Factors Associated with Sarcopenia and 7-Year Mortality in Very Old Patients with Hip Fracture Admitted to Rehabilitation Units: A Pragmatic Study

Malafarina, Vincenzo; Malafarina, Concetta; Biain Ugarte, Arantzazu; Martinez, J. Alfredo; Abete Goñi, Itziar; Zulet, M. Angeles

doi:10.3390/nu11092243

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Factors Associated with Sarcopenia and 7-Year Mortality in Very Old Patients with Hip Fracture Admitted to Rehabilitation Units: A Pragmatic Study

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,†

Department of Nutrition, Food Science and Physiology, School of Pharmacy and Nutrition, Universidad de Navarra, 31008 Pamplona, Spain

Department of Geriatrics, Complejo Hospitalario de Navarra, Calle de Irunlarrea 3, 31008 Pamplona, Spain

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)

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Abstract

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. View Full-Text

Keywords: skeletal muscle mass; sarcopenia; hip fracture; rehabilitation unit; mortality; very old patients; undernutrition

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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. https://doi.org/10.3390/nu11092243

AMA Style

Malafarina V, Malafarina C, Biain Ugarte A, Martinez JA, Abete Goñi I, Zulet MA. 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(9):2243. https://doi.org/10.3390/nu11092243

Chicago/Turabian Style

Malafarina, Vincenzo, Concetta Malafarina, Arantzazu Biain Ugarte, J. Alfredo Martinez, Itziar Abete Goñi, and M. Angeles Zulet. 2019. "Factors Associated with Sarcopenia and 7-Year Mortality in Very Old Patients with Hip Fracture Admitted to Rehabilitation Units: A Pragmatic Study" Nutrients 11, no. 9: 2243. https://doi.org/10.3390/nu11092243

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Factors Associated with Sarcopenia and 7-Year Mortality in Very Old Patients with Hip Fracture Admitted to Rehabilitation Units: A Pragmatic Study

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