Mini Nutritional Assessment predicts gait status and mortality 6 months after hip fracture

• Published in: British journal of nutrition Vol. 109; no. 9; pp. 1657 - 1661
• Main Authors: Gumieiro, David N., Rafacho, Bruna P. M., Gonçalves, Andrea F., Tanni, Suzana E., Azevedo, Paula S., Sakane, Daniel T., Carneiro, Carlos A. S., Gaspardo, David, Zornoff, Leonardo A. M., Pereira, Gilberto J. C., Paiva, Sergio A. R., Minicucci, Marcos F.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 14.05.2013
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Feeding. Feeding behavior; Female; Fractures; Fundamental and applied biological sciences. Psychology; Gait; Hip Fractures - mortality; Hip Fractures - physiopathology; Hip joint; Human and Clinical Nutrition; Humans; Male; Mortality; Nutrition; Nutrition Assessment; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Hip fractures; Nutritional Risk Screening 2002; Mini Nutritional Assessment; American Society of Anesthesiologists Physical Status Score; Nutrition; Mortality; Diseases of the osteoarticular system; Risk; Fracture; Medical screening; American Society of Anesthesiologists Physical Status Score: Nutritional Risk Screening 2002; Trauma; Hip; Physical handicap; Analysis method; Risk factor; Nutritional status
• ISSN: 0007-1145; 1475-2662
• DOI: 10.1017/S0007114512003686

The aim of the present study was to evaluate the Mini Nutritional Assessment (MNA), the Nutritional Risk Screening (NRS) 2002 and the American Society of Anesthesiologists Physical Status Score (ASA) as predictors of gait status and mortality 6 months after hip fracture. A total of eighty-eight consecutive patients over the age of 65 years with hip fracture admitted to an orthopaedic unit were prospectively evaluated. Within the first 72 h of admission, each patient's characteristics were recorded, and the MNA, the NRS 2002 and the ASA were performed. Gait status and mortality were evaluated 6 months after hip fracture. Of the total patients, two were excluded because of pathological fractures. The remaining eighty-six patients (aged 80·2 (sd 7·3) years) were studied. Among these patients 76·7 % were female, 69·8 % walked with or without support and 12·8 % died 6 months after the fracture. In a multivariate analysis, only the MNA was associated with gait status 6 months after hip fracture (OR 0·773, 95 % CI 0·663, 0·901; P= 0·001). In the Cox regression model, only the MNA was associated with mortality 6 months after hip fracture (hazard ratio 0·869, 95 % CI 0·757, 0·998; P= 0·04). In conclusion, the MNA best predicts gait status and mortality 6 months after hip fracture. These results suggest that the MNA should be included in the clinical stratification of patients with hip fracture to identify and treat malnutrition in order to improve the outcomes.