Effect of Sarcopenia Combined with Metabolic Syndrome (MS) on the Prognosis of Intertrochanteric Fractures: A Retrospective Clinical Study

Abstract Background Hip fractures, particularly intertrochanteric fractures, represent one of the most prevalent types of fractures among the elderly. This study aims to evaluate the impact of sarcopenia and metabolic syndrome (MS), individually and in combination, on postoperative outcomes in elderly patients with intertrochanteric fractures. Methods We conducted a retrospective analysis of 460 elderly patients with intertrochanteric fractures. Patients were divided into control, MS, sarcopenia, and combined group Baseline data and outcomes of MS group, sarcopenia group and combined group were each compared with control group. Binary logistic regression models were employed to identify independent risk factors for poor postoperative functional recovery. Results The study included 174 patients in the control group, 122 in the MS group, 89 in the sarcopenia group, and 75 in the combined group. The MS group had younger patients with higher BMI, hypertension, diabetes prevalence, and longer surgery durations (P < 0.05). Sarcopenia and combined groups exhibited lower weight, BMI, handgrip strength, ASMI, and higher ASA scores (P < 0.05). At the 3-month follow-up, the sarcopenia and combined groups had significantly lower Harris Hip Scores (HHS) and Barthel Index (BI) scores compared to the control group (P < 0.05). Multivariate logistic regression identified sarcopenia alone (OR 6.5, 95% CI 2.56-20,1; P < 0.001) and combined with MS (OR 9.46, 95% CI 3.33–34.8; P < 0.001) as significant predictors of poor postoperative recovery. Conclusion Sarcopenia, particularly when combined with MS, significantly worsens postoperative prognosis in elderly patients with intertrochanteric fractures. Comprehensive preoperative assessments and tailored postoperative management strategies, including nutritional support and early rehabilitation, are crucial to improve outcomes for this vulnerable population. Integrating these findings into clinical practice can enhance care and reduce postoperative complications, ultimately improving prognosis.