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Influence of Malnutrition on Clinical Outcomes in Patients With Hip Fractures in a Trauma Unit: An Observational
Li Cheng Chong1, Alia Shaaban1, Oday Al-Dadah1,2
1Department of Trauma and Orthopaedic Surgery, South Tyneside District Hospital, South Shields, GBR.
Introduction:
Hip fractures are most prevalent in the elderly population, who are also at high risk of malnutrition. Malnutrition is a significant risk factor for poor functional recovery and a higher risk of mortality. This study aimed to evaluate the influence of nutrition status on clinical outcomes in patients with hip fractures.
Methods:
An observational study of all patients with hip fractures in the year 2020 admitted to South Tyneside District Hospital, a district general hospital trauma unit in South Shields, England, was conducted. Data collected included patient demographics, nutrition status (Malnutrition Universal Screening Tool (MUST)), body mass index (BMI), mortality, biochemical markers, delirium score, acute kidney injury (AKI) status, time to surgery, and length of hospital stay. Results: A total of 188 patients were included in this study. Normal nutrition was observed in 137 patients (73%), whilst 51 patients (27%) were categorized as at risk of malnutrition. The latter group comprised older patients (p=0.005). Patients at risk of malnutrition demonstrated an increased rate of mortality (p<0.001), with mortality rates at 63% as compared to 30% for patients with normal nutrition. They were also associated with increased risk for the development of delirium (p=0.001) and length of hospital stay (p=0.034) as compared to patients with normal nutrition. There was a significant between-group difference of serum albumin, CRP, estimated glomerular filtration rate (eGFR), and urea (p<0.05).
Conclusion:
The majority of patients with hip fractures were elderly females with multiple comorbidities. Approximately one-quarter of patients were deemed at risk of malnutrition. Advanced age significantly contributed to developing malnutrition, which in turn increased the rate of mortality, delirium, and length of hospital stay. Early nutritional assessment and intervention are paramount in reducing the associated risks and enhancing clinical outcomes.
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