Pre-fracture nutritional status is predictive of functional status at discharge during the acute phase with hip fracture patients: A multicenter prospective cohort study

Pre-fracture nutritional status is predictive of functional status at discharge during the acute phase with hip fracture patients: A multicenter prospective cohort study

Summary Background & aims Malnutrition is common in patients with hip fractures, and elderly patients with hip fractures lose functional independence and often fail to recover previous functional status. The aim of this study was to determine whether pre-fracture nutritional status predicts func...

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Published in:Clinical nutrition (Edinburgh, Scotland) Vol. 36; no. 5; pp. 1320 - 1325
Main Authors: Inoue, Tatsuro, Misu, Syogo, Tanaka, Toshiaki, Sakamoto, Hiroki, Iwata, Kentaro, Chuman, Yuki, Ono, Rei
Format: Journal Article
Language:English
Published: England Elsevier Ltd 01-10-2017
Subjects:
Albumin
Elderly
Functional status
Gastroenterology and Hepatology
Hip fracture
Mini Nutritional Assessment Short-Form
Nutritional status
Body Mass Index
Mini Nutritional Assessment Short-Form
Functional Independent Measure instrument
The Hasegawa Dementia Scale-Revised
Albumin
Activity of Daily Living
ADL
HDS-R
FIM
MNA-SF
Functional status
Hip fracture
Elderly
Nutritional status
BMI
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Summary:Summary Background & aims Malnutrition is common in patients with hip fractures, and elderly patients with hip fractures lose functional independence and often fail to recover previous functional status. The aim of this study was to determine whether pre-fracture nutritional status predicts functional status of patients with hip fracture at discharge from acute hospitals. Methods In the present multicenter prospective cohort study, pre-fracture nutritional status was assessed using the Mini Nutritional Assessment Short-Form (MNA-SF). At discharge from acute hospitals, functional status was evaluated using a functional independent measurement instrument (FIM). Subsequently, multiple regression analyses were performed using FIM as the dependent variable and MNA-SF as the independent variable. Results Among the 204 patients analyzed in the present study, the mean length of hospital stay was 26.2 ± 12.6 days, and according to MNA-SF assessments, 51 (25.0%) patients were malnourished, 98 (48.0%) were at risk of malnutrition, and 55 (27.0%) were well-nourished before fracture. At discharge, FIM scores were higher in patients who were well-nourished than in those who were malnourished or were at risk of malnutrition ( p  < 0.01). After adjustment for confounding factors, multiple regression analyses showed that MNA-SF was a significant independent predictor for FIM at discharge (well-nourished vs. malnourished, β = −0.86, p  < 0.01). Conclusions Pre-fracture nutritional status was a significant independent predictor for functional status at discharge during the acute phase, warranting early assessment of nutritional status and early intervention for successful postoperative rehabilitation.
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ISSN:0261-5614
1532-1983
DOI:10.1016/j.clnu.2016.08.021