Nutritional supplementation affects postoperative oxidative stress and duration of hospitalization in patients with hip fracture.
OBJECTIVE
The objective of this prospective randomized controlled study was to investigate the effect of nutritional supplementation on postoperative oxidative stress and duration of hospitalization in elderly patients with hip fracture.


METHODS
A total of fourteen women (= SG) with hip fracture received individually adapted supplements enriched with protein and antioxidants postoperatively, nine served as unsupplemented controls (= CG). Blood samples were taken preoperatively (T1), on the day of discharge from hospital (T2) and three weeks thereafter (T3). Plasma concentrations of albumin and total protein (TP) were measured by autoanalysis, advanced oxidation protein products (AOPP) and the total antioxidant capacity (TAC) were determined photometrically. Malondialdehyde (MDA) levels were analyzed by HPLC.


RESULTS
Postoperatively, there was a significant (T1 > T2, p< 0.01) decrease in plasma albumin, TP and TAC, followed by a significant (p< 0.05) increase in the period T2-T3 in the CG, but not in the SG. This resulted in significant differences in TP (T2: SG > CG, p< 0.05) and TAC (T2: SG > CG, p< 0.01) between the investigated groups. Postoperatively, the plasma levels of AOPP and MDA increased significantly (T1 < T2, p< 0.01) in both groups, and remained at the significantly (AOPP: T1 < T3, p< 0.05; MDA: T1 < T3, p< 0.01) elevated level in the CG, but not in the SG (T2 > T3, p< 0.01). Consequently, the oxidant markers MDA and AOPP were significantly positively (p< 0.01), TAC and albumin significantly negatively (p< 0.05) related to duration of hospital stay in both groups.


CONCLUSIONS
Individualized nutritional supplementation may reduce postoperative oxidative stress and shorten duration of hospitalization in patients with hip fracture.
Department of Nutritional Sciences, University of Vienna, Vienna, Austria. elisabeth.fabian@univie.ac.at
Elisabeth
E
Fabian
Inge
I
Gerstorfer
Heinrich W
HW
Thaler
Heinrich
H
Stundner
Pia
P
Biswas
Ibrahim
I
Elmadfa
D000284:Administration, Oral; D000369:Aged, 80 and over; D000975:Antioxidants / Q000008:administration & dosage / Q000378:metabolism*; D004044:Dietary Proteins / Q000008:administration & dosage / Q000097:blood* / Q000627:therapeutic use*; D019587:Dietary Supplements; D005260:Female; D006620:Hip Fractures / Q000378:metabolism* / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D018384:Oxidative Stress / Q000187:drug effects*; D011184:Postoperative Period; D016896:Treatment Outcome
D000975:Antioxidants; D004044:Dietary Proteins
Clin Nutr. 2003 Feb;22(1):39-46
12553948
Methods Enzymol. 1994;234:279-93
7808295
Clin Nutr. 2003 Jun;22(3):235-9
12765661
Osteoporos Int. 2007 Dec;18(12):1583-93
17566814
J Am Coll Nutr. 2000 Oct;19(5):570-7
11022870
Cochrane Database Syst Rev. 2005 Apr 18;(2):CD001880
15846625
JPEN J Parenter Enteral Nutr. 2008 Mar-Apr;32(2):120-8
18407904
Clin Nutr. 2005 Dec;24(6):913-9
16046034
Injury. 2009 Oct;40(10):1073-6
19524906
BMJ. 2005 Dec 10;331(7529):1374
16299013
Acta Orthop Scand. 1999 Oct;70(5):487-90
10622483
Cell Biochem Funct. 2005 Mar-Apr;23(2):137-9
15651080
Am J Physiol Endocrinol Metab. 2000 Aug;279(2):E244-51
10913022
Kidney Int. 2002 Jun;61(6):2240-9
12028466
Free Radic Res. 2009 Oct;43(10):1008-18
19707919
Kidney Int Suppl. 2003 Nov;(87):S92-8
14531780
J Transl Med. 2009 Nov 17;7:97
19919699
Clin Nutr. 2006 Apr;25(2):330-60
16735082
Clin Nutr. 2006 Aug;25(4):563-72
16698132
Cochrane Database Syst Rev. 2009 Apr 15;(2):CD003288
19370584
Acta Orthop Belg. 2003 Dec;69(6):546-51
14748113
J Surg Res. 1990 May;48(5):476-80
2191170
Nutrition. 1994 Jul-Aug;10(4):335-41; discussion 353
8000155
Transplant Proc. 2009 Nov;41(9):3632-6
19917357
Acta Orthop Scand. 1995 Oct;66(5):473-5
7484133
Clin Orthop Relat Res. 2006 Oct;451:212-7
16770284
Clin Nutr. 2004 Aug;23(4):587-96
15297095
Am J Physiol. 1997 Nov;273(5):E898-902
9374674
Clin Nutr. 2000 Jun;19(3):171-5
10895107
Lancet. 1990 Apr 28;335(8696):1013-6
1970070
Crit Care. 2006 Feb;10(1):R36
16507162
Semin Dial. 2004 Nov-Dec;17(6):432-7
15660573
Age Ageing. 2006 Sep;35 Suppl 2:ii37-ii41
16926202
Injury. 2009 Nov;40(11):1226-30
19647251
Ann Surg. 1998 Feb;227(2):249-54
9488524