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Background <p>Sarcopenia is a prevalent issue among older patients with hip fracture and is a risk factor for poor clinical outcomes. Computed tomography (CT)-derived muscle density and areawere reported to predict the prognosis of fracture patients. This study aimed to assess the efficacy of these CT-based muscle parameters in predicting 1-year mortality in the oldest-old patients with hip fracture (≥ 80 years).</p> Methods <p>A retrospective study was conducted on 324 hip fracture patients aged ≥ 80 years from 2018 to 2022. The cross-sectional area (CSA) and Hounsfield units (HU) of periarticular hip muscles were measured from CT images. The primary outcome was 1-year mortality. A multivariate logistic regression model was constructed, and its performance was assessed using ROC analysis, calibration curves, and Hosmer-Lemeshow testing. A nomogram was developed for model visualization and early clinical application.</p> Results <p>The 1-year mortality rate in this cohort was 13.0% (42/324). Survivors and non-survivors significantly differed in age, red blood cells (RBC), platelets, albumin, urea, and gluteal muscle parameters (all <i>P</i> &lt; 0.05). Multivariate analysis identified four mortality predictors: older age (<i>P</i> = 0.048), lower albumin (<i>P</i> = 0.025), reduced gluteal density (<i>P</i> = 0.031), and smaller muscle area (<i>P</i> = 0.045). Gluteus maximus density and area independently predicted 1-year mortality (<i>P</i> &lt; 0.05) in oldest-old hip fracture patients. Our predictive model incorporating age, muscle density, albumin, and muscle area showed a moderate predictive value (AUC = 0.741).</p> Conclusion <p>This CT-based method offers a practical alternative to traditional sarcopenia assessments, facilitating early risk identification in this hip fracture population.</p>

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Gluteus maximus cross-sectional area/density in 1-year mortality prediction for oldest-old hip fracture patients

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月9日

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  • Mingyuan Song,
  • Tian Xie,
  • Renwang Sheng,
  • Mumin Cao,
  • Yucheng Gao,
  • Chuwei Tian,
  • Jinyu Wang,
  • Yingjuan Li,
  • Wei Gao,
  • Yunfeng Rui

摘要

Background

Sarcopenia is a prevalent issue among older patients with hip fracture and is a risk factor for poor clinical outcomes. Computed tomography (CT)-derived muscle density and areawere reported to predict the prognosis of fracture patients. This study aimed to assess the efficacy of these CT-based muscle parameters in predicting 1-year mortality in the oldest-old patients with hip fracture (≥ 80 years).

Methods

A retrospective study was conducted on 324 hip fracture patients aged ≥ 80 years from 2018 to 2022. The cross-sectional area (CSA) and Hounsfield units (HU) of periarticular hip muscles were measured from CT images. The primary outcome was 1-year mortality. A multivariate logistic regression model was constructed, and its performance was assessed using ROC analysis, calibration curves, and Hosmer-Lemeshow testing. A nomogram was developed for model visualization and early clinical application.

Results

The 1-year mortality rate in this cohort was 13.0% (42/324). Survivors and non-survivors significantly differed in age, red blood cells (RBC), platelets, albumin, urea, and gluteal muscle parameters (all P < 0.05). Multivariate analysis identified four mortality predictors: older age (P = 0.048), lower albumin (P = 0.025), reduced gluteal density (P = 0.031), and smaller muscle area (P = 0.045). Gluteus maximus density and area independently predicted 1-year mortality (P < 0.05) in oldest-old hip fracture patients. Our predictive model incorporating age, muscle density, albumin, and muscle area showed a moderate predictive value (AUC = 0.741).

Conclusion

This CT-based method offers a practical alternative to traditional sarcopenia assessments, facilitating early risk identification in this hip fracture population.