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Abstract：
Background Sarcopenia is highly prevalent among elderly patients with hip fracture. Studies reported a significant association between sarcopenia and clinical outcomes in patients with hip fractures. The current study aimed to determine the prevalence of sarcopenia among elderly patients with hip fracture and its effect on short-term functional outcomes, highlighting predictors of postoperative functional decline. Methods This is a cross-sectional study followed by a prospective cohort. Elderly patients (60 years and above) with hip fractures were recruited from the orthopedic department. Patients were followed by the ortho-geriatric team in the perioperative period and for three postoperative months. Patients were subjected to comprehensive geriatric assessment including a full history and physical examination. In the preoperative state and after three months of follow-up the following were assessed: functional independence using the Barthel index (BI); nutritional state using a checklist named DETERMINE Your Nutritional Health; sarcopenia using the SARC-F questionnaire assessing strength, ambulation, rising from a chair, climbing stairs, and fall history. Perioperative risk assessment and post-discharge care were obtained through medical records and by questioning patients or families. Preoperative sarcopenia was confirmed using the Ishii equation which is an equation that includes (age, calf circumference, and hand grip strength). Results Preoperative sarcopenia screening showed that 29.3% of patients suffered sarcopenia by SARC-F questionnaire and 28.6% by Ishii equation score. At the end of the follow-up, 57.9% of patients suffered sarcopenia by SARC-F questionnaire. There was a marked post-fracture decline in independence level; 52.1% had slight dependence in function, 27.1% had moderate dependence in function, and 20.7% had total dependence in function. Conclusion This study gives us the chance for a greater understanding of the negative effects of sarcopenia on the outcomes following hip fracture surgery in the geriatric population. It shows a prevalence of sarcopenia among the elderly with hip fractures at 29.3%. The elderly experience a marked post-fracture decline in their level of independence concerning basic activities of daily living. Those with older age, higher comorbidities, cognitive impairment, and functional dependence with poor nutritional state are more vulnerable to functional decline. Other perioperative risks include delayed surgery, surgery type, postoperative complications, longer hospital stays, lack of planned rehabilitative and nutritional plans, and postoperative depression. Early detection of sarcopenia helps establish early interventional plans to reverse such poor outcomes.
摘要：
背景肌肉减少症在老年髋部骨折患者中非常普遍。研究报告表明，髋部骨折患者的肌肉减少症与临床预后之间存在显着关联。本研究旨在确定老年髋部骨折患者中肌肉减少症的患病率及其对短期功能预后的影响。强调术后功能下降的预测因素。方法这是一项横断面研究，随后是一项前瞻性队列研究。从骨科招募老年髋部骨折患者（60岁及以上）。在围手术期和术后3个月，由老年骨科团队随访。对患者进行全面的老年评估，包括完整的病史和体格检查。在术前状态和随访三个月后，对以下情况进行了评估：使用Barthel指数（BI）的功能独立性；使用名为“确定您的营养健康”的清单的营养状态；使用SARC-F评估强度问卷的肌肉减少症，步行,从椅子上站起来,爬楼梯,秋天的历史。围手术期风险评估和出院后护理是通过病历和询问患者或家属获得的。术前肌肉减少症使用Ishii方程进行确认，该方程包括（年龄，小腿周长,和手握力)。结果术前肌肉减少症筛查显示，SARC-F问卷显示29.3％的患者患有肌肉减少症，Ishii方程评分显示28.6％。在后续行动结束时，通过SARC-F问卷，57.9％的患者患有肌肉减少症。骨折后独立性水平明显下降；52.1%对功能有轻微依赖，27.1%有中等程度的功能依赖，20.7%对功能有完全依赖。结论这项研究使我们有机会更好地了解老年人群髋部骨折手术后肌肉减少对预后的负面影响。它显示老年人髋部骨折中肌肉减少症的患病率为29.3％。老年人在日常生活的基本活动方面的独立性水平明显下降。那些年龄较大的人，更高的合并症，认知障碍，营养状态差的功能依赖更容易受到功能下降的影响。其他围手术期风险包括延迟手术，手术类型,术后并发症,住院时间更长，缺乏有计划的康复和营养计划，和术后抑郁。早期发现肌肉减少症有助于建立早期干预计划，以逆转这种不良结局。
