Nutritional status as independent prognostic factor of outcome and mortality until five years after hip fracture: a comprehensive prospective study
Summary We determined the prognostic value of nutritional status for outcome after hip fracture. Nutritional status was a strong independent prognostic factor for clinical outcome and 5-year mortality. Physical function showed incomplete recovery. Elderly care should focus on prevention already befo...
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| Veröffentlicht in: | Osteoporosis international 2024-07, Vol.35 (7), p.1273-1287 |
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| creator | Dagnelie, P.C. Willems, P.C. Jørgensen, N.R. |
| description | Summary
We determined the prognostic value of nutritional status for outcome after hip fracture. Nutritional status was a strong independent prognostic factor for clinical outcome and 5-year mortality. Physical function showed incomplete recovery. Elderly care should focus on prevention already before hip fracture.
Purpose
To determine the prognostic value of nutritional status in hip fracture patients for multiple clinical and functional outcomes over 6 months, and for new fractures and survival over 5 years post-fracture.
Methods
We included 152 well-characterized subjects (age 55+ years) with a hip fracture from a previously published randomized controlled trial. Nutritional status was appraised using the Mini Nutritional Assessment (MNA). Multivariable linear, logistic and Cox regression models were fitted, adjusted for age, sex, ASA score, group and additional prognostic covariates identified in backward regression models.
Results
At baseline, impaired nutritional status was significantly associated with physical disability, depression, impaired cognition and lower quality of life. Prospective analyses showed that impaired baseline nutritional status was an independent prognostic factor for postoperative complications (OR 2.00, 95%CI 1.01–3.98,
p
= 0.047), discharge location from hospital (home vs. rehabilitation clinic, OR 0.41, 95%CI 0.18–0.98,
p
= 0.044), hospital readmission (OR 4.59, 95%CI 1.70–12.4,
p
= 0.003) and total length of hospital stay (HR of being discharged: 0.63, 96%CI 0.44–0.89,
p
= 0.008), as well as for 5-year mortality (HR 3.94, 95%CI 1.53–10.2,
p
= 0.005), but not for risk of new fractures (5y-HR 0.87, 95%CI 0.34–2.24,
p
= 0.769). Curves of physical disability over time showed that the three nutritional status categories followed almost parallel trajectories from baseline until 6 months after hip fracture, without complete recovery and even with further deterioration in malnourished subjects from 3 to 6 months post-fracture.
Conclusion
As baselline nutritional status is a strong independent prognostic factor for clinical outcome after hip fracture, affecting even five-year survival, elderly health care should focus on prevention and identification of at-risk individuals already before hip fracture. |
| doi_str_mv | 10.1007/s00198-024-07088-3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3056670072</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3056670072</sourcerecordid><originalsourceid>FETCH-LOGICAL-c419t-6c95071036477e675031251b7f2c445698424393e7afe16b19543cb2513faf273</originalsourceid><addsrcrecordid>eNp9kc2OFCEUhYnROD2tL-DCkLhxU8pfQeHOTHQ0mehGE3eEpi8zTKqg5GeSfg5fWNoeNXHhBkj4zrlwDkLPKHlFCVGvCyFUTwNhYiCKTNPAH6ANFZwPTMvxIdoQzdWgBf12hs5LuSVdpLV6jM74pCQZidigH59azaGGFO2MS7W1FWwLDnEPK_QlVrzmdB1TqcFhb11NGSePU6suLYBt3OMl5WrnUA-4xRpm7MMd4APY3K18hYxvwop97tqW4Q22uCvXDDcQy5Hs_mUFV4_nUtv-8AQ98nYu8PR-36Kv7999ufgwXH2-_Hjx9mpwguo6SKdHoijhUigFUo2EUzbSnfLMCTFKPQkmuOagrAcqd1SPgrtdR7i3nim-RS9Pvv0F3xuUapZQHMyzjZBaMZyMUqoeGuvoi3_Q29Ryz-xIKaaJED34LWInyvUvlQzerDksNh8MJeZYmTlVZnpl5ldlhnfR83vrtltg_0fyu6MO8BNQ-lW8hvx39n9sfwLdcaNZ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3072904414</pqid></control><display><type>article</type><title>Nutritional status as independent prognostic factor of outcome and mortality until five years after hip fracture: a comprehensive prospective study</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Dagnelie, P.C. ; Willems, P.C. ; Jørgensen, N.R.</creator><creatorcontrib>Dagnelie, P.C. ; Willems, P.C. ; Jørgensen, N.R.</creatorcontrib><description>Summary
We determined the prognostic value of nutritional status for outcome after hip fracture. Nutritional status was a strong independent prognostic factor for clinical outcome and 5-year mortality. Physical function showed incomplete recovery. Elderly care should focus on prevention already before hip fracture.
