Sarcopenia status as assessed by hand grip strength enhances prediction of post-operative outcomes in hip fracture patients.
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Authors
Chaplin, Andrew
Langford, Sarah
Sinclair, Nicola
Reed, Mike
Issue Date
2025
Type
Article
Language
en
Keywords
Alternative Title
Abstract
Background
Measuring hand grip strength (HGS) at admission can indicate probable sarcopenia in acute hip fracture and may help predict adverse post-operative outcomes.
Aims
To assess whether HGS is independently associated with adverse post-operative outcomes and enhances risk prediction when combined with the Nottingham Hip Fracture Score (NHFS).
Methods
Routinely collected National Hip Fracture Database data were combined with HGS at a single, high-volume orthopaedic trauma centre. Sarcopenia status was categorised per 2019 European Working Group thresholds as non-sarcopenic, probable sarcopenia, or unable to complete assessment. Binary logistic regression models and receiver-operating-characteristic (ROC) curves assessed prognostic value of HGS assessment.
Results
We analysed data from 282 patients, mean age 83.2 ± 9.2 years; 200 (71%) were women. In univariate analysis, probable sarcopenia (low HGS) was associated with 120-day mortality, 30- and 120-day residential status, prolonged length of stay and post-operative delirium. In multivariate analysis including the NHFS, probable sarcopenia was associated with 120-day mortality, 120-day residential status and post-operative delirium. Combining NHFS and HGS assessment improved discrimination for 120-day mortality (c-statistic 0.79 [95%CI 0.73–0.86]), 30-day residential status (0.85 [95%CI 0.80–0.90]) 120-day residential status (0.89 [95% CI 0.85–0.94]) and post-operative delirium (0.91 [95%CI 0.87–0.94]). Inability to complete HGS assessment was associated with worse prognostic outcomes than low HGS.
Discussion
Sarcopenia is a useful additional predictor of post-operative outcomes in hip fracture, especially post-operative delirium. Inability to complete HGS assessment may indicate even higher risk.
Conclusion
HGS is an inexpensive, feasible and quick adjunct to the NHFS. Further research is required to validate a combined NHFS-HGS score.
Description
Citation
Prowse, J., Jaiswal, S., Chaplin, A. et al. (2025) Sarcopenia status as assessed by hand grip strength enhances prediction of post-operative outcomes in hip fracture patients. Aging Clinical and Experimental Research; 38: 9.
Publisher
License
Journal
Aging Clinical and Experimental Research
Volume
Issue
ISSN
1720-8319