CT-based sarcopenia is independently associated with blood transfusions after hip arthroplasty in elderly patients with femoral neck fractures: a retrospective cohort study
Abstract Background Computed tomography (CT) based sarcopenia has been linked to postoperative complications in various surgeries. Although the associations between sarcopenia and femoral neck fractures (FNF) have received considerable attention, the relationship between sarcopenia and blood transfu...
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BMC
2025-08-01
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| Series: | BMC Geriatrics |
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| Online Access: | https://doi.org/10.1186/s12877-025-06107-0 |
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| author | Lingzhi Li Haibo Yang Yue Zhang Zhiqiang Ren Zihan Lin Zheng Li Xu Liu Min Wang Jingjing Zhang Min Li Zhong Li |
| author_facet | Lingzhi Li Haibo Yang Yue Zhang Zhiqiang Ren Zihan Lin Zheng Li Xu Liu Min Wang Jingjing Zhang Min Li Zhong Li |
| author_sort | Lingzhi Li |
| collection | DOAJ |
| description | Abstract Background Computed tomography (CT) based sarcopenia has been linked to postoperative complications in various surgeries. Although the associations between sarcopenia and femoral neck fractures (FNF) have received considerable attention, the relationship between sarcopenia and blood transfusions after hip arthroplasty in FNF patients remains unclear. This study aimed to investigate the relationship between CT-based sarcopenia and blood transfusions in elderly FNF patients after hip arthroplasty. Methods A retrospective cohort study was conducted with 337 elderly FNF patients from September 2018 to January 2024. Basic demographic data, preoperative laboratory data, surgical data and chest CT data were collected. CT-based sarcopenia was diagnosed with gender-specific skeletal muscle index (SMI) cut-off values within the same ethnicity. Univariate and multivariate analyses were performed to identify independent risk factors for sarcopenia and blood transfusions in elderly FNF patients; receiver operating characteristic (ROC) curve analysis was used to determine the predictive cut-off value of SMI. Results Among the 337 patients, 99 (29.4%) patients received blood transfusions, and 104 (30.9%) patients were diagnosed with CT-based sarcopenia. Sarcopenia patients had advanced age, lower body mass index (BMI), lower hemoglobin and lower serum albumin, with an increased likelihood of undergoing hemiarthroplasty (P < 0.05). Multivariate analysis revealed that advanced age (P = 0.002) and lower BMI (P < 0.001) were independently associated with CT-based sarcopenia. Patients who received transfusions had a lower BMI, lower hemoglobin, lower serum albumin, longer operation duration, greater intraoperative blood loss (IBL), and a greater incidence of sarcopenia (P < 0.05). Multivariate analysis revealed that sarcopenia (P = 0.006), lower hemoglobin (P < 0.001), longer operation duration (P = 0.022), and greater IBL (P < 0.001) were significantly associated with transfusion. ROC analysis revealed an optimal SMI cut-off of 23.0 cm²/m² for predicting transfusion, with 71.7% sensitivity and 71.0% specificity. Conclusion CT-based sarcopenia was independently associated with blood transfusions after hip arthroplasty in elderly FNF patients. In clinical practice, attention should be given to identifying it and implementing targeted interventions. Level of evidence III, retrospective cohort study. Trial registration Not applicable. |
| format | Article |
| id | doaj-art-e75f69a2426348f18fc0708cdaacc30e |
| institution | Kabale University |
| issn | 1471-2318 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
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| series | BMC Geriatrics |
| spelling | doaj-art-e75f69a2426348f18fc0708cdaacc30e2025-08-24T11:49:12ZengBMCBMC Geriatrics1471-23182025-08-0125111110.1186/s12877-025-06107-0CT-based sarcopenia is independently associated with blood transfusions after hip arthroplasty in elderly patients with femoral neck fractures: a retrospective cohort studyLingzhi Li0Haibo Yang1Yue Zhang2Zhiqiang Ren3Zihan Lin4Zheng Li5Xu Liu6Min Wang7Jingjing Zhang8Min Li9Zhong Li10Department of Orthopedics, The Affiliated Hospital of Southwest Medical UniversityDepartment of Orthopedics, The People’s Hospital of Rongchang DistrictDepartment of Pediatric Surgery, The Affiliated Hospital of Southwest Medical UniversityDepartment of Orthopedics, The Affiliated Hospital of Southwest Medical UniversityDepartment of Orthopedics, The Affiliated Hospital of Southwest Medical UniversityDepartment of Orthopedics, The Affiliated Hospital of Southwest