Serum creatinine
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The SI remains largely constant regardless of renal function, and the two indicators are obtained from the serological results of hospitalized patients, which are readily available and convenient. In recent years, the sarcopenia index (SI, serum creatinine /cystatin C × 100) has been recommended to evaluate skeletal muscle mass. More reliable, accessible, and cost-effective approaches are thus necessary to better characterize muscle mass loss. These approaches, however, require specific instruments and are expensive, with MRI and CT scans necessitating the use of a special image-processing system to calculate muscle mass. Low muscle mass can usually be quantified through imaging approaches such as dual-energy x-ray absorptiometry (DXA), bioelectrical impedance analyses (BIA), magnetic resonance imaging (MRI), or computed tomography (CT). Sarcopenia is an age-related disorder that results in the loss of skeletal muscle mass and muscle strength, and/or reduced physical performance. Sarcopenia can lead to poor prognosis and even death after hip fracture surgery indicating the importance of preoperative identification of sarcopenia. However, there is a high risk of postoperative complications in hip fracture patients thus, the prevention of such complications is an area of active research. Hip fracture is common in older adults, and is usually treated via surgical approaches that promote fracture healing and shorten the course of the disease. The SI based on serum creatinine and cystatin C can predict pneumonia rather than other postoperative complications among older patients with hip fracture after joint replacement surgery. However, we did not find statistically significant association between SI and the risk of postoperative complications other than pneumonia among patients with two types of hip fracture surgery. After adjusting for potential confounding factors, binary logistic regression analyses showed that a higher SI was independently associated with a lower risk of pneumonia after joint replacement surgery (OR:0.39, 95% CI:0.18-0.89, P<0.05).
![serum creatinine serum creatinine](https://els-jbs-prod-cdn.jbs.elsevierhealth.com/cms/attachment/1632ddcc-4b6e-4fbb-805d-a86cff786c4b/gr1_lrg.jpg)
In the patient group that received joint replacements, the incidence of pneumonia was negatively associated with SI values. Postoperative complications included pneumonia (12%), urinary tract infections (1.8%), respiratory failure (1.5%), heart failure (1.6%), and non-A- grade healing (3.6%). ResultsĪ total of 897 patients aged 60 years and over were enrolled in this study (age range: 60 – 100 years), of whom 306(34.1%)were male, and 591(65.9%)were female. Binary logistic regression analyses were used to analyze association between SI and postoperative complications. Outcomes included postoperative complications such as pneumonia, urinary tract infection, respiratory failure, heart failure, and non-grade A healing. Primary outcome and measuresĬlinical data were collected from medical records and serum creatinine and cystatin C were measured before surgery. This observational study enrolled older adults with hip fracture who were hospitalized in the Department of Orthopedics of West China Hospital, Sichuan University, from DecemJune 14, 2017, and who underwent hip fracture surgery.
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To assess the utility of the preoperative Sarcopenia index (SI) as a predictive marker of the risk of postoperative complications following hip fracture surgery in older adults.