A prospective assessment of nutritional status and complications in patients with fractures of the hip.
A group of 40 consecutive patients with hip fractures were studied and confirmed to have a high incidence of protein-calorie malnutrition. The prospective nutritional assessment performed for this study included: serum albumin, serum transferrin, anthropometric measurements, skin testing for delayed hypersensitivity, total lymphocyte count, and a 24-h urine collection for metabolic and nitrogen balance determinations. At 3 months after their hip fracture, 37.5% returned to their premorbid ambulatory status; 42.5% sustained a decrement in their ambulatory status or independence; 12.5% died; 7.5% were lost to follow-up. Of the nutritional parameters studied, albumin was significantly associated with mortality (p = 0.004). Considering those patients with an albumin less than 3.0, a mortality rate of 70% was observed in follow-up (maximum of 11 months), compared with a mortality rate of 18% in patients with an albumin greater than or equal to 3.0. It is concluded that the serum albumin has value as a nutritional index without specialized nutritional parameters, and that a more aggressive approach to nutritional support is needed for the hypoalbuminemic patient with a hip fracture, particularly for those with a serum albumin below 3.0.
Foster
M R
MR
Triangle Orthopedic Associates, Pittsburgh, PA 15212.
Heppenstall
R B
RB
Friedenberg
Z B
ZB
Hozack
W J
WJ
D000368:Aged; D000886:Anthropometry; D005260:Female; D006620:Hip Fractures / Q000401:mortality / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011502:Protein-Energy Malnutrition / Q000503:physiopathology; D012709:Serum Albumin / Q000032:analysis*
D012709:Serum Albumin