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Background <p>Sarcopenia is prevalent in older adults with hip fracture and is associated with poor postoperative outcomes. This study aimed to evaluate the prognostic value of sarcopenia index (SI) and creatinine–cystatin C ratio (CCR) in predicting postoperative mortality in older patients with hip fracture.</p> Methods <p>A retrospective study was conducted on 485 older adults (aged ≥ 65&#xa0;years) with hip fracture treated at Zhongda Hospital between January 2018 and December 2022. SI and CCR were calculated using serum creatinine and cystatin C. The primary outcome was all-cause mortality at 1, 3, and 12&#xa0;months.</p> Results <p>Among the 485 patients, 46 (9.5%) died within one year. Both SI and CCR presented positive and significant correlations with muscle mass and density, while SI showed a stronger association than CCR. Propensity score matching confirmed that patients in the lowest SI tercile had significantly higher 1-month, 3-month, and 12-month mortality compared to those in the highest ones (7.2% vs. 0%, 10.8% vs. 2.4%, and 19.3% vs. 8.4%). ROC analyses indicated that SI had a moderate predictive accuracy for mortality, with AUCs of 0.745 (95% CI 0.628–0.862), 0.684 (95% CI 0.589–0.779), and 0.617 (95% CI 0.536–0.697) for 1-month, 3-month, and 12-month mortality, respectively. In addition, SI showed a higher predictive accuracy for postoperative mortality in the early period and in females.</p> Conclusion <p>SI is a reliable and useful marker for predicting short-term mortality in older adults with hip fracture, which can serve as a valuable tool for early diagnosis and intervention in the future.</p>

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Sarcopenia index is a superior prognostic marker to creatinine–cystatin C ratio in older adults with hip fracture

  • 期刊论文

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  • 发表日期：

    2025年12月7日

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  • Renwang Sheng,
  • Mingyuan Song,
  • Tian Xie,
  • Wei Gao,
  • Yunfeng Rui

摘要

Background

Sarcopenia is prevalent in older adults with hip fracture and is associated with poor postoperative outcomes. This study aimed to evaluate the prognostic value of sarcopenia index (SI) and creatinine–cystatin C ratio (CCR) in predicting postoperative mortality in older patients with hip fracture.

Methods

A retrospective study was conducted on 485 older adults (aged ≥ 65 years) with hip fracture treated at Zhongda Hospital between January 2018 and December 2022. SI and CCR were calculated using serum creatinine and cystatin C. The primary outcome was all-cause mortality at 1, 3, and 12 months.

Results

Among the 485 patients, 46 (9.5%) died within one year. Both SI and CCR presented positive and significant correlations with muscle mass and density, while SI showed a stronger association than CCR. Propensity score matching confirmed that patients in the lowest SI tercile had significantly higher 1-month, 3-month, and 12-month mortality compared to those in the highest ones (7.2% vs. 0%, 10.8% vs. 2.4%, and 19.3% vs. 8.4%). ROC analyses indicated that SI had a moderate predictive accuracy for mortality, with AUCs of 0.745 (95% CI 0.628–0.862), 0.684 (95% CI 0.589–0.779), and 0.617 (95% CI 0.536–0.697) for 1-month, 3-month, and 12-month mortality, respectively. In addition, SI showed a higher predictive accuracy for postoperative mortality in the early period and in females.

Conclusion

SI is a reliable and useful marker for predicting short-term mortality in older adults with hip fracture, which can serve as a valuable tool for early diagnosis and intervention in the future.