Assessment of Nutrition and Supplementation in Patients With Hip Fractures

INTRODUCTION: Malnutrition is common in older people, is known to interact with frailty, and is a risk factor for wound complications and poor functional outcomes postoperatively. Sustaining a hip fracture is a significant life event, often resulting in a decline in mobility and functional ability....

Descripción completa

Detalles Bibliográficos
Autores principales: Arkley, James, Dixon, Ján, Wilson, Faye, Charlton, Karl, Ollivere, Benjamin John, Eardley, William
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6801887/
https://www.ncbi.nlm.nih.gov/pubmed/31667002
http://dx.doi.org/10.1177/2151459319879804
_version_ 1783460683695783936
author Arkley, James
Dixon, Ján
Wilson, Faye
Charlton, Karl
Ollivere, Benjamin John
Eardley, William
author_facet Arkley, James
Dixon, Ján
Wilson, Faye
Charlton, Karl
Ollivere, Benjamin John
Eardley, William
author_sort Arkley, James
collection PubMed
description INTRODUCTION: Malnutrition is common in older people, is known to interact with frailty, and is a risk factor for wound complications and poor functional outcomes postoperatively. Sustaining a hip fracture is a significant life event, often resulting in a decline in mobility and functional ability. A poor nutritional state may further impede recovery and rehabilitation, so strategies to improve perioperative nutrition are of considerable importance. We provide a review of nutritional supplement practices in this vulnerable and growing population. METHOD: Systematic review of preoperative oral nutritional supplementation (ONS) in hip fracture patients. RESULTS: We identified 12 articles pertaining to this important area of perioperative care. The findings suggest postoperative ONS can improve postoperative outcomes in hip fracture patients, especially in terms of increasing total serum protein, improving nutritional status to near-optimum levels, and decreasing postoperative complications. DISCUSSION: There is an absence of evidence specific to preoperative ONS in patients admitted following hip fracture. Literature relating to other populations is encouraging but is yet to be robustly studied. It is unclear whether these results are generalizable to the frailer hip fracture population. There is a need for studies clearly defining outcome measurement and complication assessment pertaining to preoperative ONS. The potential benefit is considerable, and this review will provide a means to inform the construction of meaningful trials in preoperative ONS of patients sustaining hip fracture. CONCLUSION: Oral nutritional supplementation in hip fracture patients may decrease postoperative complications while increasing elderly patient’s nutritional state to a near-optimum level. This is extrapolated from postoperative literature, however with a clear gap in research pertaining specifically to preoperative care. The need for well-constructed studies focused on the impact and assessment of early ONS in this population is transparent.
format Online
Article
Text
id pubmed-6801887
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-68018872019-10-30 Assessment of Nutrition and Supplementation in Patients With Hip Fractures Arkley, James Dixon, Ján Wilson, Faye Charlton, Karl Ollivere, Benjamin John Eardley, William Geriatr Orthop Surg Rehabil Medical Student Corner INTRODUCTION: Malnutrition is common in older people, is known to interact with frailty, and is a risk factor for wound complications and poor functional outcomes postoperatively. Sustaining a hip fracture is a significant life event, often resulting in a decline in mobility and functional ability. A poor nutritional state may further impede recovery and rehabilitation, so strategies to improve perioperative nutrition are of considerable importance. We provide a review of nutritional supplement practices in this vulnerable and growing population. METHOD: Systematic review of preoperative oral nutritional supplementation (ONS) in hip fracture patients. RESULTS: We identified 12 articles pertaining to this important area of perioperative care. The findings suggest postoperative ONS can improve postoperative outcomes in hip fracture patients, especially in terms of increasing total serum protein, improving nutritional status to near-optimum levels, and decreasing postoperative complications. DISCUSSION: There is an absence of evidence specific to preoperative ONS in patients admitted following hip fracture. Literature relating to other populations is encouraging but is yet to be robustly studied. It is unclear whether these results are generalizable to the frailer hip fracture population. There is a need for studies clearly defining outcome measurement and complication assessment pertaining to preoperative ONS. The potential benefit is considerable, and this review will provide a means to inform the construction of meaningful trials in preoperative ONS of patients sustaining hip fracture. CONCLUSION: Oral nutritional supplementation in hip fracture patients may decrease postoperative complications while increasing elderly patient’s nutritional state to a near-optimum level. This is extrapolated from postoperative literature, however with a clear gap in research pertaining specifically to preoperative care. The need for well-constructed studies focused on the impact and assessment of early ONS in this population is transparent. SAGE Publications 2019-10-17 /pmc/articles/PMC6801887/ /pubmed/31667002 http://dx.doi.org/10.1177/2151459319879804 Text en © The Author(s) 2019 http://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Medical Student Corner
Arkley, James
Dixon, Ján
Wilson, Faye
Charlton, Karl
Ollivere, Benjamin John
Eardley, William
Assessment of Nutrition and Supplementation in Patients With Hip Fractures
title Assessment of Nutrition and Supplementation in Patients With Hip Fractures
title_full Assessment of Nutrition and Supplementation in Patients With Hip Fractures
title_fullStr Assessment of Nutrition and Supplementation in Patients With Hip Fractures
title_full_unstemmed Assessment of Nutrition and Supplementation in Patients With Hip Fractures
title_short Assessment of Nutrition and Supplementation in Patients With Hip Fractures
title_sort assessment of nutrition and supplementation in patients with hip fractures
topic Medical Student Corner
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6801887/
https://www.ncbi.nlm.nih.gov/pubmed/31667002
http://dx.doi.org/10.1177/2151459319879804
work_keys_str_mv AT arkleyjames assessmentofnutritionandsupplementationinpatientswithhipfractures
AT dixonjan assessmentofnutritionandsupplementationinpatientswithhipfractures
AT wilsonfaye assessmentofnutritionandsupplementationinpatientswithhipfractures
AT charltonkarl assessmentofnutritionandsupplementationinpatientswithhipfractures
AT olliverebenjaminjohn assessmentofnutritionandsupplementationinpatientswithhipfractures
AT eardleywilliam assessmentofnutritionandsupplementationinpatientswithhipfractures