Effect of sarcopenia on the efficiency of the treatment of femoral neck fracture in elderly patients / 中华老年医学杂志

ABSTRACT

Objective To investigate the effect of sarcopenia on the efficiency of the treatment of femoral neck fracture in elderly patients.Methods A total of 65 elderly patients aged ≥65 years with femoral neck fractures meeting the inclusion and exclusion criteria were investigated in our hospital from February 2014 to February 2016.The muscle cross-sectional area(cm2) at the thoracic 12 pedicle level was measured by chest CT.The skeletal muscle index(SMI)is calculated by the formula that the muscle cross-sectional area(cm2)at T12 pedicle level was divided by m2 of the patient's body height(meter).SMI cutoff values of 42.6 cm2/m2 (males)and 30.6 cm2/m2 (females)were used to diagnose sarcopenia.Linear regression analysis was used to analyze the relationship of SMI with the length of hospital stay,blood transfusion during hospitalization and Harris score one month after surgery.The difference between the patients with and without sarcopenia in the length of hospital stay,the volume of blood transfusion,incidence rate of complications,Harris score,the mortality rate of perioperative period and on.year mortality rate were analyzed by ttest.Results Among 65 elderly patients,28 cases were diagnosed as sarcopenia.Their mean SMI was(30.3 ± 5.2)cm2/m2 in the sarcopenia group and (43.0±6.5)cm2/m2 in the non-sarcopenia group,the difference was statistically significant (t =-8.448,P ＜ 0.001).There were significant differences between the sarcopenia group and the non sarcopenia group in the mean hospital stay[(14.7 ± 5.8)d vs.(13.2±4.5)d,t =1.225,P =0.225],the transfusion volume during hospitalization[(1.7 ± 1.4) units vs.(0.92±1.0)units,t=2.621,P=0.011],Harris scores[(81.1±4.4) vs.(88.7±2.3),t=-8.219,P ＜0.001)],the incidence of complications(57.1 ％ vs.16.2 ％,x2 =11.923,P =0.001),the mortality of perioperative period(7.1％ vs.2.7％,P=0.573)and the one-year mortality(35.7％ vs.10.8％,x2 =4.468,P =0.035).Conclusions Sarcopenia can delay postoperative rehabilitation in elderly patients with femoral neck fracture and increase the incidence of complications and late mortality rate.