Purpose
To determine the prognostic value of nutritional status in hip fracture patients for multiple clinical and functional outcomes over 6 months, and for new fractures and survival over 5 years post-fracture.
Methods
We included 152 well-characterized subjects (age 55+ years) with a hip fracture from a previously published randomized controlled trial. Nutritional status was appraised using the Mini Nutritional Assessment (MNA). Multivariable linear, logistic and Cox regression models were fitted, adjusted for age, sex, ASA score, group and additional prognostic covariates identified in backward regression models.
Results
At baseline, impaired nutritional status was significantly associated with physical disability, depression, impaired cognition and lower quality of life. Prospective analyses showed that impaired baseline nutritional status was an independent prognostic factor for postoperative complications (OR 2.00, 95%CI 1.01–3.98,
p
= 0.047), discharge location from hospital (home vs. rehabilitation clinic, OR 0.41, 95%CI 0.18–0.98,
p
= 0.044), hospital readmission (OR 4.59, 95%CI 1.70–12.4,
p
= 0.003) and total length of hospital stay (HR of being discharged: 0.63, 96%CI 0.44–0.89,
p
= 0.008), as well as for 5-year mortality (HR 3.94, 95%CI 1.53–10.2,
p
= 0.005), but not for risk of new fractures (5y-HR 0.87, 95%CI 0.34–2.24,
p
= 0.769). Curves of physical disability over time showed that the three nutritional status categories followed almost parallel trajectories from baseline until 6 months after hip fracture, without complete recovery and even with further deterioration in malnourished subjects from 3 to 6 months post-fracture.
Conclusion
As baselline nutritional status is a strong independent prognostic factor for clinical outcome after hip fracture, affecting even five-year survival, elderly health care should focus on prevention and identification of at-risk individuals already before hip fracture.</description><identifier>ISSN: 0937-941X</identifier><identifier>ISSN: 1433-2965</identifier><identifier>EISSN: 1433-2965</identifier><identifier>DOI: 10.1007/s00198-024-07088-3</identifier><identifier>PMID: 38760504</identifier><language>eng</language><publisher>London: Springer London</publisher><subject>Aged ; Aged, 80 and over ; Cognition ; Complications ; Endocrinology ; Female ; Fractures ; Geriatric Assessment - methods ; Hip ; Hip Fractures - mortality ; Hip Fractures - physiopathology ; Hip Fractures - rehabilitation ; Hip Fractures - surgery ; Hip joint ; Humans ; Male ; Malnutrition ; Medical prognosis ; Medicine ; Medicine & Public Health ; Middle Aged ; Mortality ; Nutrition Assessment ; Nutritional Status ; Original Article ; Orthopedics ; Osteoporotic Fractures - mortality ; Osteoporotic Fractures - physiopathology ; Postoperative ; Postoperative Complications ; Prognosis ; Prospective Studies ; Quality of Life ; Recovery of function ; Regression analysis ; Rheumatology ; Survival</subject><ispartof>Osteoporosis international, 2024-07, Vol.35 (7), p.1273-1287</ispartof><rights>The Author(s) 2024</rights><rights>2024. The Author(s).</rights><rights>The Author(s) 2024. This work is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c419t-6c95071036477e675031251b7f2c445698424393e7afe16b19543cb2513faf273</citedby><cites>FETCH-LOGICAL-c419t-6c95071036477e675031251b7f2c445698424393e7afe16b19543cb2513faf273</cites><orcidid>0000-0003-1767-8814</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00198-024-07088-3$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00198-024-07088-3$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>314,778,782,27907,27908,41471,42540,51302</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38760504$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dagnelie, P.C.</creatorcontrib><creatorcontrib>Willems, P.C.</creatorcontrib><creatorcontrib>Jørgensen, N.R.</creatorcontrib><title>Nutritional status as independent prognostic factor of outcome and mortality until five years after hip fracture: a comprehensive prospective study</title><title>Osteoporosis international</title><addtitle>Osteoporos Int</addtitle><addtitle>Osteoporos Int</addtitle><description>Summary
We determined the prognostic value of nutritional status for outcome after hip fracture. Nutritional status was a strong independent prognostic factor for clinical outcome and 5-year mortality. Physical function showed incomplete recovery. Elderly care should focus on prevention already before hip fracture.
Purpose
To determine the prognostic value of nutritional status in hip fracture patients for multiple clinical and functional outcomes over 6 months, and for new fractures and survival over 5 years post-fracture.
