To investigate the effect of sarcopenia on short-term and long-term mortality of post-operative hip fracture in elderly patients.

A total of 93 elderly patients with hip fracturesfrom February 2014 to February 2017, who met the inclusion and exclusion criteria were enrolled in the study. The cross-sectional area (cm²) of the pedicle level of the thoracic 12 (T₁₂) was measured by chest CT. The skeletal muscle index (SMI) was calculated by dividing the T₁₂ pedicle level muscle cross-sectional area with the patient's height. SMI cut-off value at T₁₂ level: 42.6 cm²/m² (male) and 30.6 cm²/m² (female) were used to diagnose sarcopenia.The patients were divided into sarcopenia group and non-sarcopenia group, and the postoperative survival time of the two groups was followed up. The survival curve of the two groups was analyzed by Kaplan Meier, and the difference in survival rates at 6 and 12 months after the operation was compared by the chi-square test. The effects of multivariate factors such as sarcopenia, fracture type (surgical type), age, gender and ASA grade on postoperative mortality of hip fracture were analyzed by Cox proportional hazard model.

There were 45 patients in sarcopenia group and 48 patients in non-sarcopenia group. Four and three patients died within 6 months after operation in the sarcopenia group and the non-sarcopenia group, respectively, and the mortality rate was 8.8% and 8.3%, respectively. There was no significant difference in the mortality rate between the two groups at 6 months after operation (P=0.929). Nineteen and ten patients died within 24 months after operation in the sarcopenia group and the non-sarcopenia group, respectively, and the mortality rate was 42.2% and 18.8%, respectively. There was significant difference in the mortality rate between the two groups at 24 months after operation (P=0.014). Results of cox proportional risk model analysis revealed that sarcopenia (HR=2.015, 95% CI: 2.690, 20.904, P=0.000) and age (HR=0.062, 95% CI: 1.004, 1.128, P=0.036) is significantly related with 24 months postoperative mortality. Patients with sarcopenia and advanced age had a higher postoperative 24-month mortality rate, while fracture type (type of surgery), gender and ASA had no significant effect on postoperative 24-month mortality.

Patients with sarcopenia and older patients had higher mortality at 24 months postoperative hip fracture. The fracture type (surgical type), gender and ASA grade had no significant effect on mortality at 24 months postoperatively.