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Most Hip fracture patients had low vitamin D and protein (needed for strong bones) – May 2017

Prevalence of malnutrition in a cohort of 509 patients with acute hip fracture: the importance of a comprehensive assessment.

European Journal of Clinical Nutrition advance online publication, 17 May 2017; doi:10.1038/ejcn.2017.72.
Díaz de Bustamante M1, Alarcón T1,2,3, Menéndez-Colino R1,2, Ramírez-Martín R1, Otero Á2,3,4, González-Montalvo JI1,2,3.
1 Geriatrics Department, Hospital Universitario La Paz, Madrid, Spain.
2 La Paz University Hospital Research Institute, IdiPAZ, Madrid, Spain.
3 RETICEF, Spain.
4 Preventive Medicine Department, Universidad Autónoma de Madrid, Madrid, Spain.


Backgrounds/objectives:
Malnutrition is very common in acute hip fracture (HF) patients. Studies differ widely in their findings, with reported prevalences between 31 and 88% mainly because of small sample sizes and the use of different criteria. The aim of this study was to learn the prevalence of malnutrition in a large cohort of HF patients in an comprehensive way that includes the frequency of protein-energy malnutrition, vitamin D deficiency and sarcopenia.

SUBJECTS/METHODS:
A 1-year consecutive sample of patients admitted with fragility HF in a 1300-bed public University Hospital, who were assessed within the first 72 h of admission. Clinical, functional, cognitive and laboratory variables were included. Energy malnutrition (body mass index (BMI) <22 kg/m2), protein malnutrition (serum total protein <6.5 g/dl or albumin <3.5 g/dl), vitamin D deficiency (serum 25-OH-vitamin D <30 ng/dl) and sarcopenia (low muscle mass plus low grip strength) were considered.

RESULTS:
Five hundred nine HF patients were included. The mean age was 85.6±6.9 years and 79.2% were women. Ninety-nine (20.1%) patients had a BMI <22 kg/m2. Four hundred nine patients (81.2%) had protein malnutrition. Eighty-seven (17.1%) patients had both energy and protein malnutrition. Serum vitamin D was <30 ng/ml in 466 (93%) patients. The prevalence of sarcopenia was 17.1%.

CONCLUSIONS:
Protein malnutrition and vitamin D deficiency are the rule in acute HF patients. Energy malnutrition and sarcopenia are also common. A nutritional assessment in these patients should include these aspects together.

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