Malnutrition in hip fracture patients: an intervention study
Article first published online: 5 APR 2007
Journal of Clinical Nursing
Volume 16, Issue 11, pages 2027–2038, November 2007
How to Cite
Olofsson, B., Stenvall, M., Lundström, M., Svensson, O. and Gustafson, Y. (2007), Malnutrition in hip fracture patients: an intervention study. Journal of Clinical Nursing, 16: 2027–2038. doi: 10.1111/j.1365-2702.2006.01864.x
- Issue published online: 5 APR 2007
- Article first published online: 5 APR 2007
- Submitted for publication: 24 March 2006 Accepted for publication: 9 September 2006
- hip fracture;
- older people;
Aims. To investigate whether a nutritional intervention in older women and men with femoral neck fracture had an effect on postoperative complications during hospitalization and on nutritional status at a four-month follow-up.
Methods. The design was a randomized controlled trial. The present study sample consisted of 157 patients aged 70 years and above with femoral neck fracture. The nutritional intervention included, among other things, a nutritional journal to detect nutrition deficiencies and protein-enriched meals for at least four days postoperatively. Further, at least two nutritional and protein drinks were served each day during the whole hospitalization and other factors that would influence the patient's nutrition were also considered and dealt with. Postoperative complications were registered and patients were assessed using the Mini Nutritional Assessment (MNA) scale, including body mass index (BMI), on admission and at a four-month follow-up.
Results. Malnutrition was common and low MNA scores were associated with postoperative complications such as delirium and decubitus ulcers. There were significantly fewer days of delirium in the intervention group, seven patients in the intervention group developed decubitus ulcers vs. 14 patients in the control group and the total length of hospitalization was shorter. There were no detectable significant improvements regarding nutritional parameters between the intervention and the control group at the four-month follow-up but men improved their mean BMI, body weight and MNA scores in both the intervention and the control groups while women deteriorated in both groups.
Conclusions. Malnutrition was common among older people with hip fractures admitted to hospital. The nutritional intervention might have contributed to the patients suffering fewer days with delirium, fewer decubitus ulcers and shorter hospitalization but did not improve the long-term nutritional status, at least not in women.
Relevance to clinical practice. This nutritional intervention, which was included in a multifactorial multidisciplinary intervention, is inexpensive and relatively easy to implement. It has significant effects on complications but no long-term effect on nutritional parameters, at least not in women.