Sarcopenia as an Independent Predictor of Poorer Functional Outcomes in Patients Undergoing Post-hip Fracture...

Sarcopenia is a critical geriatric syndrome associated with an increasing global aging population and a reduced quality of life. While sarcopenia is known to negatively impact functional ability, its specific effects on rehabilitation outcomes following hip fracture surgery remain to be fully elucidated. The purpose of this study was to investigate the influence of sarcopenia on physical function and recovery trajectory during rehabilitation after hip fracture surgery.

This retrospective, single-center observational study was conducted at Shiobara Spring Hospital in Nasushiobara, Tochigi, Japan, and included 128 patients who underwent rehabilitation after hip fracture surgery. Participants were classified into two groups based on the presence of sarcopenia, diagnosed according to the Asian Working Group for Sarcopenia 2019 (AWGS 2019) criteria. The primary outcomes were physical function and pain, evaluated by the Berg Balance Scale (BBS), Numerical Rating Scale (NRS) for pain, walking speed, and Barthel Index, measured on both admission and at discharge. We performed a multivariate logistic regression analysis to assess the independent association between sarcopenia and discharge outcomes.

Sarcopenia was prevalent in 66.4% of the patient population. At admission, the sarcopenia group had significantly worse scores on all measures compared to the non-sarcopenia group (BBS, NRS, walking speed, Barthel Index, and calf circumference). Following rehabilitation, both groups showed significant improvements in their functional scores. The multivariate analysis revealed that sarcopenia was a significant independent predictor of lower functional outcomes at discharge. Notably, sarcopenia was strongly associated with a substantially slower walking speed at discharge (odds ratio (OR) 28.635, 95% confidence interval (CI) 4.780-171.552, P < 0.001) and a smaller calf circumference (OR 1.429, 95% CI 1.145-1.784, P = 0.002).

Sarcopenia is a significant independent predictor of poorer physical outcomes at discharge for patients with hip fractures, with a particularly strong association with reduced walking speed. These findings underscore the clinical importance of early sarcopenia diagnosis and the need for targeted rehabilitation interventions to improve functional recovery in this vulnerable patient population.