Factors Associated with Sarcopenia and 7-Year Mortality in Very Old Patients with Hip Fracture Admitted to Rehabilitation Units: A Pragmatic Study
by
Vincenzo Malafarina 1,2,*
, Concetta Malafarina 3, Arantzazu Biain Ugarte 4, J. Alfredo Martinez 1,5,6,7, Itziar Abete Goñi 1,5,6,7,† and M. Angeles Zulet 1,5,6,7,†
Vincenzo Malafarina 1,2,*, Concetta Malafarina 3, Arantzazu Biain Ugarte 4, J. Alfredo Martinez 1,5,6,7, Itziar Abete Goñi 1,5,6,7,† and M. Angeles Zulet 1,5,6,7,†
1
Department of Nutrition, Food Science and Physiology, School of Pharmacy and Nutrition, Universidad de Navarra, 31008 Pamplona, Spain
2
Department of Geriatrics, Complejo Hospitalario de Navarra, Calle de Irunlarrea 3, 31008 Pamplona, Spain
3
Department of Radiology, Complejo Hospitalario de Navarra, 31008 Pamplona, Spain
4
Nursing Department, Hospitalización a Domicilio, Complejo Hospitalario de Navarra, 31008 Pamplona, Spain
5
CIBERobn, Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, 28029 Madrid, Spain
6
Centre for Nutrition Research, School of Pharmacy and Nutrition, Universidad de Navarra, 31008 Pamplona, Spain
7
Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Nutrients 2019, 11(9), 2243; https://doi.org/10.3390/nu11092243
Received: 30 August 2019 / Revised: 11 September 2019 / Accepted: 15 September 2019 / Published: 18 September 2019
(This article belongs to the Special Issue Sarcopenia and Nutritional Status)
Background: Admitted bedridden older patients are at risk of the development of sarcopenia during hospital stay (incident sarcopenia). The objective of this study was to assess the factors associated with sarcopenia (incident and chronic) and its impact on mortality in older people with hip fracture. Methods: A multicenter, pragmatic, prospective observational study was designed. Older subjects with hip fracture admitted to two rehabilitation units were included. Sarcopenia was assessed at admission and at discharge according to the revised EWGSOP (European Working Group on Sarcopenia in Older People) consensus definition. The mortality was evaluated after 7 years of follow-up. Results: A total of 187 subjects (73.8% women) age 85.2 ± 6.3 years were included. Risk factors associated to incident and chronic sarcopenia were undernutrition (body mass index—BMI and Mini Nutritional Assessment−Short Form—MNA-SF), hand-grip strength and skeletal muscle index. During follow-up 114 patients died (60.5% sarcopenic vs. 39.5% non-sarcopenic, p = 0.001). Cox regression analyses showed that factors associated to increased risk of mortality were sarcopenia (HR: 1.67, 95% CI 1.11–2.51) and low hand-grip strength (HR: 1.76, 95% CI 1.08–2.88). Conclusions: Older patients with undernutrition have a higher risk of developing sarcopenia during hospital stay, and sarcopenic patients have almost two times more risk of mortality than non-sarcopenic patients during follow-up after hip fracture.
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Keywords:
skeletal muscle mass; sarcopenia; hip fracture; rehabilitation unit; mortality; very old patients; undernutrition
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MDPI and ACS Style
Malafarina, V.; Malafarina, C.; Biain Ugarte, A.; Martinez, J.A.; Abete Goñi, I.; Zulet, M.A. Factors Associated with Sarcopenia and 7-Year Mortality in Very Old Patients with Hip Fracture Admitted to Rehabilitation Units: A Pragmatic Study. Nutrients 2019, 11, 2243.
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