NUTRIONAL CONSIDERATIONS IN ELDERLY PATIENTS WITH A HIP FRACTURE

Abstract

Introduction and purpose: Hip fractures are a significant cause of morbidity/mortality in the elderly. The increase of their prevalence has been related to a decrease in physical activity and malnutrition. Furthermore, malnutrition could be an significant factor leading to complications in these fractures. In spite of this, these patients rarely receive a complete nutritional assessment. Our aim in this study was to describe the subjects’ nutritional status, to assess the effect of malnutrition on complications, hospital stay and mortality and to establish a protocol for nutritional intervention.

Materials and methods: We carried out a complete nutritional evaluation of 45 patients over 65 years of age with hip fracture that were hospitalized during the first quarter of 2006. All malnourished patients were treated according to our protocol, and any complications were assessed during a 3 months follow-up.

Results: On admission, 94.3% of patients suffered from malnutrition (51.4% had severe malnutrition), and 31.5% had an unfavorable clinical evolution. The most frequently reported complications were bedsores and delirium/agitation. Severely malnourished patients had a greater number of complications. A significant increase in complications was seen in patients with albumin > 3 g/dL, lymphocytes < 1500 cells/ml and total cholesterol < 130 mg/dL.

Conclusions: Elderly patients with hip fractures are frequently malnourished at the moment of hospitalization, and this may adversely affect clinical results. In our opinion, it is extremely important to identify patients suffering from malnutrition or at risk of suffering from malnutrition to be able to provide them with appropriate nutritional support as early as possible.