Interrelationships between malnutrition, dehydration, frailty, and sarcopenia in older adults with proximal femur fractures: a prospective observational study

IF 4.7 3区医学 Q2 GERIATRICS & GERONTOLOGY

Aging Clinical and Experimental Research Pub Date : 2026-04-13 Epub Date: 2026-05-22 DOI:10.1007/s40520-026-03364-w

Belinda Trobec, Gianluca Canton, Emma Spedicato, Eleonora Wabitsch, Paolo De Colle, Michela Zanetti, Andrea Marchetti, Luigi Murena, Chiara Ratti

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引用次数: 0

Abstract

Background

Proximal femur fractures (PFFs) are a hallmark of frailty in patients aged ≥ 65 years. Geriatric frailty is multifactorial, with malnutrition, dehydration, and sarcopenia negatively impacting outcomes after PFF.

Aims

The primary aim of this study was to examine the interrelationships between frailty, malnutrition, hydration status, and ultrasound-defined muscle impairment in older patients with proximal femur fracture. As a secondary objective, we explored the association of these vulnerability domains with 3-month mortality as an exploratory outcome.

Methods

In this prospective observational study, 108 consecutive patients aged ≥ 65 years undergoing surgical treatment for PFF at Cattinara Hospital (Trieste) were evaluated. Clinical, nutritional (MNA, MUST), functional (ADL, CFS, NHFS, MPI), cognitive (SPMSQ), and dehydration (CDS) assessments were performed. Ultrasound sarcopenia index (USI) measurements were obtained in both upper and lower limbs of 78 patients.

Results

Mean age was 85.9 ± 6.6 years. Malnutrition, clinical dehydration, and frailty were present in 2.7%, 38%, and 56% of patients, respectively. Among patients assessed by ultrasound, 39% showed sarcopenic features. Nutritional status was significantly associated with frailty, dehydration, ultrasound-defined sarcopenia, and calf circumference (p < 0.05). At univariate analysis, poorer nutritional, cognitive, and functional status, frailty, and preoperative complications were associated with higher 3-month mortality, whereas surgery within 72 h was protective.

Discussion

Malnutrition, dehydration, and sarcopenia frequently coexist and are closely correlated with geriatric frailty and mortality in patients aged ≥ 65 years with PFF.

Conclusions

These findings support the relevance of a comprehensive orthogeriatric assessment to better characterize biological vulnerability and guide perioperative care.

Abstract Image

查看原文本刊更多论文

老年人股骨近端骨折患者营养不良、脱水、虚弱和肌肉减少症之间的相互关系：一项前瞻性观察研究。

背景：股骨近端骨折（pff）是≥65岁患者虚弱的标志。老年虚弱是多因素的，营养不良、脱水和肌肉减少症会对PFF后的结果产生负面影响。目的：本研究的主要目的是研究老年股骨近端骨折患者的虚弱、营养不良、水合状态和超声确定的肌肉损伤之间的相互关系。作为次要目标，我们探索了这些脆弱领域与3个月死亡率之间的关系，作为探索性结果。方法：在这项前瞻性观察研究中，对108例年龄≥65岁的连续在卡蒂纳拉医院（的里雅斯特）接受手术治疗的PFF患者进行评估。进行临床、营养（MNA、MUST）、功能（ADL、CFS、NHFS、MPI）、认知（SPMSQ）和脱水（CDS）评估。超声测量了78例患者的上肢和下肢肌肉减少指数（USI）。结果：平均年龄85.9±6.6岁。营养不良、临床脱水和虚弱分别出现在2.7%、38%和56%的患者中。在超声检查的患者中，39%的患者表现出肌肉减少的特征。营养状况与虚弱、脱水、超声诊断的肌肉减少症和小腿围显着相关(p讨论：营养不良、脱水和肌肉减少症经常共存，并且与年龄≥65岁的PFF患者的老年虚弱和死亡率密切相关。结论：这些发现支持综合骨科评估的相关性，以更好地表征生物脆弱性并指导围手术期护理。

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

Aging Clinical and Experimental Research 医学-老年医学

CiteScore

7.90

自引率

5.00%

发文量

283

审稿时长

1 months

期刊介绍： Aging clinical and experimental research offers a multidisciplinary forum on the progressing field of gerontology and geriatrics. The areas covered by the journal include: biogerontology, neurosciences, epidemiology, clinical gerontology and geriatric assessment, social, economical and behavioral gerontology. “Aging clinical and experimental research” appears bimonthly and publishes review articles, original papers and case reports.