scholarly journals Knee Extension Strength Measures Indicating Probable Sarcopenia Is Associated with Health-Related Outcomes and a Strong Predictor of 1-Year Mortality in Patients Following Hip Fracture Surgery

Geriatrics ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 8
Author(s):  
Morten Tange Kristensen ◽  
Signe Hulsbæk ◽  
Louise Lohmann Faber ◽  
Lise Kronborg
Keyword(s):  
Hip Fracture ◽  
Strong Predictor ◽  
Knee Extension ◽  
Acute Hospital ◽  
Cut Points ◽  
Knee Extension Strength ◽  
Hip Fracture Surgery ◽  
Hand Grip ◽  
Health Related ◽  
Fracture Surgery

To examine if knee-extension strength (KES) measures indicating probable sarcopenia are associated with health-related outcomes and if KES and hand grip strength (HGS) measures are associated with 1-year mortality after hip fracture. Two groups of older patients with hip fracture had either HGS (n = 32) or KES (n = 150) assessed during their acute hospital stay. Cut-points for HGS (<27 kg for men and <16 kg for women), and cut-points for maximal isometric KES (non-fractured limb), being the lowest sex-specific quintile (<23.64 kg for men and <15.24 kg for women), were used to examine association with health-related outcomes and 1-year mortality. Overall, 1-year mortality was 12.6% in the two strength groups, of which 47% (HGS) and 46% (KES) respectively, were classified as probable sarcopenia. Probable sarcopenia patients (KES) had lower prefracture function, performed poorly in mobility measures and expressed a greater concern of falling compared to their stronger counterparts. Hazard ratio for 1-year mortality was 2.7 (95%CI = 0.49–14.7, p = 0.3) for HGS and 9.8 (95%CI = 2.2–43.0, p = 0.002) for KES for probable sarcopenia patients compared to those not. Sex-specific KES measures indicating sarcopenia is associated with health-related outcomes and a strong predictor of 1-year mortality after hip fracture.

scholarly journals Feasibility and preliminary effect of anabolic steroids in addition to strength training and nutritional supplement in rehabilitation of patients with hip fracture: a randomized controlled pilot trial (HIP-SAP1 trial)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Signe Hulsbæk ◽  
Thomas Bandholm ◽  
Ilija Ban ◽  
Nicolai Bang Foss ◽  
Jens-Erik Beck Jensen ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Strength Training ◽  
Anabolic Steroid ◽  
Nutritional Supplement ◽  
Knee Extension ◽  
Knee Extension Strength ◽  
Hip Fracture Surgery ◽  
Link Type ◽  
Secondary Outcomes ◽  
Fracture Surgery

Abstract Background Anabolic steroid has been suggested as a supplement during hip fracture rehabilitation and a Cochrane Review recommended further trials. The aim was to determine feasibility and preliminary effect of a 12-week intervention consisting of anabolic steroid in addition to physiotherapy and nutritional supplement on knee-extension strength and function after hip fracture surgery. Methods Patients were randomized (1:1) during acute care to: 1. Anabolic steroid (Nandrolone Decanoate) or 2. Placebo (Saline). Both groups received identical physiotherapy (with strength training) and a nutritional supplement. Primary outcome was change in maximal isometric knee-extension strength from the week after surgery to 14 weeks. Secondary outcomes were physical performance, patient reported outcomes and body composition. Results Seven hundred seventeen patients were screened, and 23 randomised (mean age 73.4 years, 78% women). Target sample size was 48. Main limitations for inclusion were “not home-dwelling” (18%) and “cognitive dysfunction” (16%). Among eligible patients, the main reason for declining participation was “Overwhelmed and stressed by situation” (37%). Adherence to interventions was: Anabolic steroid 87%, exercise 91% and nutrition 61%. Addition of anabolic steroid showed a non-significant between-group difference in knee-extension strength in the fractured leg of 0.11 (95%CI -0.25;0.48) Nm/kg in favor of the anabolic group. Correspondingly, a non-significant between-group difference of 0.16 (95%CI -0.05;0.36) Nm/Kg was seen for the non-fractured leg. No significant between-group differences were identified for the secondary outcomes. Eighteen adverse reactions were identified (anabolic = 10, control = 8). Conclusions Early inclusion after hip fracture surgery to this trial seemed non-feasible, primarily due to slow recruitment. Although inconclusive, positive tendencies were seen for the addition of anabolic steroid. Trial registration Clinicaltrials.gov NCT03545347.

scholarly journals Association of Sarcopenic Dysphagia with Underlying Sarcopenia Following Hip Fracture Surgery in Older Women

Nutrients ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1365 ◽  
Author(s):  
Ayano Nagano ◽  
Keisuke Maeda ◽  
Akio Shimizu ◽  
Shinsuke Nagami ◽  
Naohide Takigawa ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Hip Fracture ◽  
Grip Strength ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Oral Intake ◽  
Hip Fracture Surgery ◽  
Hand Grip ◽  
Sarcopenic Dysphagia ◽  
Fracture Surgery

