Assessment of malnutrition in hip fracture patients: effects on surgical delay, hospital stay and mortality.

The importance of malnutrition in elderly hip fracture patients has long been recognised. All patients operated upon for a hip fracture over a five-year period were assessed according to two nutritional markers : a) serum albumin levels and b) peripheral blood total lymphocyte count. Patients were subdivided into groups according to the four possible combinations of these results. Outcomes according to four clinical outcome parameters were validated: a) waiting time to operation b) length of hospitalisation, c) in-hospital mortality, and d) one-year postoperative mortality. Significant differences were found between malnourished patients and those with normal laboratory values with regard to surgical delay and one year postoperative mortality. Malnourished patients were also more likely to be hospitalised longer than a month and to die during their hospital stay, but the difference was not significant. The combination of serum albumin level and total lymphocyte count can be used as an independent prognostic factor in hip fracture patients.