Literature DB >> 16452913

Lower limb fracture, cognitive impairment and risk of subsequent malnutrition: a prospective evaluation of dietary energy and protein intake on an orthopaedic ward.

M D Miller1, E Bannerman, L A Daniels, M Crotty.   

Abstract

OBJECTIVE: To report the dietary energy and protein intake of undernourished older adults (with and without cognitive impairment) admitted to hospital following a lower limb fracture and to determine whether dietary intakes met estimated requirements.
DESIGN: An observational study of a sequential sample.
SETTING: The orthopaedic ward of a South Australian metropolitan teaching hospital.
SUBJECTS: Sixty-eight patients aged > or =70 years screened as undernourished and admitted to hospital following lower limb fracture (50% cognitively impaired) provided 3 to 5 days of dietary data. MAJOR OUTCOME
METHODS: Dietary energy and protein intake.
METHODS: Dietary assessment using plate waste methodology and snack record charts commenced within 6 days postinjury and continued for up to five consecutive days or until discharge. Estimated resting energy requirements were calculated and adjusted for activity equivalent to bed rest and physiological stress. Protein requirements were calculated as 1 g/kg/day. Cognition was assessed using the Short Portable Mental Status Questionnaire.
RESULTS: Cognitively impaired participants and those without cognitive impairment consumed, mean (95% CI) respectively, 3661 kJ/day (3201, 4121) versus 4208 kJ/day (3798, 4619) and 38 g (33, 44) versus 47 g (41, 52) protein/day. Cognitively impaired participants consumed mean (95% CI) 48% (43, 53) of estimated total energy expenditure and 78% (69, 87) of estimated protein requirements.
CONCLUSIONS: Orthopaedic fracture patients at greatest nutritional risk, including those with cognitive impairment, do not achieve estimated energy or protein requirements from diet alone. Effective methods of achieving requirements in this vulnerable group are needed before improvements in outcomes will be observed.

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Year:  2006        PMID: 16452913     DOI: 10.1038/sj.ejcn.1602390

Source DB:  PubMed          Journal:  Eur J Clin Nutr        ISSN: 0954-3007            Impact factor:   4.016


  7 in total

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

Authors:  M Díaz de Bustamante; T Alarcón; R Menéndez-Colino; R Ramírez-Martín; Á Otero; J I González-Montalvo
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3.  A trial assessing N-3 as treatment for injury-induced cachexia (ATLANTIC trial): does a moderate dose fish oil intervention improve outcomes in older adults recovering from hip fracture?

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Review 4.  Protein and energy supplementation in elderly people at risk from malnutrition.

Authors:  Anne C Milne; Jan Potter; Angela Vivanti; Alison Avenell
Journal:  Cochrane Database Syst Rev       Date:  2009-04-15

Review 5.  The role of perioperative oral nutritional supplementation in elderly patients after hip surgery.

Authors:  Ming Liu; Jing Yang; Xi Yu; Xiao Huang; Sushan Vaidya; Fuguo Huang; Zhou Xiang
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6.  Pre-hospital dietary intake correlates with muscle mass at the time of fracture in older hip-fractured patients.

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Journal:  Front Aging Neurosci       Date:  2014-11-19       Impact factor: 5.750

Review 7.  Hospital outcomes of older people with cognitive impairment: An integrative review.

Authors:  Carole Fogg; Peter Griffiths; Paul Meredith; Jackie Bridges
Journal:  Int J Geriatr Psychiatry       Date:  2018-06-26       Impact factor: 3.485

  7 in total

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