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Psoas muscle area is associated with prognosis in elderly patients with hip fracture

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Abstract

Introduction

Sarcopenia is a key predictor of prognosis in patients with hip fractures. This study utilized computed tomography (CT) scan (1) to determine the association between psoas muscle cross-sectional area (CSA) and mortality, along with other muscles, and (2) to confirm the correlation between muscle CSA and appendicular lean mass (ALM) measured using DXA in elderly patients with hip fracture.

Materials and methods

Patients who were aged ≥ 50 years and underwent surgical treatment for hip fracture were eligible for this study. After a series of exclusion criteria, 217 female patients were included. Patient data, including clinical characteristics, such as body mass index (BMI), CSA, and ALM, were retrospectively collected. The Kaplan–Meier survival method and Cox proportional hazards regression analysis were used for the statistical analyses. The correlation between CSA/BMI and ALM was also assessed.

Results

Patients in the lowest quartile of psoas muscle CSA/BMI had shorter survival times than those in the other quartiles. When the Cox proportional hazards regression analysis was adjusted for multiple variables, the lowest quartile of the CSA/BMI of the psoas was a risk factor for mortality. The CSA/BMI of the psoas showed the highest correlation coefficient. The CSA/BMI ratio of the other muscles showed a moderately positive correlation with ALM.

Conclusion

The CSA of the psoas is associated with prognosis in elderly patients with hip fractures and shows a moderately positive correlation with ALM. Hence, the CSA of psoas is useful for predicting survival and muscle mass in elderly patients with hip fractures.

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Acknowledgements

This work was supported by the National Research Foundation of Korea grant funded by the Korean government (MSIT) (Nos. 2022R1A2C2005916 and 2022R1A2C2005887).

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, 335 Pangyo-Ro, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13488, Republic of Korea

    Seong-Eun Byun, Jeongmo Koo & Soonchul Lee

  2. Department of Orthopaedic Surgery, Nowon Eulji Medical Center, Eulji University, Seoul, 01830, Republic of Korea

    Jin-Woo Kim

  3. SL Bio, Inc., 43, Beolmal-ro 30beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea

    Soonchul Lee

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  1. Seong-Eun Byun
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  2. Jin-Woo Kim
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Contributions

Project administration, data curation, formal analysis, and writing—original draft: S-EB; Data curation, formal analysis, and writing—original draft: J-WK; Data curation and formal analysis: JK; and Conceptualization, funding acquisition, investigation, methodology, and manuscript review and editing: SL.

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Correspondence to Soonchul Lee.

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Byun, SE., Kim, JW., Koo, J. et al. Psoas muscle area is associated with prognosis in elderly patients with hip fracture. J Bone Miner Metab 42, 115–121 (2024). https://doi.org/10.1007/s00774-023-01485-0

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  • DOI: https://doi.org/10.1007/s00774-023-01485-0

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