Using dietetic assistants to improve the outcome of hip fracture: a randomised controlled trial of nutritional support in an acute trauma ward
Abstract
Objective To examine how improved attention to nutritional status and dietary intake, achieved through the employment of dietetic assistants (DAs), will affect postoperative clinical outcome among elderly women with hip fracture. Design Open prospective randomised controlled trial, comparing conventional nursing care with the additional nutritional support provided by DA. Setting Thirty-eight bedded acute trauma ward in a teaching hospital. Participants All but 11 of 344 consecutive admissions with acute nonpathological hip fracture were approached. Three hundred and eighteen (93%) agreed to inclusion. Sixteen were ineligible as they were immediately transferred to another acute ward, were managed conservatively or died preoperatively. Primary outcome measure Postoperative mortality in the acute trauma unit. Secondary outcome measures Postoperative mortality at 4 months after fracture, length of stay, energy intake and nutritional status. Results DA-supported participants were less likely to die in the acute ward (4.1 versus 10.1%, P = 0.048). This effect was still apparent at 4 month follow-up (13.1 versus 22.9%, P = 0.036). DA-supported subjects had significantly better mean daily energy intake (1,105 kcal versus 756 kcal/24 h, 95% CI 259-440 kcal/24 h, P Conclusion Dietetic or nutrition assistants are being introduced in units across the UK. This, the largest ever study of nutritional support after hip fracture, shows that their employment significantly reduced patients' r…
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In that RCT, bodyweight, grip strength, complications, and length of hospital stay were unaffected.
“Bodyweight, grip strength, complications, and length of hospital stay were however unaffected.”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [46]
In an RCT of acceptable quality, additional individual nutritional support by dietetic assistants in older hospitalized patients with hip fractures increased energy intake and decreased mortality in the trauma unit and within four months after discharge compared to standard care.
“The study reported increased energy intake and decreased mortality in the trauma unit and within four months after discharge in the intervention group compared to the group with standard care.”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [46]
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Cirurgia ortopédica em idosos: aspectos clínicos
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ORTHOPEDIC SURGERY AMONG THE ELDERLY: CLINICAL CHARACTERISTICS
Leme, L. E. G., Sitta, M. D. C., Toledo, M., & Henriques, S. D. S. (2011) · Revista Brasileira de Ortopedia (English Edition) · doi:10.1016/s2255-4971(15)30189-0 · Cited by 16 · see citing works
- Authors
- Duncan, D. G., Beck, S. J., Hood, K., & Johansen, A.
- Affiliations
- University Hospital of Wales (GB)
- Corresponding author
- Duncan, Donna Georgina
- Venue
- Age and Ageing
- Publisher
- Oxford University Press (OUP)
- Published
- 2005-12-14
- Volume
- 35
- Issue
- 2
- Pages
- 148-153
- ISSN
- 0002-0729 (ISSN-L)
- 1468-2834
- OpenAlex
- W2123746917
- Cited by
- 202
- References
- 15
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 7 · 2023: 6 · 2022: 15 · 2021: 13 · 2020: 11 · 2019: 10 · 2018: 17 · 2017: 11 · 2016: 14 · 2015: 9 · 2014: 10 · 2013: 11 · 2012: 11
- FWCI
- 3.80
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Age and Ageing (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Hip and Femur Fractures
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Keywords
- nutritional support, hip fracture, postoperative mortality, older women, energy intake, nutritional status, mid-upper arm circumference, length of hospital stay, nursing care
- MeSH terms
- Aged, Energy Intake, Dietetics, Female, Follow-Up Studies, Hip Fractures, Humans, Nutritional Status, Postoperative Care, Postoperative Complications, Prospective Studies, Nutrition Assessment, Survival Rate, Treatment Outcome
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