Effects of Nutritional Status on 6-Month Outcome of Hip Fractures in Elderly Patients
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Objective To identify the prevalence of malnutrition in elderly hip fracture and to investigate the relationship between hip fracture patients and malnutrition on functional recovery and mortality. Methods All hip fracture patients age >65 years admitted to a rehabilitation unit were recruited from July 2015 to June 2016. Nutritional status was assessed by Mini-Nutritional Assessment Short-Form (MNA-SF) within 72 hours of admission. Patients were reassessed at 6 months for functional status and place of residence. Length of hospital stay, in-patient mortality rate, and 6-month mortality rate were also recorded. Results There were 218 patients recruited. The mean age was 83.5±7.5 years. According the MNA-SF, 46 (21.1%) were well nourished, 115 (52.6%) were at risk of malnutrition, and 57 (26.1%) were malnourished. Malnourished individuals were significantly older, had lower Mini-Mental State Examination score and albumin level, were functionally more dependent and were more likely to reside in elderly care facility. A higher proportion of elderly care residents were at-risk or were malnourished on admission, discharge and at 6 months. Functional recovery was slower in the malnourished group. In-patient mortality was higher in malnourished individuals compared to those at risk of malnourishment and well-nourished individuals.Conclusion The prevalence of malnutrition is high and is associated with poor functional recovery and elderly care placement. Residents of elderly care facilities are especially at risk due a higher prevalence of malnourishment. Health authorities are encouraged to evaluate the dietetic component in elderly care facilities and initiate nutrition supplementation in their planning of healthcare resources.
Abstract
Objective To identify the prevalence of malnutrition in elderly hip fracture and to investigate the relationship between hip fracture patients and malnutrition on functional recovery and mortality. Methods All hip fracture patients age >65 years admitted to a rehabilitation unit were recruited from July 2015 to June 2016. Nutritional status was assessed by Mini-Nutritional Assessment Short-Form (MNA-SF) within 72 hours of admission. Patients were reassessed at 6 months for functional status and place of residence. Length of hospital stay, in-patient mortality rate, and 6-month mortality rate were also recorded. Results There were 218 patients recruited. The mean age was 83.5±7.5 years. According the MNA-SF, 46 (21.1%) were well nourished, 115 (52.6%) were at risk of malnutrition, and 57 (26.1%) were malnourished. Malnourished individuals were significantly older, had lower Mini-Mental State Examination score and albumin level, were functionally more dependent and were more likely to reside in elderly care facility. A higher proportion of elderly care residents were at-risk or were malnourished on admission, discharge and at 6 months. Functional recovery was slower in the malnourished group. In-patient mortality was higher in malnourished individuals compared to those at risk of malnourishment and well-nourished individuals.Conclusion The prevalence of malnutrition is high and is associated with poor functional recovery and elderly care placement. Residents of elderly care facilities are especially at risk due a higher prevalence of malnourishment. Health authorities are encouraged to evaluate the dietetic component in elderly care facilities and initiate nutrition supplementation in their planning of healthcare resources.
참고문헌 (28)
- Miller CW, "Survival and ambulation following hip fracture", J Bone Joint Surg Am, 60, pp.930~934 (1978)
- Magaziner J, "Recovery from hip fracture in eight areas of function", J Gerontol A Biol Sci Med Sci, 55, pp.M498~507 (2000)
- Shyu YI, "Predictors of functional recovery for hip fractured elders during 12 months following hospital discharge: a prospective study on a Taiwanese sample", Osteoporos Int, 15, pp.475~482 (2004)
- Charlton KE, "Older rehabilitation patients are at high risk of malnutrition: evidence from a large Australian database", J Nutr Health Aging, 14, pp.622~628 (2010)
- Olofsson B, "Malnutrition in hip fracture patients: an intervention study", J Clin Nurs, 16, pp.2027~2038 (2007)
- Chen CC, "A concept analysis of malnutrition in the elderly", J Adv Nurs, 36, pp.131~142 (2001)
- Allison SP, "Malnutrition, disease, and outcome", Nutrition, 16, pp.590~593 (2000)
- Dawson-Hughes B, "Interaction of dietary calcium and protein in bone health in humans", J Nutr, 133, pp.852S~854S (2003)
- Bonjour JP, "Dietary protein: an essential nutrient for bone health", J Am Coll Nutr, 24(6 Suppl), pp.526S~536S (2005)
- Paillaud E, "Nutritional status and energy expenditure in elderly patients with recent hip fracture during a 2-month follow-up", Br J Nutr, 83, pp.97~103 (2000)
- Neumann M, "Provision of high-protein supplement for patients recovering from hip fracture", Nutrition, 20, pp.415~419 (2004)
- Nikkel LE, "Impact of comorbidities on hospitalization costs following hip fracture", J Bone Joint Surg Am, 94, pp.9~17 (2012)
- Foss NB, "Risk factors for insufficient perioperative oral nutrition after hip fracture surgery within a multi-modal rehabilitation programme", Age Ageing, 36, pp.538~543 (2007)
- Norman K, "Prognostic impact of disease-related malnutrition", Clin Nutr, 27, pp.5~15 (2008)
- Volkert D, "ESPEN Guidelines on Enteral Nutrition: Geriatrics", Clin Nutr, 25, pp.330~360 (2006)
- Milte R, "Dietetic care of hip fracture patients across Australia: are we doing enough?", Nutr Diet, 68, pp.214~220 (2011)
- White JV, "Consensus statement: Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition:characteristics recommended for the identification and documentation of adult malnutrition (undernutrition)", JPEN J Parenter Enteral Nutr, 36, pp.275~283 (2012)
- Kaiser MJ, "Validation of the Mini Nutritional Assessment short-form (MNA-SF): a practical tool for identification of nutritional status", J Nutr Health Aging, 13, pp.782~788 (2009)
- Kwok T, "The use of armspan in nutritional assessment of the elderly", J Am Geriatr Soc, 39, pp.492~496 (1991)
- Bell JJ, "Concurrent and predictive evaluation of malnutrition diagnostic measures in hip fracture inpatients: a diagnostic accuracy study", Eur J Clin Nutr, 68, pp.358~362 (2014)
- Velasco C, "Comparison of four nutritional screening tools to detect nutritional risk in hospitalized patients: a multicentre study", Eur J Clin Nutr, 65, pp.269~274 (2011)
- Gout BS, "Malnutrition identification, diagnosis and dietetic referrals: are we doing a good enough job?", Nutr Diet, 66, pp.206~211 (2009)
- Nematy M, "Vulnerable patients with a fractured neck of femur:nutritional status and support in hospital", J Hum Nutr Diet, 19, pp.209~218 (2006)
- Hoekstra JC, "Effectiveness of multidisciplinary nutritional care on nutritional intake, nutritional status and quality of life in patients with hip fractures: a controlled prospective cohort study", Clin Nutr, 30, pp.455~461 (2011)
- Koren-Hakim T, "The relationship between nutritional status of hip fracture operated elderly patients and their functioning, comorbidity and outcome", Clin Nutr, 31, pp.917~921 (2012)
- Hedstrom M, "Metabolism and catabolism in hip fracture patients: nutritional and anabolic intervention: a review", Acta Orthop, 77, pp.741~747 (2006)
- Li HJ, "Functional recovery of older people with hip fracture: does malnutrition make a difference?", J Adv Nurs, 69, pp.1691~1703 (2013)
- Milne AC, "Protein and energy supplementation in elderly people at risk from malnutrition", Cochrane Database Syst Rev, 2, pp.CD003288~ (2009)