Methods
We included 152 well-characterized subjects (age 55+ years) with a hip fracture from a previously published randomized controlled trial. Nutritional status was appraised using the Mini Nutritional Assessment (MNA). Multivariable linear, logistic and Cox regression models were fitted, adjusted for age, sex, ASA score, group and additional prognostic covariates identified in backward regression models.
Results
At baseline, impaired nutritional status was significantly associated with physical disability, depression, impaired cognition and lower quality of life. Prospective analyses showed that impaired baseline nutritional status was an independent prognostic factor for postoperative complications (OR 2.00, 95%CI 1.01–3.98,
p
= 0.047), discharge location from hospital (home vs. rehabilitation clinic, OR 0.41, 95%CI 0.18–0.98,
p
= 0.044), hospital readmission (OR 4.59, 95%CI 1.70–12.4,
p
= 0.003) and total length of hospital stay (HR of being discharged: 0.63, 96%CI 0.44–0.89,
p
= 0.008), as well as for 5-year mortality (HR 3.94, 95%CI 1.53–10.2,
p
= 0.005), but not for risk of new fractures (5y-HR 0.87, 95%CI 0.34–2.24,
p
= 0.769). Curves of physical disability over time showed that the three nutritional status categories followed almost parallel trajectories from baseline until 6 months after hip fracture, without complete recovery and even with further deterioration in malnourished subjects from 3 to 6 months post-fracture.
Conclusion
As baselline nutritional status is a strong independent prognostic factor for clinical outcome after hip fracture, affecting even five-year survival, elderly health care should focus on prevention and identification of at-risk individuals already before hip fracture.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cognition</subject><subject>Complications</subject><subject>Endocrinology</subject><subject>Female</subject><subject>Fractures</subject><subject>Geriatric Assessment - methods</subject><subject>Hip</subject><subject>Hip Fractures - mortality</subject><subject>Hip Fractures - physiopathology</subject><subject>Hip Fractures - rehabilitation</subject><subject>Hip Fractures - surgery</subject><subject>Hip joint</subject><subject>Humans</subject><subject>Male</subject><subject>Malnutrition</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Nutrition Assessment</subject><subject>Nutritional Status</subject><subject>Original Article</subject><subject>Orthopedics</subject><subject>Osteoporotic Fractures - mortality</subject><subject>Osteoporotic Fractures - physiopathology</subject><subject>Postoperative</subject><subject>Postoperative Complications</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Quality of Life</subject><subject>Recovery of function</subject><subject>Regression analysis</subject><subject>Rheumatology</subject><subject>Survival</subject><issn>0937-941X</issn><issn>1433-2965</issn><issn>1433-2965</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><recordid>eNp9kc2OFCEUhYnROD2tL-DCkLhxU8pfQeHOTHQ0mehGE3eEpi8zTKqg5GeSfg5fWNoeNXHhBkj4zrlwDkLPKHlFCVGvCyFUTwNhYiCKTNPAH6ANFZwPTMvxIdoQzdWgBf12hs5LuSVdpLV6jM74pCQZidigH59azaGGFO2MS7W1FWwLDnEPK_QlVrzmdB1TqcFhb11NGSePU6suLYBt3OMl5WrnUA-4xRpm7MMd4APY3K18hYxvwop97tqW4Q22uCvXDDcQy5Hs_mUFV4_nUtv-8AQ98nYu8PR-36Kv7999ufgwXH2-_Hjx9mpwguo6SKdHoijhUigFUo2EUzbSnfLMCTFKPQkmuOagrAcqd1SPgrtdR7i3nim-RS9Pvv0F3xuUapZQHMyzjZBaMZyMUqoeGuvoi3_Q29Ryz-xIKaaJED34LWInyvUvlQzerDksNh8MJeZYmTlVZnpl5ldlhnfR83vrtltg_0fyu6MO8BNQ-lW8hvx39n9sfwLdcaNZ</recordid><startdate>20240701</startdate><enddate>20240701</enddate><creator>Dagnelie, P.C.</creator><creator>Willems, P.C.</creator><creator>Jørgensen, N.R.</creator><general>Springer London</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7TS</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1767-8814</orcidid></search><sort><creationdate>20240701</creationdate><title>Nutritional status as independent prognostic factor of outcome and mortality until five years after hip fracture: a comprehensive prospective study</title><author>Dagnelie, P.C. ; Willems, P.C. ; Jørgensen, N.R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c419t-6c95071036477e675031251b7f2c445698424393e7afe16b19543cb2513faf273</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cognition</topic><topic>Complications</topic><topic>Endocrinology</topic><topic>Female</topic><topic>Fractures</topic><topic>Geriatric Assessment - methods</topic><topic>Hip</topic><topic>Hip Fractures - mortality</topic><topic>Hip Fractures - physiopathology</topic><topic>Hip Fractures - rehabilitation</topic><topic>Hip Fractures - surgery</topic><topic>Hip joint</topic><topic>Humans</topic><topic>Male</topic><topic>Malnutrition</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Nutrition Assessment</topic><topic>Nutritional Status</topic><topic>Original Article</topic><topic>Orthopedics</topic><topic>Osteoporotic Fractures - mortality</topic><topic>Osteoporotic Fractures - physiopathology</topic><topic>Postoperative</topic><topic>Postoperative Complications</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Quality of Life</topic><topic>Recovery of function</topic><topic>Regression analysis</topic><topic>Rheumatology</topic><topic>Survival</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dagnelie, P.C.