The effect of unselected post-operative nutritional supplementation on nutritional status and clinical outcome of orthopaedic patients

Background and aims: Nutritional supplements are widely administered in hospitals and can benefit clinical outcome. The aim here was to determine the effect of routine post-operative nutritional supplementation on the nutritional status and clinical outcome of adult orthopaedic patients. Methods: A prospective controlled study was conducted on two adult orthopaedic wards. Patients in the study group were prescribed two nutritional supplements/day post-operatively. Nutritional and biochemical indices and incidence of clinical complications were observed. Results: Of 181 patients studied, 14 in the supplemented group and 34 in the control ( P=0.005) developed major complications. There were 22 occurrences of major complications in the supplemented group and 55 in the control ( P=0.0002). There was no significant difference in the number of minor complications between the two groups ( P=0.2). There was no statistical difference in changes in nutritional parameters or in albumin or CRP between the two groups. There were significantly greater reductions in transferrin ( P=0.002) and in haemoglobin ( P=0.002) in the control group at week 1. The median costs of hospital stay were £2068 in the supplemented group and £2199 in the control. The median cost of additional treatments was £30.16 in the supplemented group and £46.23 in the control. Conclusion: A significant reduction in major complications and in number and costs of additional treatments was seen in the supplemented group.