Table 2.
Diagnosis criteria of sarcopenia, prevalence, and its impact on clinical outcomes in patients with hip fracture.
| Author, Year, Country | Design, Setting | Age Male/Female, n (%) |
Sample Size | Diagnosis Criteria Measurement Methods of Muscle Strength, Muscle Mass, Physical Function |
Prevalence of Sarcopenia | Outcome | Main Results |
|---|---|---|---|---|---|---|---|
| González-Montalvo et al., 2015 [45] Spain |
Prospective observational study, university hospital | Mean 85.3 (SD 6.8) 47 (20.3)/382 (79.7) |
479 | EWGSOP Handgrip strength Bioimpedance analysis |
17.1% | Barthel Index at discharge | In the multivariate analysis, sarcopenia was not associated with functional prognosis at discharge (OR 1.68, 95% CI 0.99–2.84). |
| Di Monaco et al., 2015 [46] Italy |
Observational study, rehabilitation hospital | Normal: 78.9 (SD 7.7) Presarcopenia: 73.8 (SD 5.5) Sarcopenia: 81.3 (SD 7.5) All female: 138 (100) |
138 | EWGSOP Handgrip strength Dual-energy X-ray absorptiometry |
Presarcopenia: 17% Sarcopenia: 58% |
Barthel Index (at admission, end of the rehabilitation course) |
Sarcopenia was associated with Barthel Index scores at the time of assessment but not at the end of the rehabilitation course after adjusting for multiple adjustments (p < 0.001). |
| Landi et al., 2017 [43] Italy |
Observational study, Geriatric Rehabilitation Unit of the hospital |
Mean age 81.3 (SD 4.8) 45 (36.4)/82 (64.6) |
127 | FNIH Dual-energy X-ray absorptiometry |
Sarcopenia: 48% | Barthel Index (at discharge and 3 months after discharge) |
After adjustment for potential confounders, participants with sarcopenia had a significantly increased risk of incomplete functional recovery compared with nonsarcopenic patients (OR 3.07, 95% CI 1.07–8.75). |
| Di Chang et al., 2018 [47] Taiwan |
Retrospective observational study, university hospital | Mean age 81.1 (SD 12.2) 24 (26.4)/67 (73.6) |
91 | Computed tomography (total skeletal muscle area at L4) |
No details provided | Hospital stay Perioperative mortality Medical complications In-hospital blood transfusion volume Readmission rate at 90 days |
Low skeletal muscle index was independently associated with longer length of hospitalization (p = 0.032) but was not associated with any other outcomes. |
| Kim et al., 2018 [48] Korea |
Retrospective observational study, National Police Hospital | Mean 78.5 years (range, 65–94 years) 27 (29.7)/64 (70.3) |
91 | Choi et al. reported criteria Computed tomography (L3) |
49.5% | One-year and five-year mortality rates | Kaplan–Meier analysis showed that sarcopenia did not affect the 1-year mortality rate (p = 0.793) but had a significant effect on the 5-year mortality rate (p = 0.028). Both perioperative sarcopenia (p = 0.018) and osteoporosis (p < 0.001) affected the 5-year mortality rate. |
| Yoo et al., 2018 [49] Korea |
Retrospective observational study, university hospital | Mean 77.8 (SD 9.7) 78 (24.1)/246 (75.9) |
324 | AWGS Handgrip strength Dual-energy X-ray absorptiometry |
37.7% | One-year mortality | Osteosarcopenia (15.1%) was higher for 1-year mortality than other groups (normal: 7.8%, osteoporosis alone: 5.1%, sarcopenia alone: 10.3%). |
| Steihaug et al., 2018 [50] Norway |
Prospective observational study, acute hospital (three hospitals) |
Mean 79.4 (SD 8.2) (24)/(76) |
282 | EWGSOP Handgrip strength The formula reported by Heymsfield et al. (using gender, height, arm circumference, and triceps skinfold) New Mobility Score |
38% | Change in New Mobility Score Resident of a nursing home Death |
Sarcopenia did not predict change in mobility (p = 0.6), but it was associated with having lower mobility at 1-year (p = 0.003), becoming a resident of a nursing home (OR 3.2, p = 0.048), and the combined endpoint of becoming a resident of a skilled nursing home or death (OR 3.6, p = 0.02). |
| Malafarina et al., 2019 [51] Spain |
