Predicting Mobility and Functional Recovery After Hip Fracture With Handgrip Strength, Calf Circumference, and the SARC-F Questionnaire.
TL;DR
SARC-F was consistent in predicting short- and long-term functional outcomes in patients with hip fractures and may be a practical screening tool to identify patients at risk of poor recovery after hip fracture.
Abstract
Objectives
More longitudinal studies of the implications of sarcopenia are needed in patients with hip fractures. This study compared 2 sarcopenia-related measurements and 1 questionnaire-based screening tool and examined their association with rehabilitation outcomes after hip fracture.
Design
A prospective cohort study with 1-year follow-up was performed between 2021 and 2023.
Setting
AND
Participants
Four hundred thirty older adults (≥70 years) with hip fractures participated in a single university hospital.
Methods
The associations of handgrip strength, calf circumference, and the SARC-F (Strength, Assistance with walking, Rise from a chair, Climb stairs, and Falls) questionnaire were examined with early postoperative mobilization (the Cumulated Ambulation Score), walking mobility (the New Mobility Score, up to 4 months), and functional outcome [the Barthel Index (BI) up to 12 months]. The analyses were adjusted for age and sex, American Society of Anesthesiologists score, and cognitive and nutritional status.
Results
Only SARC-F was consistently associated with impaired early mobilization (odds ratio [OR], 1.99; 95% CI, 1.14-3.45 for day 1; OR, 4.90; 95% CI, 2.84-8.44 for day 2; OR, 7.56; 95% CI, 3.61-15.81 for day 3). Similarly, only the SARC-F-based sarcopenia group was associated with inferior walking ability from 1 month to 4 months after fracture and a greater functional decline in BI at 4 months compared with those without sarcopenia [mean New Mobility Score change (CI) 2.0 (1.7-2.4) vs 0.6 (0.3-0.9); mean BI change -17.5 (-20.9 to -14.2) vs -11.2 (-13.9 to -8.6)]. No significant improvement in BI was observed in either group between 4 and 12 months. Handgrip strength or calf circumference was not consistently associated with the studied outcomes.
Conclusions
AND IMPLICATIONS SARC-F was consistent in predicting short- and long-term functional outcomes. It may be a practical screening tool to identify patients at risk of poor recovery after hip fracture.