Factors Associated with Sarcopenia and 7-Year Mortality in Very Old Patients with Hip Fracture Admitted to Rehabilitation Units: A Pragmatic Study
Abstract
:1. Introduction
2. Methods
2.1. Study Population
2.2. Sarcopenia Assessment
2.3. Patients Assessment
2.4. Statistical Analysis
3. Results
3.1. Discharge Differences
3.2. Mortality
4. Discussion
5. Conclusions and Implications
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Total n = 187 | |
---|---|
Age, years | 85.2 ± 6.3 |
Sex n (%) | |
Female | 138 (73.8%) |
Male | 49 (26.2%) |
BMI kg/m2 | 25.4 ± 4.6 |
Fracture type | |
Intracapsular | 89 (47.6%) |
Extracapsular | 98 (52.4%) |
Type of surgery | |
Replacement | 69 (36.9%) |
Internal fixation | 118 (63.1%) |
Time to surgery | 2 (2–4) |
Non-weight bearing | 29 (15.5%) |
LoS orthopedics (days) | 10 (8–12) |
LoS rehabilitation (days) | 41 (29–57) |
ONS & | 73 (42.6%) |
Previous Barthel index | 85 (60–100) |
MMSE | 22 (16–26) |
MNA-SF ‡ | 10 (8–12) |
SMI kg/m2 | |
Female | 13.6 ± 2.3 |
Male | 17.2 ± 3.4 |
Grip strength kg | |
Female | 11.9 ± 5.0 |
Male | 19.6 ± 9.6 |
No Sarcopenic (Controls) n = 75 | Incident Sarcopenia n = 54 | Chronic Sarcopenia n = 41 | Reverted Sarcopenia n = 17 | p-Value | |
---|---|---|---|---|---|
Age (year) | 83.9 ± 5.6 | 86.1 ± 6.8 | 88.2 ± 4.6 ‡ | 81.1 ± 7.6 | <0.0001 |
Sex n (M/W) | 9/66 | 35/19 | 0/41 | 5/12 | <0.0001 |
BMI, Kg/m2 | 28.6 ± 4.7 | 23.9 ± 3.1 ‡ | 22.2 ± 2.8 ‡ | 23.6 ± 3.0 ‡ | <0.0001 |
Weight, Kg | 70.9 ± 15.0 | 62.1 ± 10.4 ‡ & | 53.3 ± 7.4 ‡ # | 59.0 ± 11.4 ‡ | 0.0001 |
SMI, Kg/m2 | |||||
Men | 7.4 ± 0.4 #-$ | 5.9 ± 0.6 | NA * | 6.4 ± 0.3 | <0.0001 |
Women | 6.1 ± 0.6 &-$ | 5.8 ± 0.7 &-$ | 4.9 ± 0.4 | 5.2 ± 0.3 | <0.0001 |
Hand grip, kg | |||||
Men | 28.2 ± 11.3 | 15.6 ± 6.0 ‡ $ | NA * | 33.7 ± 3.3 | <0.0001 |
Women | 13.5 ± 5.9 & | 12.3 ± 5.0 | 9.4 ± 3.0 | 12.4 ± 2.4 | 0.0008 |
Low hand-grip n (%) | 42 (56%) | 12 (22.2%) | 41 (100%) | 17 (100%) | <0.0001 |
Gait speed (m/s) | 0.41 ± 0.22 | 0.36 ± 0.27 | 0.33 ± 0.22 | 0.54 ± 0.26 & | 0.040 |
Phase Angle | 4.5 ± 1.1 & | 4.3 ± 1.4 | 3.7 ± 0.6 | 4.2 ± 1.1 | 0.010 |
Previous BI | 85 (69–100) | 85 (55–100) | 80 (60–97) | 100 (85–100) | 0.090 |
Discharge BI | 60 (30–80) | 50 (30–75) | 55 (25–70) | 75 (70–80) | 0.069 |
MMSE | 22 (16–27) | 23 (16–27) | 20 (15–25) | 23 (17–26) | 0.507 |
