Oral Nutrition Supplement Improved Nutritional Status in Malnourished Hip Fracture Patients: A Randomized Controlled Study

Abstract

Background: Nutritional status has been shown to predict post-surgical recovery and clinical outcomes in orthopedic patients. This study evaluated the effects of an oral nutrition supplement (ONS) in patients undergoing hip fracture surgery. Materials and Methods: In a multicenter, prospective, randomized study (ClincialTrials.gov, registration number NCT01011608), malnourished patients (n=127) who had surgery within 14 days of hip fracture and had screening serum albumin levels ≤ 38 g/L were enrolled. Patients in the ONS group were fed a calorically dense, high protein ONS, providing 798 kcal, 34 g protein/day for 28 days following surgery. Control patients received standard hospital diet only. Weight, nutritional and clinical markers were measured at Baseline, days 14 and 28. Suture status and functional recovery were evaluated on days 14 and 28.Means ± SEM are reported. Results: Baseline characteristics were similar between groups. On day 28, albumin level was improved in the ONS group (4.9±1.4 g/L) compared to the control group (1.2±1.0 g/L, p=0.054). A significant increase in prealbumin was observed in the ONS group (5.0±1.0 mg/dL) vs. control (1.0±1.2 mg/dL, p=0.007). Body weight increased in the ONS group (2.1±0.6 kg) but decreased in the control group (-0.8±0.8 kg; p=0.01). Conclusion: Supplementation of a nutritionally complete, calorically dense, high protein ONS for 28 days significantly improved nutritional status in mild to moderately malnourished patients undergoing hip fracture surgery.