SARC-F on admission identified hip fracture patients likely to mobilise and recover poorly

Design

Prospective single-centre cohort, 1-year follow-up

Population

430 adults aged 70+ with hip fracture

Primary outcome

Early mobilisation, walking mobility and Barthel Index

Effect

Impaired day-3 mobilisation OR 7.56 (3.61–15.81); Barthel change −17.5 vs −11.2 at 4 months

This prospective cohort at a Finnish university hospital followed 430 adults aged 70 or over with hip fracture for a year, comparing handgrip strength, calf circumference and the five-item SARC-F questionnaire as predictors of rehabilitation outcomes, adjusted for age, sex, ASA grade, cognition and nutrition.

Only SARC-F was consistently associated with impaired early mobilisation (OR 1.99 on day 1, 4.90 on day 2 and 7.56 on day 3). Patients screening positive had a larger decline in walking ability to 4 months (New Mobility Score change 2.0 vs 0.6) and in daily function (Barthel Index change −17.5 vs −11.2). Neither group regained function between 4 and 12 months. Handgrip strength and calf circumference were not consistently associated with outcomes.

SARC-F asks about strength, walking assistance, rising from a chair, climbing stairs and falls, and takes a minute. Asking it on admission — of the patient or family, about prefracture status — flags those who need earlier, more intensive rehabilitation and discharge planning. That the plateau came by 4 months makes the early window important. In Indian orthogeriatric care, where dynamometers are not always available, a questionnaire is practical.

• Complete SARC-F on admission for every older adult with hip fracture, using prefracture status
• Prioritise early physiotherapy and mobilisation for patients scoring 4 or more
• Plan nutritional support and protein intake for SARC-F positive patients
• Set expectations and discharge support early, as recovery largely plateaus by 4 months
• Do not rely on grip strength or calf circumference alone to predict recovery

Why it matters

A one-minute questionnaire outperformed physical measures in picking out patients who will struggle, in time to act.

Don't overread it

A single-centre cohort — SARC-F predicts poor recovery, but targeting rehabilitation by it has not been tested.

The statistics, in plain English

An odds ratio of 7.56 on day 3 means the odds of impaired mobility were more than seven times higher with a positive screen, though the interval (3.61–15.81) is wide. This is an association in one hospital; the study does not show that intensive rehabilitation for screen-positive patients changes outcomes.

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