Effect of postoperative nutritional supplementation on the reduction of clinical complications in geriatric patients with hip fracture: a retrospective study in a hospital setting
e202610082
DOI:
https://doi.org/10.67113/resp.v100i1.1315Keywords:
Hip fracture, Aging, Supplementation, Drugs, Bone, NutritionAbstract
BACKGROUND // The high incidence of hip fractures among the elderly population in Spain, with an estimated 50,000 to 60,000 cases annually, represents a serious public health issue due to high mortality rates and associated complications, particularly in malnourished patients. The objective of this paper was to assess the effectiveness of nutritional supplementation as part of postoperative treatment in elderly patients with hip fractures.
METHODS // A study was conducted at the University Hospital of León with a sample of 497 patients aged between seventy-five and one hundred five years. Clinical records were used to collect data on functional status prior to the fracture, nutritional support, and clinical outcomes. Statistical analysis was performed to identify associations between nutritional supplementation and the occurrence of postoperative complications.
RESULTS // Protein supplements were prescribed more frequently to patients who were completely dependent (27.1 %) and to those who required a great deal of assistance to walk or were unable to walk (25.5 %), with statistically significant associations (P=0.001 and P=0.005, respectively). Furthermore, their prescription was significantly associated with complications during hospitalisation, such as the need for a blood transfusion (P<0.001), respiratory failure (P<0.001), heart failure (P<0.001) and malnutrition (P<0.001).
CONCLUSIONS // The prescription of nutritional supplements on discharge was more common among patients with greater functional dependence and who had experienced complications during their hospital stay. No significant differences were observed by gender. These results reinforce the importance of an individualised nutritional assessment in older people with hip fractures.
Downloads
References
1. Azagra R, López-Expósito F, Martin-Sánchez JC, Aguyé-Batista A, Gabriel-Escoda P, Zwart M et al. Incidence of hip fracture in Spain (1997-2010). Med Clin (Barc). 2015;145(11):465-470. https://doi.org/10.1016/j.medcle.2016.04.001
2. Hu Y, Yang MA. A predictive scoring system for postoperative delirium in the elderly patients with intertrochanteric fracture. BMC Surg. 2023;23(1):1-8. https://doi.org/10.1186/s12893-023-02065-9
3. Pérez Durillo FT, Ruiz López MD, Bouzas PR, Martín-Lagos YA. Estado nutricional en ancianos con fractura de cadera. Nutr Hosp. 2010;25(4):676-681. https://doi.org/10.3305/nh.2010.25.4.4479
4. Frandsen CF, Glassou EN, Stilling M, Hansen TB. Malnutrition, poor function and comorbidities predict mortality up to one year after hip fracture: A cohort study of 2800 patients. Eur Geriatr Med. 2022;13:433-443. https://doi.org/10.1007/s41999-021-00598-x
5. Chen B, Zhang JH, Duckworth AD, Clement ND. Effect of oral nutritional supplementation on outcomes in older adults with hip fractures and factors influencing compliance: a systematic review and meta-analysis of randomized controlled trials. Bone Joint J. 2023;115(11):1149-1158. https://doi.org/10.1302/1358-992x.2023.6.002
6. Arkley J, Dixon J, Wilson F, Charlton K, Ollivere BJ, Eardley W. Assessment of Nutrition and Supplementation in Patients With Hip Fractures. Geriatr Orthop Surg Rehabil. 2019;10:2151459319879804. https://doi.org/10.1177/2151459319879804
7. Bardales Mas Y, González-Montalvo JI, Abizanda Soler P, Alarcón T. Guías clínicas de fractura de cadera. Comparación de sus principales recomendaciones. Rev Esp Geriatr Gerontol. 2012;47(5):220-227. https://doi.org/10.1016/j.regg.2012.02.014
8. Takahashi K, Momosaki R, Yasufuku Y, Nakamura N, Maeda K. Nutritional therapy in older patients with hip fractures undergoing rehabilitation: a systematic review and meta-analysis. J Am Med Dir Assoc. 2020;21(9):1364-1364. https://doi.org/10.1016/j.jamda.2020.07.005
9. Bell JJ, Bauer JD, Capra S, Pulle RC. Multidisciplinary, multi-modal nutritional care in acute hip fracture inpatients-results of a pragmatic intervention. Clin Nutr. 2014;33(6):1101-1107. https://doi.org/10.1016/j.clnu.2013.12.003