MNA-SF | 11 (10–13) | 12 (10–13) | 10 (10–11) ‡ | 12 (10–12) & | 0.005 |
Weight difference ¥, kg | −1.9 ± 3.4 | −2.8 ± 3.4 | −1.5 ± 2.6 | −0.5 ± 3.0 | 0.054 |
SMI difference ¥, kg/m2 | |||||
Men | −1.4 ± 2.0 | −0.8 ± 1.7 | NA * | −0.8 ± 1.7 | 0.872 |
Women | −0.6 ± 1.2 #-$ | −1.8 ± 2.2 &-$ | −0.2 ± 0.7 $ | 0.9 ± 1.2 | <0.0001 |
Grip strength difference ¥, Kg | |||||
Men | −1.2 ± 5.0 | 0.4 ± 3.8 | NA * | 0.5 ± 1.0 | 0.782 |
Women | 0.96 ± 2.9 | −0.33 ± 2.8 $ | 0.12 ± 2.3 $ | 3.5 ± 4.8 | 0.006 |
Variable | Incident * | p | Chronic ‡ | p Value |
---|---|---|---|---|
BMI | 0.73 (0.64–0.84) | <0.0001 | 0.64 (0.53–0.76) | <0.0001 |
MNA-SF | 0.93 (0.65–1.33) | 0.696 | 0.60 (0.40–0.90) | 0.015 |
TST $ | 0.94 (0.88–1.01) | 0.113 | 0.91 (0.85–0.98) | 0.022 |
Hand-grip strength | 0.92 (0.85–0.99) | 0.038 | 0.85 (0.77–0.94) | 0.002 |
SMI | 0.17 (0.07–0.43) | <0.0001 | 0.002 (0.0002–0.03) | <0.0001 |
PA | 0.97 (0.65–1.44) | 0.896 | 0.41 (0.21–0.78) | 0.007 |
Sarcopenia n = 95 | No Sarcopenia n = 92 | p-Value | |
---|---|---|---|
Sex n (M/W) | 35/60 | 14/78 | 0.001 |
Weight, Kg | 56.1 ± 9.4 | 66.4 ± 13.9 | <0.001 |
BMI, Kg/m2 | 22.3 ± 2.8 | 26.9 ± 4.5 | <0.001 |
Hb, g/dL | 11.9 ± 1.2 | 11.6 ± 1.0 | 0.046 |
Total Protein, g/dL | 6.2 ± 0.6 | 6.2 ± 0.5 | 0.616 |
Albumin, g/dL | 3.5 ± 0.4 | 3.5 ± 0.4 | 0.921 |
VitD ng/mL | 11 (12.7–24.9) | 16 (12–23.5) | 0.481 |
IL-6, pg/mL | 6.2 (3.6–9.3) | 6.0 (3.9–8.4) | 0.753 |
TNF-alpha, pg/mL | 11.3 (8.0–15.8) | 7.5 (5.0–12.4) | 0.022 |
Barthel index | 50 (30–75) | 65 (35–80) | 0.053 |
MNA-SF | 11.5 (10–12.7) | 11.5 (10.5–12.5) | 0.880 |
PA | 3.9 ± 0.7 | 4.4 ± 0.8 | 0.0001 |
Hand-grip, kg | 12.8 ± 5.4 | 16.7 ± 7.9 | 0.001 |
Men | 17.2 ± 5.6 | 32.3 ± 4.2 | <0.001 |
Women | 10.2 ± 3.3 | 14.8 ± 5.8 | <0.001 |
Low grip strength n (%) | 95 (100%) | 43 (46.7%) | <0.0001 |
SMI, Kg/m2 | |||
Men | 5.7 ± 0.6 | 6.9 ± 0.7 | <0.001 |
Women | 5.0 ± 0.4 | 5.9 ± 0.6 | <0.001 |
Low SMI n (%) | 95 (100%) | 20 (21.7%) | <0.0001 |
Gait speed, m/s | 0.3 ± 0.2 | 0.4 ± 0.2 | 0.035 |
Low gait speed n (%) | 80 (84.2%) | 68 (73.9%) | 0.083 |
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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
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 StyleMalafarina, 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