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Low muscle mass affect hip fracture treatment outcomes in older individuals: a single-institution case-control study
BACKGROUND: Although sarcopenia has been known as a risk factor for hip fracture, only a few reports have described the impact of muscle mass on hip fracture treatment outcomes. The current study aimed to investigate the impact of muscle mass on hip fracture treatment outcomes. METHODS: This case–co...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7945055/ https://www.ncbi.nlm.nih.gov/pubmed/33750363 http://dx.doi.org/10.1186/s12891-021-04143-6 |
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author | Iida, Hiroki Seki, Taisuke Sakai, Yoshihito Watanabe, Tsuyoshi Wakao, Norimitsu Matsui, Hiroki Imagama, Shiro |
author_facet | Iida, Hiroki Seki, Taisuke Sakai, Yoshihito Watanabe, Tsuyoshi Wakao, Norimitsu Matsui, Hiroki Imagama, Shiro |
author_sort | Iida, Hiroki |
collection | PubMed |
description | BACKGROUND: Although sarcopenia has been known as a risk factor for hip fracture, only a few reports have described the impact of muscle mass on hip fracture treatment outcomes. The current study aimed to investigate the impact of muscle mass on hip fracture treatment outcomes. METHODS: This case–control study involved 337 patients (67 males and 270 females) with hip fracture aged ≥65 years (mean age: 84.1 ± 7.1 years) who underwent orthopedic surgery from January 2013 to June 2019. The mean follow-up period was 17.1 (1–60) months. Upon admission, all patients were assessed for low muscle mass according to the Asian Working Group for Sarcopenia criteria (male, SMI < 7.00 kg/m(2); female, SMI < 5.40 kg/m(2)) using dual-energy X-ray absorptiometry. Treatment outcomes (stays at acute care institutions, hospital mortality, the Barthel index at discharge, and home discharge rates, and one-year mortality) were compared between patients with and without low muscle mass by Student’s t-test, Mann-Whitney U test and the Pearson Chi-Square test. A multivariate logistic regression model was used to calculate adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for factors related to low muscle mass. Kaplan–Meier survival curves on one-year mortality of hip fracture patients for those with and without low muscle mass were prepared, and log-rank tests were performed. Furthermore, we determined whether low muscle mass was a risk factor for one-year mortality in hip fracture patients using a Cox proportional hazards model. RESULTS: The prevalence of low muscle mass in patients with hip fracture was 231(68.5%). Those with low muscle mass had a lower Barthel index (P < 0.0001), hospital discharge rate (P = 0.035) and higher one-year mortality (P = 0.010). Cox proportional hazards regression analysis adjusted for age and sex found that low muscle mass was a risk factor for one-year mortality (hazard ratio, 3.182, 95% confidence interval, 1.097–9.226, P = 0.033). CONCLUSIONS: Patients with hip fracture who had low muscle mass had a lower Barthel index, lower home discharge rate, and higher one-year mortality. Moreover, low muscle mass was identified as a risk factor for one-year mortality among those with hip fracture. The aforementioned findings may help clinicians better manage those with hip fracture. |
format | Online Article Text |
id | pubmed-7945055 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-79450552021-03-10 Low muscle mass affect hip fracture treatment outcomes in older individuals: a single-institution case-control study Iida, Hiroki Seki, Taisuke Sakai, Yoshihito Watanabe, Tsuyoshi Wakao, Norimitsu Matsui, Hiroki Imagama, Shiro BMC Musculoskelet Disord Research Article BACKGROUND: Although sarcopenia has been known as a risk factor for hip fracture, only a few reports have described the impact of muscle mass on hip fracture treatment outcomes. The current study aimed to investigate the impact of muscle mass on hip fracture treatment outcomes. METHODS: This case–control study involved 337 patients (67 males and 270 females) with hip fracture aged ≥65 years (mean age: 84.1 ± 7.1 years) who underwent orthopedic surgery from January 2013 to June 2019. The mean follow-up period was 17.1 (1–60) months. Upon admission, all patients were assessed for low muscle mass according to the Asian Working Group for Sarcopenia criteria (male, SMI < 7.00 kg/m(2); female, SMI < 5.40 kg/m(2)) using dual-energy X-ray absorptiometry. Treatment outcomes (stays at acute care institutions, hospital mortality, the Barthel index at discharge, and home discharge rates, and one-year mortality) were compared between patients with and without low muscle mass by Student’s t-test, Mann-Whitney U test and the Pearson Chi-Square test. A multivariate logistic regression model was used to calculate adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for factors related to low muscle mass. Kaplan–Meier survival curves on one-year mortality of hip fracture patients for those with and without low muscle mass were prepared, and log-rank tests were performed. Furthermore, we determined whether low muscle mass was a risk factor for one-year mortality in hip fracture patients using a Cox proportional hazards model. RESULTS: The prevalence of low muscle mass in patients with hip fracture was 231(68.5%). Those with low muscle mass had a lower Barthel index (P < 0.0001), hospital discharge rate (P = 0.035) and higher one-year mortality (P = 0.010). Cox proportional hazards regression analysis adjusted for age and sex found that low muscle mass was a risk factor for one-year mortality (hazard ratio, 3.182, 95% confidence interval, 1.097–9.226, P = 0.033). CONCLUSIONS: Patients with hip fracture who had low muscle mass had a lower Barthel index, lower home discharge rate, and higher one-year mortality. Moreover, low muscle mass was identified as a risk factor for one-year mortality among those with hip fracture. The aforementioned findings may help clinicians better manage those with hip fracture. BioMed Central 2021-03-09 /pmc/articles/PMC7945055/ /pubmed/33750363 http://dx.doi.org/10.1186/s12891-021-04143-6 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Iida, Hiroki Seki, Taisuke Sakai, Yoshihito Watanabe, Tsuyoshi Wakao, Norimitsu Matsui, Hiroki Imagama, Shiro Low muscle mass affect hip fracture treatment outcomes in older individuals: a single-institution case-control study |
title | Low muscle mass affect hip fracture treatment outcomes in older individuals: a single-institution case-control study |
title_full | Low muscle mass affect hip fracture treatment outcomes in older individuals: a single-institution case-control study |
title_fullStr | Low muscle mass affect hip fracture treatment outcomes in older individuals: a single-institution case-control study |
title_full_unstemmed | Low muscle mass affect hip fracture treatment outcomes in older individuals: a single-institution case-control study |
title_short | Low muscle mass affect hip fracture treatment outcomes in older individuals: a single-institution case-control study |
title_sort | low muscle mass affect hip fracture treatment outcomes in older individuals: a single-institution case-control study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7945055/ https://www.ncbi.nlm.nih.gov/pubmed/33750363 http://dx.doi.org/10.1186/s12891-021-04143-6 |
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