</creatorcontrib><creatorcontrib>Willems, P.C.</creatorcontrib><creatorcontrib>Jørgensen, N.R.</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Physical Education Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Osteoporosis international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dagnelie, P.C.</au><au>Willems, P.C.</au><au>Jørgensen, N.R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Nutritional status as independent prognostic factor of outcome and mortality until five years after hip fracture: a comprehensive prospective study</atitle><jtitle>Osteoporosis international</jtitle><stitle>Osteoporos Int</stitle><addtitle>Osteoporos Int</addtitle><date>2024-07-01</date><risdate>2024</risdate><volume>35</volume><issue>7</issue><spage>1273</spage><epage>1287</epage><pages>1273-1287</pages><issn>0937-941X</issn><issn>1433-2965</issn><eissn>1433-2965</eissn><abstract>Summary
We determined the prognostic value of nutritional status for outcome after hip fracture. Nutritional status was a strong independent prognostic factor for clinical outcome and 5-year mortality. Physical function showed incomplete recovery. Elderly care should focus on prevention already before hip fracture.
Purpose
To determine the prognostic value of nutritional status in hip fracture patients for multiple clinical and functional outcomes over 6 months, and for new fractures and survival over 5 years post-fracture.
Methods
We included 152 well-characterized subjects (age 55+ years) with a hip fracture from a previously published randomized controlled trial. Nutritional status was appraised using the Mini Nutritional Assessment (MNA). Multivariable linear, logistic and Cox regression models were fitted, adjusted for age, sex, ASA score, group and additional prognostic covariates identified in backward regression models.
Results
At baseline, impaired nutritional status was significantly associated with physical disability, depression, impaired cognition and lower quality of life. Prospective analyses showed that impaired baseline nutritional status was an independent prognostic factor for postoperative complications (OR 2.00, 95%CI 1.01–3.98,
p
= 0.047), discharge location from hospital (home vs. rehabilitation clinic, OR 0.41, 95%CI 0.18–0.98,
p
= 0.044), hospital readmission (OR 4.59, 95%CI 1.70–12.4,
p
= 0.003) and total length of hospital stay (HR of being discharged: 0.63, 96%CI 0.44–0.89,
p
= 0.008), as well as for 5-year mortality (HR 3.94, 95%CI 1.53–10.2,
p
= 0.005), but not for risk of new fractures (5y-HR 0.87, 95%CI 0.34–2.24,
p
= 0.769). Curves of physical disability over time showed that the three nutritional status categories followed almost parallel trajectories from baseline until 6 months after hip fracture, without complete recovery and even with further deterioration in malnourished subjects from 3 to 6 months post-fracture.
Conclusion
As baselline nutritional status is a strong independent prognostic factor for clinical outcome after hip fracture, affecting even five-year survival, elderly health care should focus on prevention and identification of at-risk individuals already before hip fracture.</abstract><cop>London</cop><pub>Springer London</pub><pmid>38760504</pmid><doi>10.1007/s00198-024-07088-3</doi><tpages>15</tpages><orcidid>https://orcid.org/0000-0003-1767-8814</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Osteoporosis international, 2024-07, Vol.35 (7), p.1273-1287 |
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| language | eng |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Aged Aged, 80 and over Cognition Complications Endocrinology Female Fractures Geriatric Assessment - methods Hip Hip Fractures - mortality Hip Fractures - physiopathology Hip Fractures - rehabilitation Hip Fractures - surgery Hip joint Humans Male Malnutrition Medical prognosis Medicine Medicine & Public Health Middle Aged Mortality Nutrition Assessment Nutritional Status Original Article Orthopedics Osteoporotic Fractures - mortality Osteoporotic Fractures - physiopathology Postoperative Postoperative Complications Prognosis Prospective Studies Quality of Life Recovery of function Regression analysis Rheumatology Survival |
| title | Nutritional status as independent prognostic factor of outcome and mortality until five years after hip fracture: a comprehensive prospective study |
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