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Purpose <p>Hip fractures (HF) in older adults are a major public health issue due to their high incidence and association with mortality and long-term disability. Simple bedside measures reflecting nutritional and muscular status—such as handgrip strength (HGS), arm circumference, and calf circumference—may help identify patients at higher risk of adverse outcomes. This study compared the predictive value of these parameters for 1-year mortality in older adults hospitalized for hip fracture.</p> Methods <p>We conducted a retrospective study on 295 patients aged ≥65&#xa0;years admitted for fragility HF at the Azienda Ospedale-Università Padova. Demographic, clinical, and anthropometric data were collected at admission, along with a comprehensive geriatric assessment. Twelve-month mortality was the primary outcome. Prognostic value was assessed using ROC curves, Kaplan–Meier analysis, and multivariable Cox regression.</p> Results <p>At 12&#xa0;months, mortality was higher among patients with low arm (27.1%) and calf circumference (28.8%) (<i>p</i> = 0.008 and <i>p</i> = 0.010), while no difference was observed for HGS. ROC curve analysis showed that arm (AUC = 0.704, <i>p</i> &lt; 0.001) and calf circumference (AUC = 0.634, <i>p</i> = 0.006) were associated with mortality, unlike HGS (<i>p</i> = 0.307). Kaplan–Meier survival analysis confirmed lower survival in patients with arm and calf circumference under 20th percentile, defined, respectively, low arm and calf (log-rank <i>p</i> = 0.003 and <i>p</i> = 0.02, respectively). In Cox models, low arm circumference remained independently associated with mortality across all adjustments (HR = 2.86; 95% CI 1.45–5.64; <i>p</i> = 0.002), whereas the association for calf circumference lost significance.</p> Conclusion <p>Arm circumference is a simple, cost-effective, and reliable bedside tool to help identify older adults at increased risk of mortality after HF.</p>

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Arm circumference predicts 12-month mortality in older adults with hip fracture

  • 期刊论文

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  • 发表日期：

    2025年11月28日

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  • Chiara Ceolin,
  • Giulia Termini,
  • Stefania Sella,
  • Valentina Camozzi,
  • Anna Bertocco,
  • Marco Onofrio Torres,
  • Alberta Cecchinato,
  • Martin Diogo,
  • Mor Peleg Falb,
  • Francesca Guidolin,
  • Maria Grazia Rodà,
  • Michele Cannito,
  • Antonio Berizzi,
  • Andrea Venturin,
  • Vito Cianci,
  • Elisa Pala,
  • Mariachiara Cerchiaro,
  • Deris Gianni Boemo,
  • Maria Vittoria Nesoti,
  • Gaetano Paride Arcidiacono,
  • Paolo Simioni,
  • Pietro Ruggieri,
  • Giuseppe Sergi,
  • Sandro Giannini,
  • Marina De Rui,
  • Carlotta Andaloro,
  • Gaetano Paride Arcidiacono,
  • Giulia Bano,
  • Antonio Berizzi,
  • Anna Bertocco,
  • Sara Bertolino,
  • Deris Gianni Boemo,
  • Ester Bukli,
  • Valentina Camozzi,
  • Davide Cannavò,
  • Michele Cannito,
  • Alberta Cecchinato,
  • Chiara Ceolin,
  • Mariachiara Cerchiaro,
  • Vito Cianci,
  • Giacomo Contini,
  • Martina Dall’Agnol,
  • Marina De Rui,
  • Mario Degan,
  • Marta Dianin,
  • Martin Diogo,
  • Michela Ferrarese,
  • Claudia Finamoni,
  • Sandro Giannini,
  • Francesca Guidolin,
  • Mario Rosario Lo Storto,
  • Elena Marigo,
  • Stefano Masiero,
  • Caterina Mian,
  • Maria Vittoria Nesoti,
  • Elisa Pala,
  • Mor Peleg Falb,
  • Alessandra Pizziol,
  • Maria Grazia Rodà,
  • Giovanna Romanato,
  • Paola Romano,
  • Pietro Ruggieri,
  • Cristina Russo,
  • Sandro Savino,
  • Stefania Sella,
  • Giuseppe Sergi,
  • Paolo Simioni,
  • Cristina Simonato,
  • Giulia Termini,
  • Michele Tessarin,
  • Marco Onofrio Torres,
  • Andrea Venturin,
  • Franz Villanova,
  • Federica Vilona,
  • Hillary Veronese,
  • Francesca Zanchetta,
  • Chiara Ziliotto

摘要

Purpose

Hip fractures (HF) in older adults are a major public health issue due to their high incidence and association with mortality and long-term disability. Simple bedside measures reflecting nutritional and muscular status—such as handgrip strength (HGS), arm circumference, and calf circumference—may help identify patients at higher risk of adverse outcomes. This study compared the predictive value of these parameters for 1-year mortality in older adults hospitalized for hip fracture.

Methods

We conducted a retrospective study on 295 patients aged ≥65 years admitted for fragility HF at the Azienda Ospedale-Università Padova. Demographic, clinical, and anthropometric data were collected at admission, along with a comprehensive geriatric assessment. Twelve-month mortality was the primary outcome. Prognostic value was assessed using ROC curves, Kaplan–Meier analysis, and multivariable Cox regression.

Results

At 12 months, mortality was higher among patients with low arm (27.1%) and calf circumference (28.8%) (p = 0.008 and p = 0.010), while no difference was observed for HGS. ROC curve analysis showed that arm (AUC = 0.704, p < 0.001) and calf circumference (AUC = 0.634, p = 0.006) were associated with mortality, unlike HGS (p = 0.307). Kaplan–Meier survival analysis confirmed lower survival in patients with arm and calf circumference under 20th percentile, defined, respectively, low arm and calf (log-rank p = 0.003 and p = 0.02, respectively). In Cox models, low arm circumference remained independently associated with mortality across all adjustments (HR = 2.86; 95% CI 1.45–5.64; p = 0.002), whereas the association for calf circumference lost significance.

Conclusion

Arm circumference is a simple, cost-effective, and reliable bedside tool to help identify older adults at increased risk of mortality after HF.