Malnutrition = Poor Hip Fracture Outcomes

The poorer the nutrition, says a new retrospective, multicenter study of hip fracture surgery, the worse the outcomes.

Researchers looked at 12,373 patients who underwent hip fracture surgery from 2006 to 2013 (National Surgery Quality Improvement Project data). Their work, “Increasing Severity of Malnutrition Is Associated With Poorer 30-Day Outcomes in Patients Undergoing Hip Fracture Surgery,” is published in the April 2018 edition of the Journal of Orthopaedic Trauma.

Andrew S. Chung, D.O., with the Department of Orthopedic Surgery at Mayo Clinic-Arizona in Phoenix and co-author on this study, told OTW, “The annual incidence of hip fractures is estimated at 340,000 in the United States and with the aging population, represents a growing economic problem.”

“The majority of these fractures occur in the geriatric population. Unfortunately, many of these patients concomitantly are at high risk of being malnourished.”

“While serum albumin is not the most accurate measure of nutritional status, hypoalbuminemia has long been considered a quick and cost-effective surrogate measure of malnutrition. While previous studies have outlined the deleterious effects of poor nutritional status on hip fracture outcomes, no large multi-center study, that we are aware of, has previously stratified outcomes based on the severity of hypoalbuminemia.”

“We found that increasing severity of malnutrition was associated with progressively poorer 30-day outcomes following hip fracture surgery. Translated clinically, this represents a useful measure by which to identify patients who may require closer multi-disciplinary monitoring and more aggressive peri-operative nutritional optimization. The ramifications of this study very likely extend outside the realm of hip fracture surgery to other orthopedic surgical settings as well.”

“The information presented in this study offers yet another risk assessment tool that should be utilized in both the surgical decision-making process and during the discussion of risks and benefits that occurs pre-operatively between surgeon and patient.”