Does nutritional intervention for patients with hip fractures reduce postoperative complications and improve rehabilitation?

Abstract

Aims and objectives: The aims were to investigate whether there were any differences between patients receiving nutritional intervention preoperatively and over five days postoperatively and patients who did not, in terms of postoperative complications, rehabilitation, length of stay and food and liquid intake.

Background: Patients with hip fractures are often malnourished at admission to hospital and they typically do not receive the energy and calories needed postoperatively.

Design: The design was a quasi-experimental, pre- and post-test comparison group design without random group assignment.

Methods: One hundred patients with hip fractures were consecutively included. The control group (n = 50) received regular nutritional support. The intervention group (n = 50) received nutrition according to nutritional guidelines. The outcome measures used were risk of pressure ulcer, pressure ulcers, weight, nosocomial infections, cognitive ability, walking assistance and functional ability, collected preoperatively and five days postoperatively. Each patient's nutrient and liquid intake were assessed daily for five days postoperatively.

Results: Significantly fewer (p = 0.043) patients in the intervention group (18%) had pressure ulcers five days postoperatively compared with the control group (36%). Nutrient and liquid intake was significantly higher (p < 0.001) in the intervention group. Median length of stay decreased from nine to seven days (p = 0.137), as did nosocomial infections, from 18-8.7% (p = 0.137).

Conclusion: Patients with hip fractures receiving nutrition according to nutritional guidelines developed fewer pressure ulcers. This is invaluable to patients' quality of life and a major economic saving for society.

Relevance to clinical practice: Great benefits can be gained for the patients through modest efforts by nurses and physicians such as nutritional intervention.