10. Ekinci O, Yanlk S, Terzioglu Bebitoglu B, Yllmaz Akyüz E, Dokuyucu A, Erdem S. Effect of Calcium β-Hydroxy-β-Methylbutyrate (CaHMB), Vitamin D, and Protein Supplementation on Postoperative Immobilization in Malnourished Older Adult Patients with Hip Fracture. Nutr Clin Pract. 2016;31(6):829-835. https://doi.org/10.1177/0884533616629628
11. Bally MR, Yildirim PZB, Bounoure L, Gloy VL, Mueller B, Briel M et al. Nutritional support and outcomes in malnourished medical inpatients: a systematic review and meta-analysis. JAMA Intern Med. 2016;176(1):43-53. https://doi.org/10.1001/jamainternmed.2015.6587
12. Williams DGA, Ohnuma T, Haines KL, Krishnamoorthy V, Raghunathan K, Sulo S, Cassady BA, Hegazi R, Wischmeyer PE. Association between early postoperative nutritional supplement utilisation and length of stay in malnourished hip fracture patients. Br J Anaesth. 2021;126:730-737. https://doi.org/10.1016/j.bja.2020.12.026
13. Li HJ, Cheng HS, Liang J, Wu CC, Shyu YI. Functional recovery of older people with hip fracture: does malnutrition make a difference? J Adv Nurs. 2013;69(8):1691-1703. https://doi.org/10.1111/jan.12027
14. Avenell A, Smith TO, Curtain JP, Mak JC, Myint PK. Nutritional supplementation for hip fracture aftercare in older people. Cochrane Database Syst Rev. 2016;11(11):CD001880. https://doi.org/10.1002/14651858.cd001880.pub3
15. Chew STH, Tan NC, Cheong M, Oliver J, Baggs G, Choe Y et al. Impact of specialized oral nutritional supplement on clinical, nutritional, and functional outcomes: A randomized, placebo-controlled trial in community-dwelling older adults at risk of malnutrition. Clin Nutr. 2021;40(4):1879-1892. https://doi.org/10.1016/j.clnu.2020.10.015
16. Ashkenazi I, Rotman D, Amzalleg N, Graif N, Khoury A, Ben-Tov T et al. Efficacy of oral nutritional supplements in patients undergoing surgical intervention for hip fracture. Geriatr Orthop Surg Rehabil. 2022;20(13):21514593221102252. https://doi.org/10.1177/21514593221102
17. Bischoff SC, Escher J, Hébuterne X, Kłek S, Krznaric Ž, Schneider S et al. ESPEN guideline: clinical nutrition in inflammatory bowel disease. Nutr Hosp. 2022;39(3):678-703. https://doi.org/10.1177/21514593221102252
18. Volkert D, Beck AM, Cederholm T, Cruz-Jentoft A, Hooper L, Kiesswetter E et al. ESPEN practical guideline: Clinical nutrition and hydration in geriatrics. Clin Nutr. 2022;41(4):958-989. https://doi.org/10.1016/j.clnu.2022.01.024
Downloads
Additional Files
Published
How to Cite
License
Copyright (c) 2026 María Plaza-Carmona, Sonia Jiménez-Mola, Javier Idoate-Gil, Jesús Seco-Calvo
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Usted es libre de:
Compartir — copiar y redistribuir el material en cualquier medio o formato.
La licenciante no puede revocar estas libertades en tanto usted siga los términos de la licencia.
Bajo los siguientes términos:
Atribución — Usted debe dar crédito de manera adecuada , brindar un enlace a la licencia, e indicar si se han realizado cambios. Puede hacerlo en cualquier forma razonable, pero no de forma tal que sugiera que usted o su uso tienen el apoyo de la licenciante.
NoComercial — Usted no puede hacer uso del material con propósitos comerciales.
SinDerivadas — Si remezcla, transforma o crea a partir del material, no podrá distribuir el material modificado.
No hay restricciones adicionales — No puede aplicar términos legales ni medidas tecnológicas que restrinjan legalmente a otras a hacer cualquier uso permitido por la licencia.
Avisos:
No tiene que cumplir con la licencia para elementos del material en el dominio público o cuando su uso esté permitido por una excepción o limitación aplicable.
No se dan garantías. La licencia podría no darle todos los permisos que necesita para el uso que tenga previsto. Por ejemplo, otros derechos como publicidad, privacidad, o derechos morales pueden limitar la forma en que utilice el material.
![¿Cómo evaluar para la RESP? [PARA REVISORES]](https://ojs.sanidad.gob.es/public/site/images/rmartinb/pastilla-revisores-0eaa113abcbc4fc554c7c6c7840ca4c6.jpg)
![¿Cómo recibir avisos sobre nuevos artículos de la RESP? [PARA LECTORES]](https://ojs.sanidad.gob.es/public/site/images/rmartinb/pastilla-lectores-aa689338e95aab07df45b4b0d583188f.jpg)
