Nutritional Supplementation Decreases Hip Fracture-related Complications
Abstract
Protein energy malnutrition is an important determinant of clinical outcome in older patients after hip fracture, but the effectiveness of nutritional support programs in routine clinical practice is controversial. We performed a prospective, randomized, controlled clinical trial to determine if nutritional supplementation decreased fracture-related complications in a selection of otherwise healthy patients with hip fractures. Patients were randomized to intervention or control groups. The control group (n = 40) was given ordinary hospital food and beverage. The intervention group (n = 40) also was administered a 1000 kcal daily intravenous supplement for 3 days, followed by a 400 kcal oral nutritional supplement for 7 days. We recorded daily fluid and energy intake during the first 10 days of hospitalization and fracture-related complications up to 4 months. The total fluid and energy intake in the intervention group neared optimal levels. The control group received 54% and 64% of optimal energy and fluid intake, respectively. The risk of fracture- related complications was greater in the control group (70%) than in the intervention group (15%). Four patients in the control group died within 120 days postoperatively. The comprehensive balanced nutrition supplement resulted in lower complication rates and mortality at 120 days postoperatively.
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One RCT of low quality evaluated three days of perioperative peripheral parenteral nutrition followed by seven days of ONS compared with standard care in 80 patients with a fractured hip.
“182) included one RCT of low quality that evaluated three days of perioperative peripheral PN followed by seven days of ONS compared with standard care in 80 patients with a fractured hip (184, 185).”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [185]
This short-time combined intervention increased total fluid and energy intake to near-optimal levels during the hospital stay.
“This shorttime combined intervention increased total fluid and energy intake to near-optimal levels during the hospital stay.”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [185]
The risk of complications within four months was significantly reduced (RR 0.21 (99% CI 0.08-0.59)), while mortality risk, length of hospital stay and the proportion of participants who were discharged to their own homes were unaffected.
“The risk of complications within four months was significantly reduced (RR 0.21 (99% CI 0.08-0.59),while mortality risk, length of hospital stay and the proportion of participants who were discharged to their own homes were unaffected (185).”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [185]
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- Authors
- Eneroth, M., Olsson, U.-B., & Thorngren, K.-G.
- Affiliations
- National Board of Health and Welfare (SE)
- Corresponding author
- Eneroth, Magnus
- Venue
- Clinical Orthopaedics and Related Research
- Published
- 2006-10
- Volume
- 451
- Pages
- 212-217
- ISSN
- 0009-921X (ISSN-L)
- OpenAlex
- W2080897463
- Cited by
- 169
- References
- 28
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 2 · 2023: 8 · 2022: 14 · 2021: 9 · 2020: 12 · 2019: 20 · 2018: 11 · 2017: 9 · 2016: 7 · 2015: 8 · 2014: 6 · 2013: 5 · 2012: 5
- FWCI
- 7.12
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Orthopaedics and Related Research (publishedVersion)
- PubMed (publishedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- 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
- hip fracture, dietary supplementation, protein-energy malnutrition, postoperative complications, older adults, oral nutritional supplements, fluid intake, energy intake, postoperative mortality, nutritional support
- MeSH terms
- Administration, Oral, Aged, Aged, 80 and over, Energy Intake, Drug Administration Schedule, Female, Follow-Up Studies, Fracture Fixation, Hip Fractures, Hospitalization, Humans, Infusions, Intravenous, Male, Prospective Studies, Dietary Supplements
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