies were included in the review. A total of 3,009 patients were included, of whom 2,146 (71%) were female and 863 (29%) were male. The mean age of the patients was 75.1 years (SD 7.1). Five studies included patients who underwent spinal surgery, 13 included hip or knee surgery, and one involved patients who underwent fixation of a distal radial fixation. The mean follow-up was 1.9 years (SD 1.9; 5 days to 5.6 years). There was wide heterogeneity in the measurement tools which were used and the parameters for the diagnosis of sarcopenia in the studies. Sarcopenia was associated with at least one deleterious effect on surgical outcomes in all 19 studies. The postoperative rate of mortality was reported in 11 studies (57.9%) and sarcopenia was associated with poorer survival in 73% (8/11) of these. The outcome was most commonly assessed using the Barthel Index (4/19), and sarcopenic patients recorded lower scores in 75% (3/4) of these. Sarcopenia was defined using the gold-standard three parameters (muscle strength, muscle quantity or quality, and muscle function) in four studies (21%), using two parameters in another four (21%) and one in the remaining 11 (58%). The methodological quality of the studies was moderate to high. Conclusion There is much heterogeneity in the reporting of the parameters which are used for the diagnosis of sarcopenia, and evaluating the outcome of orthopaedic surgery in sarcopenic patients. However, what data exist suggest that sarcopenia impairs recovery and increases postoperative mortality, especially in patients undergoing emergency surgery. Further research is required to develop processes that allow the accurate diagnosis of sarcopenia in orthopaedics, which may facilitate targeted pre- and postoperative interventions that would improve outcomes. Cite this article: Bone Joint J 2022;104-B(3):321–330.

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Section: Resultsmentioning

confidence: 99%

The effect of sarcopenia on outcomes following orthopaedic surgery

Brzeszczyński

Brzeszczyńska

Duckworth

et al. 2022

The Bone & Joint Journal

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“…A balanced and appetizing diet, proper meal timing, and the avoidance of foods interfering with medicines should be addressed through telemedicine interventions [ 90 , 119 ]. It is of paramount importance to overcome a pre-existing/hospital-derived osteosarcopenia, as it is known to be associated with poor outcome after surgery and increased risk of new fall-related traumas [ 120 ]. Undesirably, there remains uncertainty on how to defy this decay [ 121 ], and (with current knowledge) the further we move away from the peak of bone mass the more we are destined to fall.…”

Section: Resultsmentioning

confidence: 99%

“…Summary IV. A total of 20 references ([ 10 , 33 , 53 , 90 , 116 , 117 , 118 , 119 , 120 , 121 , 122 , 123 , 124 , 125 , 127 , 128 , 129 , 130 , 133 , 134 ]) were used to scope the following nutritional commonalities between hospital-associated vs. space-associated deconditioning/resilience. The significance of having an efficient food system that contributes to the maintenance of the individual’s good nutritional status; the goal of reducing nutritional deficits and the intake of counterproductive substances; the importance of meal timing; the need to balance the musculoskeletal involution; the goal to avoid the recurrence of osteosarcopenia-related traumas.…”

Section: Resultsmentioning

confidence: 99%

“… Reduced food intake Flavor/pleasure issues [ 117 ] β-hydroxy-β-methylbutyrate in older adults. Advanced nutrition [ 120 , 121 , 123 ] Hospital-associated deconditioning, interventions, and outcomes. Osteosarcopenia Risk of falls/fracture Space Nutrition Nutritional conditioning prior to launch [ 39 ] Food to sustain life during early ventures in space.…”

Section: Figure A1mentioning

confidence: 99%

“… [ 119 ] Briguglio, 2020 Neuropsychiatr Dis Treat, Opinion Older adults/Healthy eating, exercise, and sleep are critical components to prevent and manage neuropsychiatric disorders. [ 120 ] Bae, 2020 Ger Orthop Surg Rehab, Human study Orthopedic patients/Osteoporosis is correlated to sarcopenia. Osteosarcopenia is associated with poor outcomes and high fracture rates.…”

Section: Figure A1mentioning

confidence: 99%

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Nutritional Orthopedics and Space Nutrition as Two Sides of the Same Coin: A Scoping Review

