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Low postoperative dietary intake is associated with worse functional course in geriatric patients up to 6 months after hip fracture§

  • Sabine Goisser (a1), Eva Schrader (a1), Katrin Singler (a1) (a2), Thomas Bertsch (a3), Olaf Gefeller (a4), Roland Biber (a5), Hermann-Josef Bail (a5), Cornel C. Sieber (a1) (a6) and Dorothee Volkert (a1)...

Abstract

We examined the relationship between postoperative dietary intake (DI) of geriatric hip fracture (HF) patients and their functional and clinical course until 6 months after hospital discharge. In eighty-eight HF patients ≥ 75 years, postoperative DI was estimated with plate diagrams of main meals over four postoperative days. DI was stratified as >50, >25–50, ≤ 25 % of meals served. Functional status according to Barthel index (activities of daily living) and patients' mobility level before fracture, postoperatively, at discharge and 6 months later were assessed and related to DI levels. In-hospital complications were recorded according to clinical diagnosis. Associations were evaluated using χ2 and Kruskal–Wallis tests, and repeated-measures ANOVA and ANCOVA. Postoperatively, 28 % of participants ate >50 %, 43 % ate >25–50 % and 28 % ≤ 25 % of meals served. Irrespective of pre-fracture functional status, patients with DI ≤ 25 % had significantly lower Barthel index scores at all times after surgery (all P< 0·05) and ANOVA revealed a significant time × DI interaction effect (P= 0·047) on development of Barthel index scores that remained significant after adjustment for potential confounders. Patients with DI >50 % more often had regained their pre-fracture mobility level than those with DI ≤ 25 % at discharge (>50 %: 36 %; >25–50 %: 10 %; ≤ 25 %: 0 %; P= 0·001) and 6 months after discharge (88; 87; 68 %; P= 0·087) and had significantly less complications (median 2 (25th–75th percentile 1–3); 3 (25th–75th percentile 2–4); 3 (25th–75th percentile 3–4); P= 0·012). To conclude, geriatric HF patients had very low postoperative voluntary DI and thus need specific nutritional interventions to achieve adequate DI to support functional and clinical recovery.

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Corresponding author

* Corresponding author: S. Goisser, fax +49 911 53 02 96 151, email sabine.goisser@fau.de

References

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Keywords

Low postoperative dietary intake is associated with worse functional course in geriatric patients up to 6 months after hip fracture§

  • Sabine Goisser (a1), Eva Schrader (a1), Katrin Singler (a1) (a2), Thomas Bertsch (a3), Olaf Gefeller (a4), Roland Biber (a5), Hermann-Josef Bail (a5), Cornel C. Sieber (a1) (a6) and Dorothee Volkert (a1)...

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