Influence of Macro-nutrient Status on Recovery after Hip Fracture

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Abstract
The objective of this study was to evaluate the influence of macro-nutrient status on recovery in patients with hip fracture and to observe nutrition during 2 post-operative months. Fifty patients aged 70 years or older, admitted from their homes, were included. Weight index, triceps skinfolds thickness, arm-muscle circumference, serum albumin and transthyretin, body composition, food intake and functional state were determined on admission and 2 and 9 weeks later. On admission, 38% of the patients were regarded as protein-energy malnourished. Subsequent discharge to own homes or need of continued institutional care was not significantly influenced by admission values of nutritional status and body composition, but was related to mental state and social conditions before the fracture and post-operative functional state, including activities of daily living. Deterioration of nutritional status 9 weeks after fracture was significantly greater in the continuing care group than in the discharged patients. Macro-nutrient status at admission to hospital did not predict return to the patient's own home or need of continued institutional care. Nutritional deterioration in hospital seems to depend on the mental state and associated factors before the fracture, although these did not affect the pre-admission nutritional state. A more comprehensive programme of care is advocated.