What Postoperative Nutritional Interventions Lead to Better Outcomes in Fragility Hip Fractures? A Systematic Review
Background Fragility hip fracture patients are often malnourished. Nutrition supplementation may help, but it is unclear if supplementation is impactful when considering outcomes. A systematic review of literature examining perioperative nutrition status for older adults experiencing a hip fracture...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2023-02-01
|
| Series: | Geriatric Orthopaedic Surgery & Rehabilitation |
| Online Access: | https://doi.org/10.1177/21514593231155828 |
| _version_ | 1797905215890915328 |
|---|---|
| author | Jennifer S. Oberstar MD Caitlin J. Bakker MLIS, AHIP Megan Sorich MD Teresa McCarthy MD |
| author_facet | Jennifer S. Oberstar MD Caitlin J. Bakker MLIS, AHIP Megan Sorich MD Teresa McCarthy MD |
| author_sort | Jennifer S. Oberstar MD |
| collection | DOAJ |
| description | Background Fragility hip fracture patients are often malnourished. Nutrition supplementation may help, but it is unclear if supplementation is impactful when considering outcomes. A systematic review of literature examining perioperative nutrition status for older adults experiencing a hip fracture was performed. Methods We searched Medline, CAB Abstracts and Embase (Ovid); Cochrane Library (Wiley); PubMed; Scopus; Global Index Medicus; Web of Science Core Collection; SPORTDiscus (EBSCO); and clinical trial registries ClinicalTrials.gov and WHO ICTRP from inception to April 2021, incorporating terminology related to nutritional interventions, fragility fractures, and postoperative outcomes. Two investigators reviewed citations for inclusion, extracted nutrition intervention criteria, and categorized hip fragility outcomes. Results Of 1792 citations, 90 articles underwent full-text screening, and 14 articles were included in the final sample. We identified nutritional interventions and 4 outcomes of interest. 8 studies (n = 649) demonstrated a mean difference of .78 days (CI .34-1.21) in length of stay (LOS) between the nutritional intervention and control groups. Rehabilitation ward stays were discussed in 2 studies demonstrating a non-statistically significant difference. 7 studies (n = 341) reported mortality rates; when pooled there was no statistically significant difference. 5 studies showed data for postoperative infections and 4 studies reported on postoperative urinary tract infections. Pooling of data found a statistically significant result (Relative Risk: .49 [.32, .75], P = .001) with low heterogeneity (I 2 = 27%). 4 studies reported urinary tract infections (n = 140) in the intervention group and (n = 121) in the control group with a non-statistically significant result. Grip strength was only reported in two studies but pooling of the data was non-statistically significant. Conclusions This systematic review highlighted the lack of consensus regarding the type of nutrition interventions available and impact on outcomes of interest including mortality, length of stay, infections, and grip strength for fragility hip fractures in older adults. |
| first_indexed | 2024-04-10T10:01:33Z |
| format | Article |
| id | doaj.art-c3fafd17e7a5438ba77b6ff98dd4fb60 |
| institution | Directory Open Access Journal |
| issn | 2151-4593 |
| language | English |
| last_indexed | 2024-04-10T10:01:33Z |
| publishDate | 2023-02-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Geriatric Orthopaedic Surgery & Rehabilitation |
| spelling | doaj.art-c3fafd17e7a5438ba77b6ff98dd4fb602023-02-16T08:33:35ZengSAGE PublishingGeriatric Orthopaedic Surgery & Rehabilitation2151-45932023-02-011410.1177/21514593231155828What Postoperative Nutritional Interventions Lead to Better Outcomes in Fragility Hip Fractures? A Systematic ReviewJennifer S. Oberstar MDCaitlin J. Bakker MLIS, AHIPMegan Sorich MDTeresa McCarthy MDBackground Fragility hip fracture patients are often malnourished. Nutrition supplementation may help, but it is unclear if supplementation is impactful when considering outcomes. A systematic review of literature examining perioperative nutrition status for older adults experiencing a hip fracture was performed. Methods We searched Medline, CAB Abstracts and Embase (Ovid); Cochrane Library (Wiley); PubMed; Scopus; Global Index Medicus; Web of Science Core Collection; SPORTDiscus (EBSCO); and clinical trial registries ClinicalTrials.gov and WHO ICTRP from inception to April 2021, incorporating terminology related to nutritional interventions, fragility fractures, and postoperative outcomes. Two investigators reviewed citations for inclusion, extracted nutrition intervention criteria, and categorized hip fragility outcomes. Results Of 1792 citations, 90 articles underwent full-text screening, and 14 articles were included in the final sample. We identified nutritional interventions and 4 outcomes of interest. 8 studies (n = 649) demonstrated a mean difference of .78 days (CI .34-1.21) in length of stay (LOS) between the nutritional intervention and control groups. Rehabilitation ward stays were discussed in 2 studies demonstrating a non-statistically significant difference. 7 studies (n = 341) reported mortality rates; when pooled there was no statistically significant difference. 5 studies showed data for postoperative infections and 4 studies reported on postoperative urinary tract infections. Pooling of data found a statistically significant result (Relative Risk: .49 [.32, .75], P = .001) with low heterogeneity (I 2 = 27%). 4 studies reported urinary tract infections (n = 140) in the intervention group and (n = 121) in the control group with a non-statistically significant result. Grip strength was only reported in two studies but pooling of the data was non-statistically significant. Conclusions This systematic review highlighted the lack of consensus regarding the type of nutrition interventions available and impact on outcomes of interest including mortality, length of stay, infections, and grip strength for fragility hip fractures in older adults.https://doi.org/10.1177/21514593231155828 |
| spellingShingle | Jennifer S. Oberstar MD Caitlin J. Bakker MLIS, AHIP Megan Sorich MD Teresa McCarthy MD What Postoperative Nutritional Interventions Lead to Better Outcomes in Fragility Hip Fractures? A Systematic Review Geriatric Orthopaedic Surgery & Rehabilitation |
| title | What Postoperative Nutritional Interventions Lead to Better Outcomes in Fragility Hip Fractures? A Systematic Review |
| title_full | What Postoperative Nutritional Interventions Lead to Better Outcomes in Fragility Hip Fractures? A Systematic Review |
| title_fullStr | What Postoperative Nutritional Interventions Lead to Better Outcomes in Fragility Hip Fractures? A Systematic Review |
| title_full_unstemmed | What Postoperative Nutritional Interventions Lead to Better Outcomes in Fragility Hip Fractures? A Systematic Review |
| title_short | What Postoperative Nutritional Interventions Lead to Better Outcomes in Fragility Hip Fractures? A Systematic Review |
| title_sort | what postoperative nutritional interventions lead to better outcomes in fragility hip fractures a systematic review |
| url | https://doi.org/10.1177/21514593231155828 |
| work_keys_str_mv | AT jennifersoberstarmd whatpostoperativenutritionalinterventionsleadtobetteroutcomesinfragilityhipfracturesasystematicreview AT caitlinjbakkermlisahip whatpostoperativenutritionalinterventionsleadtobetteroutcomesinfragilityhipfracturesasystematicreview AT megansorichmd whatpostoperativenutritionalinterventionsleadtobetteroutcomesinfragilityhipfracturesasystematicreview AT teresamccarthymd whatpostoperativenutritionalinterventionsleadtobetteroutcomesinfragilityhipfracturesasystematicreview |