Prevalence and consequences of malnutrition and malnourishment in older individuals admitted to hospital with a hip fracture.


Journal

European journal of clinical nutrition
ISSN: 1476-5640
Titre abrégé: Eur J Clin Nutr
Pays: England
ID NLM: 8804070

Informations de publication

Date de publication:
04 2021
Historique:
received: 30 05 2020
accepted: 28 09 2020
revised: 07 09 2020
pubmed: 9 10 2020
medline: 8 7 2021
entrez: 8 10 2020
Statut: ppublish

Résumé

Major causes of hip fractures are osteoporosis and falls, both of which are determined by nutrition. Information on the nutritional status of patients admitted to hospital with a hip fracture is lacking. In this study, we assessed determinants and adverse outcomes associated with malnutrition and malnourishment. Nutritional status, assessed using the Malnutrition Universal Screening Tool protocol, was compared to age and residency prior to admission, and outcomes during hospital stay and at discharge. A total of 1239 patients admitted with a hip fracture (349 men, 890 women), aged 60-100 years. Compared with well-nourished individuals, the prevalences of malnutrition risk or malnourishment were higher in older age groups and those from residential or nursing care. Those with risk of malnutrition or malnourishment stayed in hospital longer by 3.0 days (95% confidence interval (CI), 1.5-4.5 days; p < 0.001) and 3.1 days (95% CI, 0.7-5.5 days; p = 0.011), respectively. Compared with the well-nourished group, malnourished individuals had increased: (1) risk for failure to mobilise within 1 day of surgery (rates = 17.9 versus 27.0%; odds ratio (OR) = 1.6 (95% CI, 1.0-2.7), p = 0.045); (2) pressure ulcers (rates = 1.0% versus 5.0%; OR = 5.5 (95% CI, 1.8-17.1), p = 0.006); (3) in-patient mortality (rates = 4.5% versus 10.1%; OR = 2.3 (95% CI, 1.1-4.8) p = 0.033) and (4) discharge to residential/nursing care: rates = 4.3% versus 11.1%; OR = 2.8 (95% CI, 1.2-6.6), p = 0.022. Inadequate nutrition is common in patients admitted to hospital with a hip fracture, which in turn predisposes them to a number of complications. More research on nutritional support should be directed to this group to prevent or minimise hip fractures.

Sections du résumé

BACKGROUND/OBJECTIVES
Major causes of hip fractures are osteoporosis and falls, both of which are determined by nutrition. Information on the nutritional status of patients admitted to hospital with a hip fracture is lacking. In this study, we assessed determinants and adverse outcomes associated with malnutrition and malnourishment.
METHODS
Nutritional status, assessed using the Malnutrition Universal Screening Tool protocol, was compared to age and residency prior to admission, and outcomes during hospital stay and at discharge.
RESULTS
A total of 1239 patients admitted with a hip fracture (349 men, 890 women), aged 60-100 years. Compared with well-nourished individuals, the prevalences of malnutrition risk or malnourishment were higher in older age groups and those from residential or nursing care. Those with risk of malnutrition or malnourishment stayed in hospital longer by 3.0 days (95% confidence interval (CI), 1.5-4.5 days; p < 0.001) and 3.1 days (95% CI, 0.7-5.5 days; p = 0.011), respectively. Compared with the well-nourished group, malnourished individuals had increased: (1) risk for failure to mobilise within 1 day of surgery (rates = 17.9 versus 27.0%; odds ratio (OR) = 1.6 (95% CI, 1.0-2.7), p = 0.045); (2) pressure ulcers (rates = 1.0% versus 5.0%; OR = 5.5 (95% CI, 1.8-17.1), p = 0.006); (3) in-patient mortality (rates = 4.5% versus 10.1%; OR = 2.3 (95% CI, 1.1-4.8) p = 0.033) and (4) discharge to residential/nursing care: rates = 4.3% versus 11.1%; OR = 2.8 (95% CI, 1.2-6.6), p = 0.022.
CONCLUSIONS
Inadequate nutrition is common in patients admitted to hospital with a hip fracture, which in turn predisposes them to a number of complications. More research on nutritional support should be directed to this group to prevent or minimise hip fractures.

Identifiants

pubmed: 33028971
doi: 10.1038/s41430-020-00774-5
pii: 10.1038/s41430-020-00774-5
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

645-652

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Auteurs

Thang S Han (TS)

Institute of Cardiovascular Research, Royal Holloway, University of London, Egham, Surrey, TW20 0EX, UK. thang.han@rhul.ac.uk.

Keefai Yeong (K)

Department of Orthogeriatrics, Ashford and St Peter's NHS Foundation Trust, Guildford Road, Chertsey, Surrey, KT16 0PZ, UK.

Radcliffe Lisk (R)

Department of Orthogeriatrics, Ashford and St Peter's NHS Foundation Trust, Guildford Road, Chertsey, Surrey, KT16 0PZ, UK.

David Fluck (D)

Department of Cardiology, Ashford and St Peter's NHS Foundation Trust, Guildford Road, Chertsey, Surrey, KT16 0PZ, UK.

Christopher H Fry (CH)

School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, BS8 1TD, UK.

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