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Relationship between postoperative dietary intake and walking ability among older adults with hip fractures: A
Hikaru Kobayashi1, Koutatsu Nagai2, Yasuhiro Shimamura3
1Department of Rehabilitation, Kobe City Nishi-Kobe Medical Center, Kobe, Japan.
Objective:
This study aimed to determine whether total dietary intake assessed in the acute phase after hip fracture surgery is associated with walking ability.
Design:
The retrospective observational study.
Setting:
A single institution.
Participants:
Patients with hip fractures aged ≥65 years.
Main Measures:
Dietary intake was recorded daily on an 11-point scale using visual plate waste. The primary outcome was walking ability, which was assessed using functional ambulation categories at discharge. We categorised the patients into those with improved walking ability (functional ambulation categories score ≥3) and those without (<3). Cox proportional hazard models were used to estimate hazard ratios and 95% confidence intervals for functional ambulation categories according to total dietary intake during acute hospitalisation.
Results:
In total, 182 patients were included with a median age of 85 years; 73.6% were women. The median dietary intake during the first week after surgery, the second postoperative week, and throughout the postoperative period were 24.5, 28.4, and 27.1 kcal, respectively. After adjusting for potential confounders, high total dietary intake (hazard ratio, 1.05; 95% confidence intervals, 1.02-1.09; P = .006) and high dietary intake after the second week (hazard ratio, 1.04; 95% confidence intervals, 1.01-1.08; P = .017) were associated with walking ability.
Conclusions:
Total dietary intake was associated with walking ability at discharge during the acute postoperative period after hip fracture. Dietary intake following the second postoperative week may play a significant role in the recovery of walking ability.
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