Abstract
AIMS: To investigate whether the size and density of proximal femur muscle and surrounding subcutaneous adipose tissue (SAT) are associated with the risk of mortality in elderly women with hip fractures (HF) across different age groups, and to assess how this association changes over time following the fracture. METHODS: Between January 2020 and July 2022, CT images and data were retrospectively collected from 337 female patients diagnosed with low-energy acute HF, with an average follow-up duration of four years. The study measured the cross-sectional area and density of the gluteal muscles surrounding the hip, the thigh muscles, and the adjacent SAT. The Cox proportional hazards model was employed to assess the covariable-adjusted risk of death from HF across different age groups. RESULTS: By the end of the follow-up period, 245 patients were lost to follow-up, 58 had died, and 279 had survived. In the group aged > 80 years, the area of gluteal muscle and SAT was negatively correlated with the mortality rate of patients (P < 0.05). Gluteal muscle size was inversely associated with mortality at one year and beyond following a HF. The midthigh muscle (MM) area was negatively correlated with mortality rates 1-2 years after HF (hazard ratio (HR) 0.96, 95% CI 0.93-0.99, P < 0.01). The mid-thigh SAT (MSAT) area exhibited an inverse association with mortality within one year after HF (HR 0.97, 95% CI 0.95-1.00, P = 0.03). CONCLUSIONS: In elderly women aged over 80 with HF, it was the size-not the density-of the gluteal muscles and surrounding SAT that was associated with mortality rates.