PD986 - ANALYSIS OF RISK FACTORS AND RISK STRATIFICATION FOR SECONDARY FRACTURES IN ELDERLY PATIENTS WITH HIP FRACTURE AND SARCOPENIA

PD986

ANALYSIS OF RISK FACTORS AND RISK STRATIFICATION FOR SECONDARY FRACTURES IN ELDERLY PATIENTS WITH HIP FRACTURE AND SARCOPENIA

C. Chen^1,*, X. Shen¹, W. Sun¹, Y. Huang¹

¹The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

Rationale: Elderly hip fracture patients are at high risk of secondary fractures. Sarcopenia may elevate this risk, but the optimal diagnostic approach for risk stratification remains unclear.

Methods: We enrolled 346 elderly hip fracture patients (≥60 years, 2023–2024) and followed until December 2025. Sarcopenia was defined by 2019 Asian consensus (grip strength + bioelectrical impedance). A total of 178 patients with L3-CT data were stratified into high-/medium-/low-risk groups by clinical indicators and CT-SMI. Analyses included t-test, chi-square test, Kaplan–Meier and Cox regression.

Results: Median follow-up was 18.5 months. Sarcopenia prevalence was 16.8% and overall secondary fracture rate 15.6%. The sarcopenia group had higher secondary fracture rate (29.3% vs. 12.8%, P<0.05). In stratified analysis, high-risk patients had the highest rate (56.0%). Cox regression showed sarcopenia (HR=2.743, P<0.001) and FT4 (HR=1.177, P<0.01) were independent risk factors; after adjustment, only high-risk sarcopenia remained significant (HR=4.296, P=0.0013).

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Conclusion: Sarcopenia is an independent risk factor for secondary fractures. Combined clinical and L3-CT SMI assessment enables effective risk stratification. Double-positive high-risk patients have 4.3-fold higher risk and warrant targeted intervention.

Disclosure of Interest: None declared