Prevalence of sarcopenia in older South African patients following surgery for fragility fractures of the hip
Date
2020
Journal Title
Journal ISSN
Volume Title
Publisher
SAGE Publications
Abstract
Introduction: Geriatric patients with a fragility fracture of the hip (FFH) are especially prone to sarcopenia with poor functional
outcomes and quality of life. We assessed the prevalence of sarcopenia in older South African patients with FFH. Risk factors for
sarcopenia were also investigated. Materials and Methods: From August 1 to November 30, 2018, all older patients with FFH
were invited to participate. Sarcopenia was diagnosed based on the revised criteria of the European Working Group on Sarcopenia
in Older People (EWGSOP2). Handgrip strength (HGS) and muscle strength were assessed. Muscle quantity was
determined by dual-energy X-ray absorptiometry. Demographic information was collected, and 25-hydroxyvitamin D (25[OH]D)
status was determined. Results: Of the 100 hip fracture cases, 65 were enrolled, and 52% (34/65) were sarcopenic (women: 62%;
men: 38%). HGS accurately identified sarcopenia (sensitivity and specificity: 100%). Patients >80 years of age had a prevalence of
sarcopenia twice (18/21 [83%]) that of younger patients (18/44 [36%]). Women with sarcopenia were smaller than those without
(weight: p < 0.001; height: p < 0.001; body mass index: p ¼ 0.018). Low 25(OH)D was almost universally present, with median
25(OH)D levels significantly lower in the patients with sarcopenia (27 nmol/L [interquartile range {IQR}: 20–39] vs. 40 nmol/L
[IQR: 29–53]). Several risk factors, including advanced age; female sex; a smaller body size, especially among women; limited
physical activity; and low 25(OH)D levels, were identified. Discussion: The accuracy of HGS testing in this cohort underscores
EWGSOP2’s recommendation that muscle strength is key to sarcopenia. Further study and follow-up are required to determine
the clinical relevance of sarcopenia among FFH patients. Conclusion: The prevalence of sarcopenia in our FFH population is high.
Sarcopenia is associated with poor patient outcomes following surgical intervention. Orthopaedic surgeons should therefore be
cognizant of the presentation and associated risk of sarcopenia as our patient populations age.
Description
CITATION: Laubscher, C. V., et al. 2020. Prevalence of sarcopenia in older South African patients following surgery for fragility fractures of the hip. Geriatric Orthopaedic Surgery and Rehabilitation, 11:1-10, doi:10.1177/2151459320971560.
The original publication is available at https://journals.sagepub.com
Publication of this article was funded by the Stellenbosch University Open Access Fund
The original publication is available at https://journals.sagepub.com
Publication of this article was funded by the Stellenbosch University Open Access Fund
Keywords
Sarcopenia, Fractures in old age, Hip joint -- Surgery
Citation
Laubscher, C. V., et al. 2020. Prevalence of sarcopenia in older South African patients following surgery for fragility fractures of the hip. Geriatric Orthopaedic Surgery and Rehabilitation, 11:1-10, doi:10.1177/2151459320971560