This study aimed to investigate the association between the development of dysphagia in patients with underlying sarcopenia and the prevalence of sarcopenic dysphagia in older patients following surgical treatment for hip fracture. Older female patients with hip fractures (n = 89) were studied. The data of skeletal muscle mass, hand-grip strength, and nutritional status were examined. The development of dysphagia postoperatively was graded using the Food Oral Intake Scale by a certified nurse in dysphagia nursing. The patients’ mean age was 85.9 ± 6.5 years. The prevalence of sarcopenia was 76.4% at baseline. Of the 89 patients, 11 (12.3%) and 12 (13.5%) had dysphagia by day 7 of hospitalization and at discharge, respectively. All patients who developed dysphagia had underlying sarcopenia. Lower skeletal muscle mass index (SMI) (<4.7 kg/m2) and grip strength (<8 kg) at baseline indicated a higher incidence of dysphagia on day 7 (p = 0.003 and Phi = 0.391) and at discharge (p = 0.001 and Phi = 0.448). Dysphagia developed after hip fracture surgery could be sarcopenic dysphagia, and worsening sarcopenia was a risk factor for dysphagia following hip fracture surgery. Clinicians and medical coworkers should become more aware of the risks of sarcopenic dysphagia. Early detection and preventive interventions for dysphagia should be emphasized.

Patient-reported outcomes at acute hospital stay and four months after hip fracture surgery. A register and questionnaire study

2018 ◽  
Vol 6 (1) ◽  
pp. 119
Author(s):  
Berit Gesar ◽  
Carina Baath ◽  
Hanne Hedin ◽  
Ami Hommel
Keyword(s):  
Hip Fracture ◽  
Hospital Stay ◽  
Age Groups ◽  
Acute Hospital ◽  
Questionnaire Study ◽  
Hip Fracture Surgery ◽  
Quality Register ◽  
Patient Reported ◽  
Fracture Surgery

Introduction: The large and increasing number of hip fracture patients, in combination with the large impact that this is having on daily living activities, is emphasizing the importance of identifying factors that have a detrimental impact on post-operative outcomes. There are benefits to planning the ward in a way that prevents a steep decline in recovery after hip fracture surgery. Adding the patient`s perspective into the healthcare assessment, via shared healthcare decision-making, allows the patient’s needs and preferences to be taken fully into account. The aim of this study was to identify factors that predict how patients recover after hip fracture surgery.Methods: A descriptive quality register/questionnaire study in acute orthopaedic wards, 2 to 5 days after surgery, with a follow-up 4 months later. The patients included were ≥65 years of age and had been previously healthy and living independently before the hip fracture.Results: The participants in this study had returned to their own homes after 4 months, but only 21% reported themselves as being fully or almost fully recovered. In several domains of recovery, all 3 age groups (65-74, 75-84 and 85-97) reported different challenges both during their acute hospital stay and at the 4 months follow-up. The recovery phase is heterogeneous and requires individual care. The way that this is planned has an influence on patient outcome.Conclusion: Patients sustaining a hip fracture are heterogeneous and different age groups experience different challenges. At 4 months follow-up, one fifth of the participants reported themselves fully or almost fully recovered and most of them had returned to their own homes. The Swedish National Hip Fracture Register and the patient-reported questionnaires employed in this study are appropriate tools to audit further development of healthcare to improve quality of life after hip fracture surgery.

scholarly journals Patient perspectives on treatment, care and rehabilitation after hip fracture: A meta-aggregative systematic review

2019 ◽  
Author(s):  
Charlotte Abrahamsen ◽  
Birgitte Nørgaard
Keyword(s):  
Systematic Review ◽  
Hip Fracture ◽  
Patient Perspectives ◽  
Hip Fracture Surgery ◽  
Health Related ◽  
Critical Appraisal Skills ◽  
Trajectory Methods ◽  
Fracture Surgery ◽  
And Training

Abstract Background: Hip fracture surgery is a distressing and life-changing event for patients. The treatment, care and rehabilitation of hip fracture patients governed by evidence-based recommendations, the patients’ preferences are often not represented. The aim of this systematic review is to identify elderly hip fracture patients’ priorities during their care trajectory. Methods: A meta-aggregative approach was applied to present findings on patient perspectives. Data were extracted from the findings in the Results section of each study, categorized by similarity in meaning by both authors as either “health-related outcomes” or “healthcare-related experiences”. The quality of the presented evidence was evaluated, and all studies were assessed using the Critical Appraisal Skills Programme (CASP) checklist.Results: Sixteen qualitative studies met the inclusion criteria. The health-related outcomes category included: 1) symptoms and complications, 2) physical health, 3) mental health and 4) social relationships and 5) personal goals. Healthcare-related experiences revolved around: 1) waiting time, 2) information, 3) being treated with respect, 4) participation and 5) discharge.Conclusions: This systematic review provides an overview of hip fracture patients’ perspectives on important aspects of care, treatment and training during their trajectory, thereby contributing to the development of a patient-derived measure of hip fracture.

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