Association Between Sarcopenia and Functional Independence After Acute Fragility Hip Fracture at 6 Months

Science Metadilogkul, Naputt Virasathienpornkul, Pariyut Chiarapattanakom, Nuttavut Chavalparit, Piyabuth Kittithamvongs, Piyatida Yousuk
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Abstract

Purpose: The primary goal of hip fracture treatment is to allow ambulatory life as early as possible to avoid any subsequent complication after fracture. The European Working Group on Sarcopenia in Older People (EWGSOP) defined sarcopenia as the presence of both low muscle strength and low muscle quantity. Our purpose in this study was to identify the association between sarcopenia and functional independence after acute fragility hip fracture. Methods: Patients 50 years old or more without neurologic diseases who encountered fragility hip fracture for the first time were included. Sarcopenia was assessed using EWGSOP revised 2018 criteria. Functional independence was assessed using the Barthel Index (BI) at 6 months after injury. Data were analyzed using multiple linear regression. Results: A total of 240 patients were included; overall, 84 patients with and 156 without sarcopenia. Multiple linear regression analysis showed significant difference in BI at 6 months among those with and without sarcopenia (p<0.001). Specifically, the lower limb related components of BI were decreased four points in patients with sarcopenia, which is a more statistically significant result when compared to the overall BI score. Conclusions: In this study, patients with sarcopenia were associated with functional independence impairment. Lower limb-related components of the BI must be specifically assessed in patients with hip fracture. Moreover, rehabilitation programs should be tailored to the specific needs of the patient.
肌肉疏松症与急性脆性髋部骨折后 6 个月的功能独立性之间的关系
目的:髋部骨折治疗的首要目标是尽早恢复行动自如的生活,以避免骨折后出现任何后续并发症。欧洲老年人肌肉疏松症工作组(EWGSOP)将肌肉疏松症定义为肌肉力量和肌肉数量均不足。本研究旨在确定肌肉疏松症与急性脆性髋部骨折后功能独立性之间的关系:方法:纳入年龄在 50 岁或以上、无神经系统疾病、首次遭遇脆性髋部骨折的患者。采用 EWGSOP 2018 年修订标准评估肌肉疏松症。采用伤后6个月的Barthel指数(BI)评估功能独立性。数据采用多元线性回归法进行分析:共纳入 240 名患者;总体而言,84 名患者患有肌肉疏松症,156 名患者未患有肌肉疏松症。多元线性回归分析显示,肌肉疏松症患者与非肌肉疏松症患者在 6 个月后的 BI 有显著差异(P<0.001)。具体而言,肌肉疏松症患者的下肢相关指数下降了4分,与整体指数相比,这一结果在统计学上更为显著:在这项研究中,肌肉疏松症患者的功能独立性受损。必须对髋部骨折患者的 BI 中与下肢相关的部分进行专门评估。此外,康复计划应根据患者的具体需求量身定制。
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