After hip fracture, five SARC-F questions predicted recovery better than grip or calf measurements

Design

Prospective cohort, single university hospital, 1-year follow-up

Population

430 adults ≥70 years after hip fracture

Primary outcome

Early mobilisation, walking ability and Barthel Index

Effect

SARC-F: OR 7.56 (3.61–15.81) for impaired mobility on day 3; grip and calf not consistent

A Finnish university hospital followed 430 adults aged 70 or over after hip fracture for a year, comparing three sarcopenia measures: handgrip strength, calf circumference and the five-item SARC-F questionnaire on strength, walking assistance, rising from a chair, climbing stairs and falls.

After adjusting for age, sex, anaesthetic risk, cognition and nutrition, only SARC-F consistently predicted poorer early mobilisation, with the odds of impaired mobility rising from about twofold on day one to over sevenfold on day three. SARC-F-positive patients also had worse walking at one to four months and a larger fall in Barthel score at four months. Neither group improved much between four and twelve months. Grip strength and calf circumference were not consistently associated with outcomes.

SARC-F takes a minute, needs no equipment and can be asked of the patient or family on admission. It may help target early rehabilitation, nutrition and discharge planning to those likely to struggle.

• Ask the five SARC-F questions on admission for hip fracture, from the patient or a relative.
• Flag SARC-F-positive patients for early, intensive rehabilitation and dietetic review.
• Start discharge planning early for these patients, who recovered walking and function more slowly.
• Expect most functional recovery within four months; little further improvement occurred by a year.

Why it matters

A free, one-minute questionnaire outperformed physical measurements that need equipment and staff time.

Don't overread it

This single-centre cohort shows prediction, not that acting on SARC-F improves recovery.

The statistics, in plain English

An odds ratio of 7.56 for impaired mobility on day three (95% CI 3.61 to 15.81) is a strong association; the wide interval reflects modest numbers in each group.

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