Effect of Sarcopenia on Postoperative Mortality in Osteoporotic Hip Fracture Patients

Kim, You Keun; Yi, Seung Rim; Lee, Ye Hyun; Kwon, Jieun; Jang, Seok In; Park, Sang Hoon

doi:10.11005/jbm.2018.25.4.227

Cited by 45 publications

(41 citation statements)

References 23 publications

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“…In our study, there were no significant difference between the postoperative 1 year mortality rate of osteosarcopenic and normal control group in our study ( P = .512). However, Kim et al 8 reported a significant difference between the postoperative 5-year mortality rates of osteosarcopenic and normal controls ( P = .028). In particular, their osteosarcopenia group (n = 45, mortality rate 82.7%) had a 30% higher mortality rate than the control group (n = 46, 52.7%).…”

Section: Discussionmentioning

confidence: 97%

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

Bae

Moon

2020

Geriatr Orthop Surg Rehabil

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Introduction: In this study, we evaluated how muscle mass and bone density affect postoperative functional scores and subsequent fracture rates and investigated the correlation between sarcopenia and osteoporosis by measuring preoperative psoas muscle indices (PMIs) and bone mineral densities (BMDs) in elderly patients followed for more 1 year after surgical treatment for hip fracture. Methods: Among patients older than 65 years who underwent surgery for hip fracture from January 2009 to November 2018, 154 patients with preoperative 3D pelvic bone computed tomography and dual-energy X-ray absorptiometry BMD data and followed postoperatively for at least 1 year were considered for the present study. One hundred twenty-six patients were finally included. These patients were divided into 4 groups based on PMIs and T-score, that is, to osteoporosis, sarcopenia, osteosarcopenia, or normal groups. To analyze outcomes after surgery, we measured functional activity levels using the Barthel index and Harris hip score (HHS) systems. In addition, we compared the rates of subsequent hip fracture ratio with patient’s characteristics, and analyzed the correlation between PMIs and BMDs using Pearson correlations analysis. Results: Barthel index and HHS score showed significant differences between the normal and osteosarcopenia group at 6 weeks, 3 months, and 1 year after surgery ( P < .001). Subsequent fracture incidences were significantly higher in the osteosarcopenia group than in the normal group ( P = .046), and T-score and PMI were found to be strongly correlated (a < 0.01; R = 0.763). Conclusion: Postoperative functional outcomes were significantly poorer and the subsequent fracture rate was significantly higher in the osteosarcopenia group than in the normal group. In addition, sarcopenia and osteoporosis were found to be highly correlated.

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Section: Discussionmentioning

confidence: 97%

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

Bae

Moon

2020

Geriatr Orthop Surg Rehabil

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“…Sarcopenia is characterized by loss of muscle mass and function with aging which increases risk of disability and death [ 44 ]. This factor is of paramount importance and should be assessed and treated as it was associated with increased mortality in patients with hip fractures and in those with vertebral fragility fractures [ 45 , 46 ]. Good management of these patients should include focus on rich and equilibrated dietary intake, physical rehabilitation, and fall prevention.…”

Section: Discussionmentioning

confidence: 99%

Comparison of morbidity and mortality of hip and vertebral fragility fractures: Which one has the highest burden?

Rizkallah

Bachour

Khoury

et al. 2020

Osteoporosis and Sarcopenia

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Objectives Hip fragility fractures were regarded as one of the most severe, but recent papers report on the underestimated burden of vertebral compression fractures. This study aims to compare morbidity and mortality of hip and vertebral fragility fractures in patients treated in the same setting. Methods Patients aged ≥50 years with hip fracture, and those with vertebral fracture presenting to our hospital between January 2014 and January 2017 were included. Patients were evaluated 1 year after their index fracture. SF-36 scores, mortality, and institutionalization are then recorded. Patients were divided into 2 groups: hip fractures and vertebral fractures. Results There were 106 and 90 patients respectively evaluated in hip and vertebral fracture groups at 1 year. Patients in both groups were comparable for age, sex, comorbidities and neuropsychiatric condition (P > 0.05). At 1 year follow-up, SF-36 showed better averages in all 8 scales in hip fracture group compared to vertebral fracture group. Mortality in the hip fracture group reached 32.1% compared to 10% for the vertebral fracture group (P < 0.01). Fifteen patients were institutionalized in the hip fracture group compared to 18 patients in the vertebral fracture group (P > 0.05). Conclusions When comparing patients treated in the same setting, hip fracture is associated with significantly increased mortality than vertebral fracture; however, the latter is associated with more morbidity.

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“…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 muscle mass on hip fracture treatment [13][14][15]. Therefore, the current study aimed to investigate the characteristics of patients with low muscle mass and determine the impact of muscle mass on hip fracture treatment outcomes.…”

Section: Introductionmentioning

confidence: 99%

Low muscle mass affect hip fracture treatment outcomes in older individuals: a single-institution case-control study

Seki

Sakai

Watanabe

et al. 2021

BMC Musculoskelet Disord

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Background Although 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. Methods This 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. Results The 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). Conclusions Patients 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.

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Effect of Sarcopenia on Postoperative Mortality in Osteoporotic Hip Fracture Patients

Cited by 45 publications

References 23 publications

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

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

Comparison of morbidity and mortality of hip and vertebral fragility fractures: Which one has the highest burden?

Low muscle mass affect hip fracture treatment outcomes in older individuals: a single-institution case-control study

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