Aim: This study evaluated the effect of preoperative sarcopenia, assessed by psoas muscle index, on postoperative outcomes in elderly patients undergoing surgery for intertrochanteric femoral fractures.Material and Methods: A total of 142 patients operated between January 2018 and August 2024 were retrospectively analyzed. Psoas muscle area was measured at the L3 level on preoperative CT scans and normalized to height squared. Sarcopenia was defined as a psoas index 2.45 cm²/m². Patients were divided into sarcopenic (n=62) and non-sarcopenic (n=80) groups, and perioperative outcomes, complications, ICU admission, length of stay, ambulation time, and mortality were compared.Results: Sarcopenic patients were older and had lower BMI and albumin levels (all p0.001). They had higher complication rates (38.7% vs. 17.5%, p=0.008), longer hospitalization (9.9 ± 3.6 vs. 7.6 ± 3.0 days, p0.001), higher ICU admission (29.0% vs. 13.8%, p=0.028), and increased one-year mortality (29.0% vs. 11.3%, p=0.011). Low psoas index, advanced age, ASA ≥III, ICU admission, and postoperative complications independently predicted one-year mortality.Conclusion: Low psoas index was significantly associated with increased postoperative complications, prolonged hospitalization, higher ICU admission, and greater one-year mortality in elderly patients undergoing surgery for intertrochanteric femoral fractures. These findings suggest that CT-based assessment of psoas muscle mass may provide a simple, objective, and clinically useful marker for identifying frail patients at higher perioperative risk. Incorporating psoas index into preoperative evaluation may help improve risk stratification, guide perioperative planning, and support individualized postoperative care in this vulnerable patient population.
Bulum et al. (Sun,) studied this question.