Does sarcopenia predict change in mobility after hip fracture? a multicenter observational study with one-year follow-up

Ole Martin Steihaug, Clara Gram Gjesdal, Bård Bogen, Målfrid Holen Kristoffersen, Gunhild Lien, Karl Ove Hufthammer, Anette Hylen Ranhoff, Ole Martin Steihaug, Clara Gram Gjesdal, Bård Bogen, Målfrid Holen Kristoffersen, Gunhild Lien, Karl Ove Hufthammer, Anette Hylen Ranhoff

Abstract

Background: Patients with hip fracture frequently have sarcopenia and are at great risk of loss of mobility. We have investigated if sarcopenia predicts change in mobility after hip fracture.

Methods: This is a prospective, multicenter observational study with one-year follow-up. Patients with hip fracture who were community-living and capable of walking before the fracture were included at three hospitals in Norway (2011-2013). The primary outcome of the study was change in mobility, measured by the New Mobility Score (NMS). Sarcopenia was determined postoperatively by anthropometry, grip strength, and NMS.

Results: We included 282 participants and sarcopenia status was determined in 201, of whom 38% (77/201) had sarcopenia, 66% (128/194) had low muscle mass, 52% (116/222) had low grip strength and 8% (20/244) had low pre-fracture mobility (NMS < 5). Sarcopenia did not predict change in mobility (effect 0.2 points; 95% CI -0.5 to 0.9, P = 0.6), but it was associated with having lower mobility at one-year (NMS 5.8 (SD 2.3) vs. 6.8 (SD 2.2), P = 0.003), becoming a resident of a nursing home (odds ratio 3.2, 95% CI 0.9 to 12.4, P = 0.048), and the combined endpoint of becoming a resident of a skilled nursing home or death (odds ratio 3.6, 95% CI 1.2 to 12.2, P = 0.02).

Conclusions: Sarcopenia did not predict change in mobility in the year after hip fracture.

Keywords: Activities of daily living; Hip fractures; Independent living; Mobility limitation; Sarcopenia; Skilled nursing facilities.

Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the research committees at the participating hospitals (Haraldsplass Deaconess Hospital and Haukeland University Hospital, Bergen, and Diakonhjemmet Hospital, Oslo, Norway), the Regional Committee on Medical and Health Research Ethics (case 2011/1322/REK sør-øst B) and was conducted according to the principles of the Declaration of Helsinki. Participation was by written informed consent with participants receiving oral and written information on the first day and signed the consent form on a subsequent day.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Overview of patients with hip fracture, patients included in the study and patients returning for follow-up
Fig. 2
Fig. 2
What participants were assessed for muscle mass, grip strength, mobility and sarcopenia
Fig. 3
Fig. 3
New Mobility Score (NMS) during hospitalization, at three months, and at one year, stratified by sarcopenia status during hospitalization. The horizontal lines show mean NMS scores
Fig. 4
Fig. 4
New Mobility Score (NMS) pre-fracture and at one-year follow-up. The first number in each cell is the number of patients with the given combination of NMS scores. For each row, the percentage values and the cell shadings show the distribution of NMS at follow-up for a given NMS score at baseline. No patients had a NMS of 1 at baseline, and patients with a NMS score of 0 was excluded from the study. Patients with the same NMS score at baseline and follow-up are shown in boldface, and any cell to the right of this diagonal indicates an improvement in the NMS

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