Definitions and adverse outcomes of sarcopenia in older patients in orthopedic and trauma care: A scoping review on current evidence

Jan Gewiess; Sebastian Kreuzer; Anna Katharina Eggimann; Dominic Bertschi; Johannes Dominik Bastian

doi:10.1007/s00068-024-02541-8

Definitions and adverse outcomes of sarcopenia in older patients in orthopedic and trauma care: A scoping review on current evidence

Eur J Trauma Emerg Surg. 2024 May 8. doi: 10.1007/s00068-024-02541-8. Online ahead of print.

Authors

Jan Gewiess¹, Sebastian Kreuzer², Anna Katharina Eggimann³, Dominic Bertschi³, Johannes Dominik Bastian²

Affiliations

¹ Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, 3010, Bern, Switzerland. jan.gewiess@insel.ch.
² Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, 3010, Bern, Switzerland.
³ Department of Geriatrics, Inselspital, Bern University Hospital, University of Bern, 3010, Bern, Switzerland.

PMID: 38717485
DOI: 10.1007/s00068-024-02541-8

Abstract

Purpose: Sarcopenia, defined as the loss of muscle mass and strength, can hinder postoperative recovery and raise mortality rates. However, the current evidence on the harmful effects of sarcopenia in older patients in orthopedic and trauma care is unclear. This scoping review investigates different definitions that were used for the diagnosis of sarcopenia in older patients in orthopedic and trauma care and what adverse consequences have been examined.

Methods: We performed a comprehensive literature search in PubMed and Embase, following the PRISMA guidelines. We included original studies that examined clinical outcomes (such as length of hospital stay, rate of non-home discharge, rate of subsequent falls, rate of refractures, mortality, and functional outcome/quality of life) in older patients in orthopedic and trauma care (aged 65 years and above) with diagnosed sarcopenia (S) compared to a group without sarcopenia (NS).

Results: Our search identified 2,748 publications. Out of these, 23 articles met the inclusion criteria. Most publications were from Asia (n = 13). A total of 6174 patients were examined, with a prevalence of sarcopenia in 14-92%. 11 articles focused on patients with hip joint pathologies. Most studies diagnosed sarcopenia according to the Asian Working Group on Sarcopenia (AWGSOP1 or AWGSOP2) definitions (n = 10). Length of hospital stay was investigated in 13 studies. Seven studies assessed rates of non-home discharge rates. Subsequent falls were not investigated in any of the studies. 1 study reported the overall refracture rate (S: 10.4%; NS: 5.8%). Mortality was assessed in 11 studies (S: 1-60.5%; NS: 0-39.5%). The functional outcome/quality of life was investigated by 17 studies (Barthel Index decline S: -4.5 to -15.3 points; NS: -11.7 to -54.7 points).

Conclusion: Sarcopenia has been increasingly studied in older patients in orthopedic and trauma care but there is a lack of consistent definition criteria. This scoping review suggests that sarcopenia may be associated with prolonged length of stay, higher rates of non-home discharge, and increased mortality among older patients in orthopedic and trauma care. However, prospective studies are necessary to establish the relationship between sarcopenia and refractures, falls, and functional outcome/quality of life among older patients in orthopedic and trauma care.

Keywords: Fracture; Functional decline; Hospitalized; Mortality; Muscle health; Older adults.

Publication types

Review