Association of nutritional status as measured by the Mini-Nutritional Assessment Short Form with changes in mobility, institutionalization and death after hip fracture.
OBJECTIVE
We examined the association of nutritional status as measured by the Mini-Nutritional Assessment Short Form (MNA-SF) with changes in mobility, institutionalization and death after hip fracture.


METHODS
Population-based prospective data were collected on 472 out of 693 consecutive hip fracture patients aged 65 years and over between January 2010 and December 2012. Declined vs same or improved mobility level, institutionalization and death during the 4-month follow-up were the outcomes. Age, gender, American Society of Anesthesiologists scores, pre-fracture diagnosis of a memory disorder, mobility level, living arrangements and MNA-SF scores at baseline were the independent variables. Age-adjusted and multivariate logistic regression and Cox proportional hazards models were conducted.


RESULTS
At baseline, 41 (9%) patients were malnourished and 200 (42%) patients at risk of malnutrition according to the MNA-SF. During the follow-up, 90 (19%) had died. In the multivariate Cox proportional hazards model, malnutrition (hazard ratio 2.16; 95% confidence interval (CI) 1.07-4.34) was associated with mortality. In the multivariate binary logistic regression analyses, risk of malnutrition (odds ratios (OR) 2.42; 95% CI 1.25-4.66) and malnutrition (OR 6.10;95% CI 2.01-18.5) predicted institutionalization. Risk of malnutrition (OR 2.03; 95% CI 1.24-3.31) was associated with decline in the mobility level.


CONCLUSIONS
Malnutrition or risk of malnutrition as measured by the MNA-SF were independent predictors of negative outcomes after hip fracture. Patients classified as being at risk of malnutrition by the MNA-SF may constitute a patient population with mild-to-moderate malnutrition and may require specific attention when nutritional interventions are designed after hip fracture.
Department of Geriatric Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland.
M
M
Nuotio
Department of Nutritional Therapy, Seinäjoki Central Hospital, Seinäjoki, Finland.
P
P
Tuominen
Science Centre, Pirkanmaa Hospital District, Tampere, Finland.|School of Health Sciences, University of Tampere, FIN-33014 Tampere, Finland.
T
T
Luukkaala
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006620:Hip Fractures / Q000401:mortality* / Q000628:therapy; D006801:Humans; D007326:Institutionalization; D016015:Logistic Models; D008297:Male; D044342:Malnutrition / Q000175:diagnosis / Q000453:epidemiology*; D051346:Mobility Limitation; D015999:Multivariate Analysis; D015596:Nutrition Assessment; D009752:Nutritional Status; D059035:Perioperative Period; D011183:Postoperative Complications / Q000175:diagnosis / Q000628:therapy; D015995:Prevalence; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome