The effect of unselected post-operative nutritional supplementation on nutritional status and clinical outcome of orthopaedic patients.
OBJECTIVE
Nutritional supplements are widely administered in hospitals and can benefit clinical outcome. The aim here was to determine the effect of routine post-operative nutritional supplementation on the nutritional status and clinical outcome of adult orthopaedic patients.


METHODS
A prospective controlled study was conducted on two adult orthopaedic wards. Patients in the study group were prescribed two nutritional supplements/day post-operatively. Nutritional and biochemical indices and incidence of clinical complications were observed.


RESULTS
Of 181 patients studied, 14 in the supplemented group and 34 in the control (P=0.005) developed major complications. There were 22 occurrences of major complications in the supplemented group and 55 in the control (P=0.0002). There was no significant difference in the number of minor complications between the two groups (P=0.2). There was no statistical difference in changes in nutritional parameters or in albumin or CRP between the two groups. There were significantly greater reductions in transferrin (P=0.002) and in haemoglobin (P=0.002) in the control group at week 1. The median costs of hospital stay were 2068 UK pounds in the supplemented group and 2199 UK pounds in the control. The median cost of additional treatments was 30.16 UK pounds in the supplemented group and 46.23 UK pounds in the control.


CONCLUSIONS
A significant reduction in major complications and in number and costs of additional treatments was seen in the supplemented group.
Lawson
R M
RM
Department of Medicine, North Tyneside General Hospital, Rake Lane, North Shields, Tyne and Wear, Sheffield, UK.
Doshi
M K
MK
Barton
J R
JR
Cobden
I
I
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001132:Arm / Q000502:physiology; D001798:Blood Proteins / Q000032:analysis / Q000187:drug effects; D015992:Body Mass Index; D004044:Dietary Proteins / Q000008:administration & dosage; D019587:Dietary Supplements / Q000191:economics / Q000706:statistics & numerical data*; D002149:Energy Intake / Q000502:physiology; D005260:Female; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status / Q000187:drug effects*; D019637:Orthopedic Procedures / Q000009:adverse effects*; D011182:Postoperative Care / Q000191:economics / Q000706:statistics & numerical data*; D011446:Prospective Studies; D016896:Treatment Outcome
D001798:Blood Proteins; D004044:Dietary Proteins