Sarcopenia and sarcopenic obesity: Their association with postoperative outcomes in patients with hip fractures

IF 2.3 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Journal of hospital medicine Pub Date : 2025-02-16 DOI:10.1002/jhm.70007

Betül Gülsüm Yavuz Veizi MD, Valbona Imeri MD, Ömer Faruk Naldöven MD, Şahan Güven MD

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引用次数: 0

Abstract

Background

Sarcopenia, characterized by age-related loss of muscle mass and function, significantly impacts the quality of life of older adults. This condition is prevalent among elderly patients with hip fractures.

Objective

To investigate the association of sarcopenia and sarcopenic obesity with mortality and length of hospital stay in patients admitted for hip fracture. Additionally, this study aims to investigate possible risk factors associated with higher mortality rates in the same patient groups.

Methods

A retrospective cohort study was conducted involving patients aged 60 and older who underwent hip fracture surgery between February 2019 and April 2023 at a single tertiary care hospital. Sarcopenia was defined using appendicular skeletal muscle mass index (ASMI) and psoas muscle index values derived from preoperative computed tomography scans. Patients were categorized into sarcopenic, sarcopenic obese, and non-sarcopenic groups. Primary outcomes included 1-year mortality, and secondary outcomes included hospital stay duration. Cox regression and binary logistic regression analyses were performed, adjusting for potential confounders including age, sex, and comorbidities.

Results

The study included 311 patients (mean age 79.7 years). After adjustment for confounders, sarcopenia, as defined by ASMI, was associated with a higher 1-year mortality risk (hazard ratio [HR]: 1.80, 95% confidence interval [CI]: 1.04–3.13, p = .034). Sarcopenic obesity further increased mortality risk (HR: 2.68, 95% CI: 1.10–2.57, p = .016). Sarcopenia alone was not significantly associated with prolonged hospital stays after adjustment.

Conclusions

Sarcopenia remained independently associated with mortality in patients with hip fractures after adjustment for various factors. Sarcopenic obesity was associated with a higher risk of mortality than sarcopenia alone. These findings underscore the prognostic significance of sarcopenia in this vulnerable population.

Abstract Image

查看原文本刊更多论文

肌肉减少症和肌肉减少性肥胖：它们与髋部骨折患者术后预后的关系。

背景：骨骼肌减少症的特征是与年龄相关的肌肉质量和功能损失，显著影响老年人的生活质量。这种情况在老年髋部骨折患者中很常见。目的：探讨髋部骨折患者肌肉减少症和肌肉减少性肥胖与死亡率和住院时间的关系。此外，本研究旨在调查同一患者群体中与较高死亡率相关的可能风险因素。方法：对2019年2月至2023年4月在一家三级医院接受髋部骨折手术的60岁及以上患者进行回顾性队列研究。通过术前计算机断层扫描得出的阑尾骨骼肌质量指数（ASMI）和腰肌指数值来定义肌肉减少症。患者分为肌肉减少组、肌肉减少肥胖组和非肌肉减少组。主要结局包括1年死亡率，次要结局包括住院时间。进行Cox回归和二元逻辑回归分析，调整潜在混杂因素，包括年龄、性别和合并症。结果：纳入311例患者，平均年龄79.7岁。校正混杂因素后，ASMI定义的肌肉减少症与较高的1年死亡风险相关（风险比[HR]: 1.80, 95%可信区间[CI]: 1.04-3.13, p = 0.034）。肌肉减少型肥胖进一步增加了死亡风险（HR: 2.68, 95% CI: 1.10-2.57, p = 0.016）。单纯肌少症与调整后住院时间延长无显著相关。结论：调整各种因素后，骨骼肌减少症仍然与髋部骨折患者的死亡率独立相关。与单纯的肌肉减少症相比，肌肉减少性肥胖与更高的死亡风险相关。这些发现强调了肌少症在这一易感人群中的预后意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of hospital medicine 医学-医学：内科

CiteScore

4.40

自引率

11.50%

发文量

233

审稿时长

4-8 weeks

期刊介绍： JHM is a peer-reviewed publication of the Society of Hospital Medicine and is published 12 times per year. JHM publishes manuscripts that address the care of hospitalized adults or children. Broad areas of interest include (1) Treatments for common inpatient conditions; (2) Approaches to improving perioperative care; (3) Improving care for hospitalized patients with geriatric or pediatric vulnerabilities (such as mobility problems, or those with complex longitudinal care); (4) Evaluation of innovative healthcare delivery or educational models; (5) Approaches to improving the quality, safety, and value of healthcare across the acute- and postacute-continuum of care; and (6) Evaluation of policy and payment changes that affect hospital and postacute care.