Handgrip strength as a predictor of one-year mortality in elderly patients with fragility hip fracture

Background

Fragility fractures occur on porotic bones due to minor trauma and are associated with high rates of disability and mortality.

Aims

To evaluate the ability of handgrip strength to predict one-year mortality in elderly patients with fragility hip fracture.

Methods

We enrolled patients aged 65 years and older with fragility hip fractures admitted to an Italian orthopedic unit. They underwent a comprehensive geriatric assessment, including handgrip strength measurement, and all received surgical intervention.

Results

Among the 322 enrolled patients (median age: 84 years; 75.2% women), the one-year mortality rate was 15.5%. According to the European Working Group on Sarcopenia in Older People 2 guidelines, 235 subjects (73.0%) exhibited low handgrip strength. This group revealed HR: 2.36 (95%CI: 1.06–5.24) for one-year mortality compared to the group with adequate handgrip strength (p = 0.036). After adjusting for age and risk of adverse event, through Multidimensional Prognostic Index, the HR decreased to 1.31 (95%CI: 0.56–3.07), with a lower validity.

Discussion

Our study found a slightly lower one-year mortality than other studies with similar samples, probably due to the co-management of orthopedic and geriatric teams. As for the main outcome, low handgrip strength was significantly associated with one-year mortality. However, the significance diminished when considering possible confounding variables, despite a lower precision of the model.

Conclusions

Low handgrip strength predicts one-year mortality in elderly people with fragility hip fractures. Further studies are needed to explore the possible influence of confounders.