Medical UniversityDepartment of Orthopedics, The Affiliated Hospital of Southwest Medical UniversityDepartment of Nutrition, The Affiliated Hospital of Southwest Medical UniversityDepartment of Nutrition, The Affiliated Hospital of Southwest Medical UniversityDepartment of Nutrition, The Affiliated Hospital of Southwest Medical UniversityDepartment of Orthopedics, The Affiliated Hospital of Southwest Medical UniversityAbstract Background Computed tomography (CT) based sarcopenia has been linked to postoperative complications in various surgeries. Although the associations between sarcopenia and femoral neck fractures (FNF) have received considerable attention, the relationship between sarcopenia and blood transfusions after hip arthroplasty in FNF patients remains unclear. This study aimed to investigate the relationship between CT-based sarcopenia and blood transfusions in elderly FNF patients after hip arthroplasty. Methods A retrospective cohort study was conducted with 337 elderly FNF patients from September 2018 to January 2024. Basic demographic data, preoperative laboratory data, surgical data and chest CT data were collected. CT-based sarcopenia was diagnosed with gender-specific skeletal muscle index (SMI) cut-off values within the same ethnicity. Univariate and multivariate analyses were performed to identify independent risk factors for sarcopenia and blood transfusions in elderly FNF patients; receiver operating characteristic (ROC) curve analysis was used to determine the predictive cut-off value of SMI. Results Among the 337 patients, 99 (29.4%) patients received blood transfusions, and 104 (30.9%) patients were diagnosed with CT-based sarcopenia. Sarcopenia patients had advanced age, lower body mass index (BMI), lower hemoglobin and lower serum albumin, with an increased likelihood of undergoing hemiarthroplasty (P < 0.05). Multivariate analysis revealed that advanced age (P = 0.002) and lower BMI (P < 0.001) were independently associated with CT-based sarcopenia. Patients who received transfusions had a lower BMI, lower hemoglobin, lower serum albumin, longer operation duration, greater intraoperative blood loss (IBL), and a greater incidence of sarcopenia (P < 0.05). Multivariate analysis revealed that sarcopenia (P = 0.006), lower hemoglobin (P < 0.001), longer operation duration (P = 0.022), and greater IBL (P < 0.001) were significantly associated with transfusion. ROC analysis revealed an optimal SMI cut-off of 23.0 cm²/m² for predicting transfusion, with 71.7% sensitivity and 71.0% specificity. Conclusion CT-based sarcopenia was independently associated with blood transfusions after hip arthroplasty in elderly FNF patients. In clinical practice, attention should be given to identifying it and implementing targeted interventions. Level of evidence III, retrospective cohort study. Trial registration Not applicable.https://doi.org/10.1186/s12877-025-06107-0Femoral neck fractureArthroplastyRisk factorsSarcopeniaBlood transfusion |
| spellingShingle | Lingzhi Li Haibo Yang Yue Zhang Zhiqiang Ren Zihan Lin Zheng Li Xu Liu Min Wang Jingjing Zhang Min Li Zhong Li CT-based sarcopenia is independently associated with blood transfusions after hip arthroplasty in elderly patients with femoral neck fractures: a retrospective cohort study BMC Geriatrics Femoral neck fracture Arthroplasty Risk factors Sarcopenia Blood transfusion |
| title | CT-based sarcopenia is independently associated with blood transfusions after hip arthroplasty in elderly patients with femoral neck fractures: a retrospective cohort study |
| title_full | CT-based sarcopenia is independently associated with blood transfusions after hip arthroplasty in elderly patients with femoral neck fractures: a retrospective cohort study |
| title_fullStr | CT-based sarcopenia is independently associated with blood transfusions after hip arthroplasty in elderly patients with femoral neck fractures: a retrospective cohort study |
| title_full_unstemmed | CT-based sarcopenia is independently associated with blood transfusions after hip arthroplasty in elderly patients with femoral neck fractures: a retrospective cohort study |
| title_short | CT-based sarcopenia is independently associated with blood transfusions after hip arthroplasty in elderly patients with femoral neck fractures: a retrospective cohort study |
| title_sort | ct based sarcopenia is independently associated with blood transfusions after hip arthroplasty in elderly patients with femoral neck fractures a retrospective cohort study |
| topic | Femoral neck fracture Arthroplasty Risk factors Sarcopenia Blood transfusion |
| url | https://doi.org/10.1186/s12877-025-06107-0 |
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