Nutritional status and clinical outcome in elderly female surgical orthopaedic patients

• Published in: Clinical nutrition (Edinburgh, Scotland) Vol. 15; no. 3; pp. 101 - 108
• Main Authors: LUMBERS, M, DRIVER, L. T, HOWLAND, R. J, OLDER, M. W. J, WILLIAMS, C. M
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier 01.06.1996
• Subjects: Biological and medical sciences; Human physiology applied to population studies and life conditions. Human ecophysiology; Medical sciences; Nutritional survey. Food supply and nutritional requirement; Human; Femur; Nutrition; Force; Anthropometry; Diseases of the osteoarticular system; Trauma; Statistical study; Long term; Orthopedic surgery; Evolution; Clinical investigation; Subcapital fracture; Bone; Woman; Elderly; Nutritional status
• ISSN: 0261-5614; 1532-1983
• DOI: 10.1016/S0261-5614(96)80033-1

The possible relationship between nutritional status and clinical outcome following orthopaedic hip surgery was investigated. The nutritional status of 60 elderly female patients admitted for elective total hip replacement (THR) and emergency fractured neck of femur surgery (FNF) was measured over time. Specific measures of clinical outcome, including well-being and functional status, were monitored during hospital stay and at 4, 8 and 26 weeks following discharge. Patients were allocated to a high nutritional risk group where any three of the following were less than the 5th percentile value: serum albumin, haemoglobin, triceps skinfold thickness, mid-upper arm muscle circumference and body weight. Using this definition, malnutrition was present in 4% of THR patients and 41% of FNF patients. It was found that the high risk patients had significantly longer convalescence periods, (median stay 27.5 days compared with 0 days, P < 0.0009), and a greater proportion were dependent upon walking frames at 6 months (46% compared with 11%, P < 0.01). Fifty percent of the high risk patients had been living independently prior to admission, in contrast only 29% had returned to their homes at 6 months after discharge. The results indicate an apparent link between clinical outcome and nutritional status based upon the allocation procedure employed, which has the potential for ensuring cost-effective nutritional intervention.