Background: This study addresses the prevalence and outcomes of sarcopenic diabetes among older adults hospitalized for hip fractures, highlighting its association with nutritional status, frailty, in-hospital outcomes, and mortality. With the global incidence of hip fractures anticipated to rise significantly, understanding these associations is crucial, especially considering the higher prevalence of sarcopenia in diabetic patients, which exacerbates outcomes. Methods: An observational, unicentric case–control study nested within a real-world data cohort was conducted. It included 2631 older adults (aged ≥ 70 years) hospitalized for hip fractures at the Hospital Universitario de la Ribera, Spain, from 2014 to 2021. Diabetic patients were classified as cases, and non-diabetic patients served as controls. The study examined demographic variables, comorbidities, nutritional status, geriatric syndromes, and mortality, using the SARC-F questionnaire for sarcopenia screening. Results: The study found that cases (diabetic patients) presented with higher comorbidities, longer hospital stays, and a higher prevalence of sarcopenia, significantly impacting in-hospital and long-term mortality rates. The prevalence of possible sarcopenia was notably higher at 61.5% among diabetic patients. Sarcopenia was strongly correlated with worse functional outcomes and higher mortality. Conclusions: Sarcopenic diabetes significantly increases the risk of adverse outcomes and mortality in older adults with hip fractures. The findings underscore the importance of routine screening for diabetes and sarcopenia in this patient population to mitigate risks and improve rehabilitation outcomes.

Introduction: Hip fractures pose a significant challenge for older individuals given their high incidence and one-year mortality rate. The objective of this study was to identify the primary predictors of one-year mortality in older adults hospitalized for hip fractures. Methods: We conducted a retrospective cohort study involving adults aged 70 years or older who were admitted to the hospital for fragility hip fractures between 1 January 2014 and 31 December 2021. A total of 3229 patients were recruited, with 846 (26.2%) experiencing one-year mortality. Results: Respiratory complications (HR 2.42, 95%CI 1.42–4.14; p = 0.001) were the most significant predictors of one-year mortality, followed by hospital readmission (HR 1.96, 95%CI 1.66–2.32; p < 0.001), the male sex (HR 1.88, 95%CI 1.46–2.32; p < 0.001), cardiac complications (HR 1.88, 95%CI 1.46–2.32; p < 0.001), and a diagnosis of dementia at admission (HR 1.37, 95%CI 1.13–1.66; p = 0.001). The Charlson Index and the American Society of Anesthesiologists physical status classification system also significantly increased the mortality risk. Conversely, higher hemoglobin levels at admission and elevated albumin at discharge significantly reduced the mortality risk. Conclusions: The one-year mortality rate is substantial in older adults with hip fractures who are admitted to an orthogeriatric unit. The appropriate management of anemia, nutritional disorders, and comorbidity at admission and during the follow-up could potentially mitigate long-term mortality after hip fractures.