Abstract:
OBJECTIVE:To examine how improved attention to nutritional status and dietary intake, achieved through the employment of dietetic assistants (DAs), will affect postoperative clinical outcome among elderly women with hip fracture. DESIGN:Open prospective randomised controlled trial, comparing conventional nursing care with the additional nutritional support provided by DA. SETTING:Thirty-eight bedded acute trauma ward in a teaching hospital. PARTICIPANTS:All but 11 of 344 consecutive admissions with acute nonpathological hip fracture were approached. Three hundred and eighteen (93%) agreed to inclusion. Sixteen were ineligible as they were immediately transferred to another acute ward, were managed conservatively or died preoperatively. PRIMARY OUTCOME MEASURE:Postoperative mortality in the acute trauma unit. SECONDARY OUTCOME MEASURES:Postoperative mortality at 4 months after fracture, length of stay, energy intake and nutritional status. RESULTS:DA-supported participants were less likely to die in the acute ward (4.1 versus 10.1%, P = 0.048). This effect was still apparent at 4 month follow-up (13.1 versus 22.9%, P = 0.036). DA-supported subjects had significantly better mean daily energy intake (1,105 kcal versus 756 kcal/24 h, 95% CI 259-440 kcal/24 h, P<0.001), significantly smaller reduction in mid-arm circumference during their inpatient stay (0.39 cm, P = 0.002) and nonsignificantly favourable results for other anthropometric and laboratory measurements. CONCLUSION:Dietetic or nutrition assistants are being introduced in units across the UK. This, the largest ever study of nutritional support after hip fracture, shows that their employment significantly reduced patients' risk of dying in the acute trauma unit; an effect that persisted at 4 month follow-up.
journal_name
Age Ageingjournal_title
Age and ageingauthors
Duncan DG,Beck SJ,Hood K,Johansen Adoi
10.1093/ageing/afj011subject
Has Abstractpub_date
2006-03-01 00:00:00pages
148-53issue
2eissn
0002-0729issn
1468-2834pii
afj011journal_volume
35pub_type
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