Predictive value of handgrip strength, calf circumference, and the SARC-F questionnaire for institutionalization and mortality after hip fracture – a real-world cohort study

Background The longitudinal associations between indicators of sarcopenia – such as muscle and functional impairments – and subsequent institutionalization and mortality after hip fracture are not well known. Aims The aim of this study was to examine handgrip strength (HGS), calf circumference (CC), and the SARC-F questionnaire as predictors of admission to a long-term care facility (LTCF) and mortality among hip fracture patients. Methods Study population consisted of 430 older adults with a low-energy hip fracture admitted in a university hospital between September 2021 to January 2023. Of these patients, 222 had data on HGS, CC, and the SARC-F questionnaire. Admission to an LTCF and mortality were followed for up to one year. Analyses were adjusted for age, sex, ASA score, and cognitive and nutritional status. Results During one-year follow-up, 14% entered long-term care and 13% died. Positive SARC-F-screen significantly increased the odds of admission to LTCF (OR 8.20; 95% CI 2.34–28.7), but no association was observed for HGS or CC. Positive SARC-F screening predicted mortality (HR 3.00, 95% CI 1.11–8.07). HGS-based probable sarcopenia showed a tendency towards increased mortality in the age and sex adjusted model (HR 8.07; 95% CI 1.09–59.9), but not after adjusting for ASA score, cognitive and nutritional status (HR 7.01; 95% CI 0.93–52.6). Conclusions The SARC-F questionnaire emerged as a strong predictor for both LTCF admission and mortality one year after hip fracture, suggesting that the SARC-F may help clinicians identify patients at highest risk after hip fracture.