Increased 1-year mortality rates after hip fracture surgery in geriatric patients with skeletal muscle atrophy: a propensity score-matched study.

PURPOSE: To investigate the relationship between skeletal muscle atrophy (SMA), assessed using chest CT-derived skeletal muscle index (SMI) at the T12 vertebra level, and 1-year mortality in geriatric patients following hip fracture surgery.

METHODS

After applying exclusion criteria, 1,243 patients (514 SMA) were analyzed. SMA was diagnosed by the skeletal muscle index at the T12 vertebral level (males: T12-SMI < 25.75 cm2/ m2; females: T12-SMI < 20.16 cm2/m2). The association between T12-SMI and 1-year mortality risk was assessed using multivariate logistic regression and propensity score-matched analyses. The predictive accuracy of T12-SMI for 1-year mortality rates was evaluated by ROC curves. The dose-response relationship between T12-SMI and 1-year mortality rates was examined.

RESULTS

SMA was present in 41.4% of patients. The 1-year mortality rate was significantly higher in SMA patients compared to non-SMA patients (35.8% vs. 10.2%, p < 0.001). Lower T12-SMI levels were strongly associated with increased mortality, exhibiting a dose-response relationship. Multivariable-adjusted odds ratios for 1-year mortality decreased significantly across higher T12-SMI quartiles for both males and females.

CONCLUSIONS

SMA, defined by low T12-SMI, is an independent predictor of 1-year mortality in geriatric hip fracture patients.