Prevalence and clinical impact of sarcopenia in osteoporotic hip fracture: Single center retrospective cohort study.

OBJECTIVE

The study aimed to identify the prevalence of sarcopenia in patients with osteoporotic hip fractures, investigate the anthropometric differences between sarcopenic and non-sarcopenic patients, and evaluate and compare the surgical outcomes between the two groups.

METHODS

The study included 135 patients (35 men and 100 women; mean age: 74.1 years (range; 25-96)) who received surgical treatment for hip fracture between March 2014 and October 2016 and underwent whole-body dual-energy X-ray absorptiometry (DEXA). The skeletal muscle mass index (SMI) for diagnosis of sarcopenia was measured using whole-body DEXA. The following data were collected to compare the preoperative details of the sarcopenic and non-sarcopenic groups: SMI, age, sex, type of fracture, type of operation, BMI, obesity, American society of Anesthesiologists (ASA) class, pre-injury mobility score, BMD, and follow-up period. We compared clinical outcomes, including Harris Hip Score (HSS) and the walking ability at the last follow-up visit and radiologic outcomes, including non-union and the time to union.

RESULTS

The average HHS and Parker's mobility score at the last follow-up were 81.7 and 6.9 in the sarcopenic group, and 77.6 and 6.3 in the non-sarcopenic group, respectively (p=0.149 and 0.122). Non-union was identified 0 (0%) in sarcopenic group and 4 (10%) in non-sarcopenic group (p=0.288). The mean union timer of the patients in the sarcopenia group was 4.0 months and that of patients in the non-sarcopenic group was 4.4 months (p=0.210). Multiple regression analysis did not show any significant association between sarcopenia and postoperative surgical outcomes, including HHS, mobility score at the last follow up, non-union, and time to union.

CONCLUSION

Although the present study showed that the prevalence of sarcopenia in hip fracture patients was 45.9% (62/135), there was no clinical association between sarcopenia and postoperative. Based on these results, the clinical impact of sarcopenia may be confined to increased risk of hip fracture occurrence and surgical outcomes of hip fracture may not be affected by sarcopenia.

LEVEL OF EVIDENCE: Level III, Therapeutic Study.