title: The relationship between nutritional status of hip fracture operated elderly patients and their functioning, comorbidity and outcome.
abstract: OBJECTIVE
  Malnutrition is common in hip fracture elderly patients. The purpose of this study was to examine the relationship between the Mini Nutrition Assessment Short Form (MNA-SF) and cognitive, functional status, comorbidity and outcome of operated patients.
  
  
  METHODS
  Clinical data, MNA, functioning, cognition were prospectively determined. Retrospectively, the Charlson Comorbidity Index (CCI) and Cumulative Illness Rating Scale for Geriatrics (CIRS-G) were applied.
  
  
  RESULTS
  The study consisted of 95 well-nourished (WN), 95 at risk of malnutrition (ARM) and 25 malnourished (MN) patients. More WN patients were independent vs. partially or fully dependent; more WN patients were cognitively normal vs. cognitively impaired (p < 0.001). CIRS-G was higher in MN vs. WN patients and CCI was higher in MN and ARM vs. WN patients (p < 0.001). During a 6 month period, 100 patients were readmitted, with less readmissions in the WN group (p = 0.024). During a 36 month follow-up, 79 patients died. The mortality rate was lower in the WN group (p = 0.01). Stepwise regression analysis found that the only independent variables for mortality were CCI and functioning (p < 0.01).
  
  
  CONCLUSIONS
  Patients with higher cognitive and functional status were in superior nutritional condition. Poor nutritional status was associated with higher comorbidity indices, mortality and readmissions. However, we found that only comorbidity and low functioning can predict long-term mortality.
authors.affiliation: Department of Geriatrics, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel.
authors.forename: Tamar
authors.initials: T
authors.lastname: Koren-Hakim
authors.forename: Avraham
authors.initials: A
authors.lastname: Weiss
authors.forename: Avital
authors.initials: A
authors.lastname: Hershkovitz
authors.forename: Irena
authors.initials: I
authors.lastname: Otzrateni
authors.forename: Boris
authors.initials: B
authors.lastname: Grosman
authors.forename: Sigal
authors.initials: S
authors.lastname: Frishman
authors.forename: Moshe
authors.initials: M
authors.lastname: Salai
authors.forename: Yichayaou
authors.initials: Y
authors.lastname: Beloosesky
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006620:Hip Fractures / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology; D006760:Hospitalization; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000453:epidemiology* / Q000503:physiopathology; D015596:Nutrition Assessment; D009752:Nutritional Status; D018570:Risk Assessment; D011795:Surveys and Questionnaires