P723 - LOSS OF ERECTOR SPINAE MUSCLES AFTER VERTEBRAL FRACTURE INHIBITS RECOVERY OF ACTIVITIES OF DAILY LIVING IN POSTOPERATIVE HIP FRACTURE PATIENTS

P723

LOSS OF ERECTOR SPINAE MUSCLES AFTER VERTEBRAL FRACTURE INHIBITS RECOVERY OF ACTIVITIES OF DAILY LIVING IN POSTOPERATIVE HIP FRACTURE PATIENTS

T. Ogasawara^1,*, Y. Hiraoka¹, Y. Miyazawa², M. Ogiku³, T. Nihashi⁴

¹Respiratory medicine, ²Rehabilitation, ³Surgery, ⁴Nutrition, Hamamatsu Medical Center, Hamamatsu, Japan

Rationale: Hip fracture is a critical trauma in the elderly, because it can lead to bedridden life and poor prognosis. In our hospital, general internal medicine physicians evaluate hip fracture patients on admission for their medical history and their ability to undergo surgery. The aim of this study is to evaluate which factors inhibit the recovery of activities of daily living (ADL) in hip fracture patients after surgery.

Methods: A retrospective cohort study of patients with hip fracture who were assessed by physicians and underwent surgery at our hospital between October 2022 and December 2024. Minimum nutritional targets for energy and protein were 25 kcal/kg/day and 1 g/kg/day, respectively. Oral nutritional supplements were added by dietitians as needed, and nutritional therapy was initiated by the nutrition support team. The cross-sectional area of the erector spinae muscle (ESM) and the psoas muscle was measured at the 12 thoracic and 3 lumbar vertebrae on admission using computed tomography. ADL was assessed on admission and discharge using the Barthel Index (BI).

Results: One hundred of 116 patients were included in the study. History of any fracture was significantly associated with loss of ESM (ESM cross-sectional area/height², ESMI; 8.21 vs 6.87 cm²/cm², P=0.045). Among these fractures, vertebral fracture was associated with low ESMI (P=0.02). History of any fracture was also associated with poor recovery of ADL at discharge, even with good nutritional support (26 vs 29kcal/kg/day, protein 1.1 vs 1.2 g/kg/day), and ESMI was significantly correlated with the recovery of ADL (r=0.42, P=0.037). Previous vertebral fracture was associated with poor ADL at discharge (BI 50 vs 20, P=0.018).

Conclusion: Loss of ESM due to vertebral fracture may inhibit the recovery of ADL in postoperative hip fracture patients.

Disclosure of Interest: None declared