Handgrip strength as a predictor of one-year mortality in elderly patients with fragility hip fracture

Background: Fragility fractures occur on porotic bones due to minor trauma and are associated with high rates of disability and mortality. Aims: To evaluate the ability of handgrip strength to predict one-year mortality in elderly patients with fragility hip fracture. Methods: We enrolled patients aged 65 years and older with fragility hip fractures admitted to an Italian orthopedic unit. They underwent a comprehensive geriatric assessment, including handgrip strength measurement, and all received surgical intervention. Results: Among the 322 enrolled patients (median age: 84 years; 75.2% women), the one-year mortality rate was 15.5%. According to the European Working Group on Sarcopenia in Older People 2 guidelines, 235 subjects (73.0%) exhibited low handgrip strength. This group revealed HR: 2.36 (95%CI: 1.06–5.24) for one-year mortality compared to the group with adequate handgrip strength (p = 0.036). After adjusting for age and risk of adverse event, through Multidimensional Prognostic Index, the HR decreased to 1.31 (95%CI: 0.56–3.07), with a lower validity. Discussion: Our study found a slightly lower one-year mortality than other studies with similar samples, probably due to the co-management of orthopedic and geriatric teams. As for the main outcome, low handgrip strength was significantly associated with one-year mortality. However, the significance diminished when considering possible confounding variables, despite a lower precision of the model. Conclusions: Low handgrip strength predicts one-year mortality in elderly people with fragility hip fractures. Further studies are needed to explore the possible influence of confounders.