J Bone Metab.  2018 Nov;25(4):227-233. 10.11005/jbm.2018.25.4.227.

Effect of Sarcopenia on Postoperative Mortality in Osteoporotic Hip Fracture Patients

• Kim YK
• Yi SR
• Lee YH
• Kwon J
• Jang SI
• Park SH

• KMID: 2427988
• DOI: http://doi.org/10.11005/jbm.2018.25.4.227

Abstract

BACKGROUND
Few studies have investigated the effects of sarcopenia on postoperative outcomes including mortality rates following surgery for osteoporotic hip fractures. The purpose of the present study was to determine the prevalence of sarcopenia and the relationship between sarcopenia and 1- and 5-year mortality rates in a consecutive series of patients with osteoporotic hip fractures.
METHODS
Among patients who underwent hip surgery for osteoporotic hip fractures, this study included 91 patients subjected to abdominal computed tomography within 1 year of hip surgery. We defined sarcopenia using sex-specific cut-off points for the skeletal muscle index at the level of the third lumbar vertebra. All patients were divided into 2 groups according to the presence or absence of sarcopenia and the 1- and 5-year mortality rates were compared. To confirm factors affecting mortality in addition to sarcopenia, we examined patient age, sex, American Society of Anesthesiologists grade, location of fracture, type of surgery, and bone mineral density.
RESULTS
The 1- and 5-year mortality rates were 20.9% and 67.2%, respectively. Among the 45 patients with sarcopenia, the 1- and 5-year mortality rates were 22.2% and 82.7%, respectively. Of the 46 patients without sarcopenia, the 1- and 5-year mortality rates were 19.6% and 52.7%, respectively. Results of the Kaplan-Meier analysis showed that sarcopenia did not affect the 1-year mortality rate (P=0.793), but had a significant effect on the 5-year mortality rate (P=0.028). Both perioperative sarcopenia (P=0.018) and osteoporosis (P=0.000) affected the 5-year mortality rate.
CONCLUSIONS
Sarcopenia increases the risk of 5-year mortality in patients with osteoporotic hip fractures.

Keyword

Hip fractures; Mortality; Osteoporotic fractures; Sarcopenia

MeSH Terms

Bone Density
Hip Fractures
Hip*
Humans
Kaplan-Meier Estimate
Mortality*
Muscle, Skeletal
Osteoporosis
Osteoporotic Fractures
Prevalence
Sarcopenia*
Spine

Figure

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  Fig. 1 Flow chart presenting the study subjects. CT, computed tomography; DXA, dual energy X-ray absorptiometry.

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  Fig. 2 Kaplan-Meier survival curve. Bold line is for non-sarcopenic patients. Fine line is for sarcopenic patients.

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