Impact of nutritional risk scores on clinical outcomes in elderly patients with hip fracture without PN EN support: a prospective cohort study / 中华临床营养杂志

ABSTRACT

Objective To investigate the prevalence of nutritional risk and undernutrition of geriatric patients with hip fracture in the department of orthopaedics and analyze the relationship between nutritional risk scores and clinical outcomes.Methods In this prospective cohort study,the baseline demographic data of 235 elderly patients with hip fracture in the department of orthopaedics of Ningbo First Hospital were consecutively recorded from November 2013 to December 2015.The prevalence of nutritional risk and undernutrition,infectious complications,and length of hospital stay were also recorded.The infectious complications and length of hospital stay in patients in different age groups(60-69 years,70-79 years,and ≥80 years)and those with different nutritional risks(<3 points,3-4 points,and ≥5 points)were analyzed.Results All patients without PN EN support during hospitalized durations.The incidence of nutritional risk was 62.98％in 235 elderly patients with hip fracture,twenty patients were undernutritioned by multi-item standard based on Nutritional Risk Screening 2002 nutrition disorder score,and 15 patients were undernutritioned by one-item standard with body mass index.Hip arthroplasty patients had significantly higher nutritional risk than those who had undergone internal fixation(74.04％vs.54.20％,P=0.002).Patients with comorbidities had significantly higher nutritional risk than patients without comorbidities(71.56％vs.55.56％,P=0.011).There were significant differences in infectious complications(2.30％vs.3.91％vs.50.00％)and length of hospital stay[(6.35±0.87)d vs.(8.12±1.13)d vs.(10.85±1.52)d,(8.66±2.06)d vs.(10.45±2.43)d vs.(13.25 ±3.65)d] among patients with different nutritional risks(<3 points,3-4 points,and ≥5 points)(P=0.000).Conclusions Elderly patients with hip fracture has relatatively high nutritional risk.These patients tend to have more complications and longer hospital stay.