title: Low postoperative dietary intake is associated with worse functional course in geriatric patients up to 6 months after hip fracture.
abstract: We examined the relationship between postoperative dietary intake (DI) of geriatric hip fracture (HF) patients and their functional and clinical course until 6 months after hospital discharge. In eighty-eight HF patients ≥ 75 years, postoperative DI was estimated with plate diagrams of main meals over four postoperative days. DI was stratified as >50, >25-50, ≤ 25 % of meals served. Functional status according to Barthel index (activities of daily living) and patients' mobility level before fracture, postoperatively, at discharge and 6 months later were assessed and related to DI levels. In-hospital complications were recorded according to clinical diagnosis. Associations were evaluated using χ2 and Kruskal-Wallis tests, and repeated-measures ANOVA and ANCOVA. Postoperatively, 28 % of participants ate >50 %, 43 % ate >25-50 % and 28 % ≤ 25 % of meals served. Irrespective of pre-fracture functional status, patients with DI ≤ 25 % had significantly lower Barthel index scores at all times after surgery (all P50 % more often had regained their pre-fracture mobility level than those with DI ≤ 25 % at discharge (>50 %: 36 %; >25-50 %: 10 %; ≤ 25 %: 0 %; P= 0·001) and 6 months after discharge (88; 87; 68 %; P= 0·087) and had significantly less complications (median 2 (25th-75th percentile 1-3); 3 (25th-75th percentile 2-4); 3 (25th-75th percentile 3-4); P= 0·012). To conclude, geriatric HF patients had very low postoperative voluntary DI and thus need specific nutritional interventions to achieve adequate DI to support functional and clinical recovery.
authors.affiliation: Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg,Kobergerstraße 60,D-90408Nuremberg,Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Goisser
authors.affiliation: Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg,Kobergerstraße 60,D-90408Nuremberg,Germany.
authors.forename: Eva
authors.initials: E
authors.lastname: Schrader
authors.affiliation: Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg,Kobergerstraße 60,D-90408Nuremberg,Germany.
authors.forename: Katrin
authors.initials: K
authors.lastname: Singler
authors.affiliation: Institute of Clinical Chemistry, Laboratory Medicine and Transfusion Medicine, Central Laboratory, Klinikum Nürnberg, Paracelsus Medical University,Professor-Ernst-Nathan-Straße 1,D-90418Nuremberg,Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Bertsch
authors.affiliation: Institute for Medical Informatics, Biometrics und Epidemiology, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg,Waldstraße 6,D-91054Erlangen,Germany.
authors.forename: Olaf
authors.initials: O
authors.lastname: Gefeller
authors.affiliation: Department of Trauma and Orthopaedic Surgery,Klinikum Nürnberg, Paracelsus Medical University,Breslauer Straße 201,D-90471Nuremberg,Germany.
authors.forename: Roland
authors.initials: R
authors.lastname: Biber
authors.affiliation: Department of Trauma and Orthopaedic Surgery,Klinikum Nürnberg, Paracelsus Medical University,Breslauer Straße 201,D-90471Nuremberg,Germany.
authors.forename: Hermann-Josef
authors.initials: HJ
authors.lastname: Bail
authors.affiliation: Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg,Kobergerstraße 60,D-90408Nuremberg,Germany.
authors.forename: Cornel C
authors.initials: CC
authors.lastname: Sieber
authors.affiliation: Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg,Kobergerstraße 60,D-90408Nuremberg,Germany.
authors.forename: Dorothee
authors.initials: D
authors.lastname: Volkert
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D004032:Diet; D004435:Eating; D005260:Female; D006615:Hip / Q000503:physiopathology*; D006620:Hip Fractures / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D009752:Nutritional Status / Q000502:physiology*; D011183:Postoperative Complications / Q000453:epidemiology; D011184:Postoperative Period
keywords: Functional course; Functional recovery; Geriatric patients; Hip fracture patients; Postoperative dietary intake