Briguglio

2021

Nutrients

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Since the Moon landing, nutritional research has been charged with the task of guaranteeing human health in space. In addition, nutrition applied to Orthopedics has developed in recent years, driven by the need to improve the efficiency of the treatment path by enhancing the recovery after surgery. As a result, nutritional sciences have specialized into two distinct fields of research: Nutritional Orthopedics and Space Nutrition. The former primarily deals with the nutritional requirements of old patients in hospitals, whereas the latter focuses on the varied food challenges of space travelers heading to deep space. Although they may seem disconnected, they both investigate similar nutritional issues. This scoping review shows what these two disciplines have in common, highlighting the mutual features between (1) pre-operative vs. pre-launch nutritional programs, (2) hospital-based vs. space station nutritional issues, and (3) post-discharge vs. deep space nutritional resilience. PubMed and Google Scholar were used to collect documents published from 1950 to 2020, from which 44 references were selected on Nutritional Orthopedics and 44 on Space Nutrition. Both the orthopedic patient and the astronaut were found to suffer from food insecurity, malnutrition, musculoskeletal involution, flavor/pleasure issues, fluid shifts, metabolic stresses, and isolation/confinement. Both fields of research aid the planning of demand-driven food systems and advanced nutritional approaches, like tailored diets with nutrients of interest (e.g., vitamin D and calcium). The nutritional features of orthopedic patients on Earth and of astronauts in space are undeniably related. Consequently, it is important to initiate close collaborations between orthopedic nutritionists and space experts, with the musculoskeletal-related dedications playing as common fuel.

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Global epidemiological features and impact of osteosarcopenia: A comprehensive meta‐analysis and systematic review

Chen,

Xu,

Gong

et al. 2023

J cachexia sarcopenia muscle

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Osteosarcopenia is defined as the concurrent occurrence of osteopenia/osteoporosis and sarcopenia. The aim of the current study was to perform a systematic review with meta‐analysis to determine the global prevalence, risk factors and clinical outcomes of osteosarcopenia. This review was registered in PROSPERO (CRD42022351229). PubMed, Cochrane, Medline and Embase were searched from inception to February 2023 to retrieve eligible observational population‐based studies. Pooled osteosarcopenia prevalence was calculated with 95% confidence interval (CI), and subgroup analyses were performed. The risk factor of osteosarcopenia and its association with clinical outcomes were expressed as odds ratio (OR) and hazard ratio (HR), respectively. Heterogeneity was estimated using the I2 test. Study quality was assessed using validated instruments matched to study designs. The search identified 55 158 studies, and 66 studies (64 404 participants, mean age from 46.6 to 93 years) were analysed in the final analysis, including 48 cross‐sectional studies, 17 cohort studies and 1 case–control study. Overall, the pooled prevalence of osteosarcopenia was 18.5% (95% CI: 16.7–20.3, I2 = 98.7%), including 15.3% (95% CI: 13.2–17.4, I2 = 97.6%) in men and 19.4% (95% CI: 16.9–21.9, I2 = 98.5%) in women. The prevalence of osteosarcopenia diagnosed using sarcopenia plus osteopenia/osteoporosis was 20.7% (95% CI: 17.1–24.4, I2 = 98.55%), and the prevalence of using sarcopenia plus osteoporosis was 16.1% (95% CI: 13.3–18.9, I2 = 98.0%). The global osteosarcopenia prevalence varied in different regions with 22.9% in Oceania, 21.6% in Asia, 20.8% in South America, 15.7% in North America and 10.9% in Europe. A statistically significant difference was found in the subgroups of the study population between the hospital (24.7%) and community (12.9%) (P = 0.001). Frailty (OR = 4.72, 95% CI: 2.71–8.23, I2 = 61.1%), malnutrition (OR = 2.35, 95% CI: 1.62–3.40, I2 = 50.0%), female sex (OR = 5.07, 95% CI: 2.96–8.69, I2 = 73.0%) and higher age (OR = 1.10, 95% CI: 1.06–1.15, I2==86.0%) were significantly associated with a higher risk for osteosarcopenia. Meta‐analysis of cohort studies showed that osteosarcopenia significantly increased the risk of fall (HR = 1.54, 95% CI: 1.20–1.97; I2 = 1.0%, three studies), fracture (HR = 2.13, 95% CI: 1.61–2.81; I2 = 67.8%, seven studies) and mortality (HR = 1.75, 95% CI: 1.34–2.28; I2 = 0.0%, five studies). Despite the heterogeneity arising from varied definitions and criteria, our findings highlight a significant global prevalence of osteosarcopenia and its negative impact on clinical health. Standardizing diagnostic criteria for osteosarcopenia would be advantageous in the future, and early detection and management should be emphasized in this patient population.

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Effect of Osteosarcopenia on Postoperative Functional Outcomes and Subsequent Fracture in Elderly Hip Fracture Patients

Cited by 8 publications

References 16 publications

The effect of sarcopenia on outcomes following orthopaedic surgery

The effect of sarcopenia on outcomes following orthopaedic surgery

Nutritional Orthopedics and Space Nutrition as Two Sides of the Same Coin: A Scoping Review

Global epidemiological features and impact of osteosarcopenia: A comprehensive meta‐analysis and systematic review

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