title: Effect of oral taurine on morbidity and mortality in elderly hip fracture patients: a randomized trial.
abstract: Hip fracture patients represent a large part of the elderly surgical population and face severe postoperative morbidity and excessive mortality compared to adult surgical hip fracture patients. Low antioxidant status and taurine deficiency is common in the elderly, and may negatively affect postoperative outcome. We hypothesized that taurine, an antioxidant, could improve clinical outcome in the elderly hip fracture patient. A double blind randomized, placebo controlled, clinical trial was conducted on elderly hip fracture patients. Supplementation started after admission and before surgery up to the sixth postoperative day. Markers of oxidative status were measured during hospitalization, and postoperative outcome was monitored for one year after surgery. Taurine supplementation did not improve in-hospital morbidity, medical comorbidities during the first year, or mortality during the first year. Taurine supplementation lowered postoperative oxidative stress, as shown by lower urinary 8-hydroxy-2-deoxyguanosine levels (Generalized estimating equations (GEE) analysis average difference over time; regression coefficient (Beta): -0.54; 95% CI: -1.08--0.01; p = 0.04), blunted plasma malondialdehyde response (Beta: 1.58; 95% CI: 0.00-3.15; p = 0.05) and a trend towards lower lactate to pyruvate ratio (Beta: -1.10; 95% CI: -2.33-0.12; p = 0.08). We concluded that peri-operative taurine supplementation attenuated postoperative oxidative stress in elderly hip fracture patients, but did not improve postoperative morbidity and mortality.
authors.affiliation: Department of Surgery, Medical Center Alkmaar, Wilhelminalaan 12, 1815 JD Alkmaar, The Netherlands. m.f.vanstijn@amc.uva.nl.|Academic Medical Center Amsterdam, Department of Anesthesiology, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. m.f.vanstijn@amc.uva.nl.
authors.forename: Mireille F M
authors.initials: MF
authors.lastname: Van Stijn
authors.affiliation: Department of Surgery, Medical Center Alkmaar, Wilhelminalaan 12, 1815 JD Alkmaar, The Netherlands. arnoudbruins@hotmail.com.
authors.forename: Arnoud A
authors.initials: AA
authors.lastname: Bruins
authors.affiliation: VU University Medical Center Amsterdam, Department of Surgery, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands. mar.vermeulen@vumc.nl.|VU University Medical Center Amsterdam, Internal Medicine, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands. mar.vermeulen@vumc.nl.
authors.forename: Mechteld A R
authors.initials: MA
authors.lastname: Vermeulen
authors.affiliation: Medical Center Alkmaar, Geriatric Medicine, Wilhelminalaan 12, 1815 JD Alkmaar, The Netherlands. j.witlox@mca.nl.
authors.forename: Joost
authors.initials: J
authors.lastname: Witlox
authors.affiliation: VU University Medical Center Amsterdam, Clinical Chemistry, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands. t.teerlink@vumc.nl.
authors.forename: Tom
authors.initials: T
authors.lastname: Teerlink
authors.affiliation: Medical Center Alkmaar, Clinical Chemistry, Hematology & Immunology, Wilhelminalaan 12, 1815 JD Alkmaar, The Netherlands. m.g.schoorl@mca.nl.
authors.forename: Margreet G
authors.initials: MG
authors.lastname: Schoorl
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, EA4466 Paris, France. jean-pascal.de-bandt@univ-paris.fr.
authors.forename: Jean Pascal
authors.initials: JP
authors.lastname: De Bandt
authors.affiliation: VU University Medical Center Amsterdam, Epidemiology and Biostatistics, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands. jwr.twisk@vumc.nl.
authors.forename: Jos W R
authors.initials: JW
authors.lastname: Twisk
authors.affiliation: VU University Medical Center Amsterdam, Department of Surgery, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands. pam.vleeuwen@vumc.nl.
authors.forename: Paul A M
authors.initials: PA
authors.lastname: Van Leeuwen
authors.affiliation: Department of Surgery, Medical Center Alkmaar, Wilhelminalaan 12, 1815 JD Alkmaar, The Netherlands. a.p.j.houdijk@mca.nl.|Trial Center Holland Health, Kennemerstraatweg 10, 1817 MS Alkmaar, The Netherlands. a.p.j.houdijk@mca.nl.
authors.forename: Alexander P J
authors.initials: AP
authors.lastname: Houdijk
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000975:Antioxidants / Q000008:administration & dosage* / Q000627:therapeutic use; D015897:Comorbidity; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D006620:Hip Fractures / Q000178:diet therapy* / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008297:Male; D018384:Oxidative Stress / Q000187:drug effects; D019990:Perioperative Care; D016019:Survival Analysis; D013654:Taurine / Q000008:administration & dosage* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000975:Antioxidants; D013654:Taurine
keywords: elderly patients; oxidative stress; surgery; taurine supplementation