Prospective observational study, two rehabilitation units | Mean 85.2 (SD 6.3) 49 (26.2)/138 (73.8) |
187 | EWGSOP2 Handgrip strength Bioimpedance analysis 4 meter walking test |
Incident sarcopenia during hospitalization: 54 patients Sarcopenia at admission and at discharge (chronic sarcopenia): 41 patients Sarcopenic at admission but reverted sarcopenia during the admission period (reverted sarcopenia): 17 patients |
Mortality after 7 years | Cox regression analyses showed that sarcopenia was a risk factor for mortality (HR: 1.67, 95% CI 1.11–2.51) and low handgrip strength (HR: 1.76, 95% CI 1.08–2.88). |
| Byun et al., 2019 [52] Korea |
Retrospective study, university hospital | Mean 78.4 (SD 9.7) 121 (24.5)/373 (75.5) |
494 | AWGS Handgrip strength Computed tomography (psoas cross-sectional area at L4–L5 level) |
No details provided | One-year mortality | After adjusting for potential confounders, the lowest quintile of psoas cross-sectional area was significantly associated with mortality only in females (HR 1.76, 95% CI 1.05–2.70). |
| Chen et al., 2020 [53] Hong Kong |
Prospective observational study, acute hospital | Mean 80.72 (SD 9.66) 36 (25.9)/103 (74.1) |
139 | AWGS Handgrip strength Dual-energy X-ray absorptiometry |
50.36% | EQ5D and Barthel Index at 6 months after the operation | After 6 months, patients with sarcopenia had a poor Barthel Index and a lower EQ5D than patients without sarcopenia before injury. |
| Chiles Shaffer et al., 2020 [54] USA |
Prospective observational study, the seventh cohort of the Baltimore Hip Studies | Male: 81.0 (SD 7.5) Female: 80.2 (SD 7.6) 82 (51.3)/78 (48.7) |
160 | EWGSOP IWGS FNIH Handgrip strength Dual-energy X-ray absorptiometry Gait speed |
No details provided | Sarcopenia prevalence over 12 months after hip fracture | Sarcopenia prevalence was stable over time in men by all definitions, whereas the prevalence in women by FNIH was lowest at 2 months, significantly increased at 6 months (p = 0.03) and remained higher at 12 months. Sarcopenia prevalence differed significantly by sex and varied by time point and definition; however, when different, men had a higher prevalence than women did (p < 0.05). |
| Shin et al., 2020 [55] Korea |
Retrospective cohort study, university Hospital | Mean age 74.1 (range, 25–96) 35 (25.9)/100 (74.1) |
135 | AWGS Dual-energy X-ray absorptiometry |
45.9% | Harris Hip Score Parker’s mobility score at the last follow-up Discharge disposition |
In multiple regression analysis, no significant association was found between sarcopenia and the Harris Hip Score of mobility at the last follow-up, nonunion, or time to union. |
| Nagano et al., 2020 [56] Japan |
Retrospective observational study, acute hospital | Mean 85.9 (SD 6.5) All female patients, 89 (100) |
89 | AWGS 2019 Handgrip strength Bioimpedance analysis |
76.4% | Incidence of dysphagia on day 7 and discharge | All patients who developed dysphagia had underlying sarcopenia. |
| Ha et al., 2020 [57] Korea |
Cross-sectional study, acute hospital | Not sarcopenia: 76.02 (SD 6.87) Sarcopenia: 82.62 (SD 7.72) 22 (19.1)/93 (80.9) |
115 | SARC-F, EWGSSOP2, AWGS, IWGS Handgrip strength Dual-energy X-ray absorptiometry |
SARC-F: 63.5% EWGS2: 43 (37.4%) AWGS: 35 (30.4%) IWGS: 60 (52.2%) |
Comparison of the results with criteria | Accuracy of SARC-F was that the sensitivity, specificity, positive predictive value, negative predictive value, and positive predictive value with the EWGSOP2 criteria as the reference standard were 95.35%, 56.94%, 56.94%, 95.35%, and 71.3%, respectively. |
Abbreviations: EWGSOP, European Working Group on Sarcopenia in Older People; OR, odds ratio; CI, confidence interval; FNIH, Foundation for the National Institutes of Health; AWGS, Asian Working Group for Sarcopenia; IWGS, International Working Group on Sarcopenia; HR, hazard ratio.