A Prospective, Observational Study of the Effect of a High-Calorie, High-Protein Oral Nutritional Supplement with HMB in an Old and Malnourished or at-Risk-of-Malnutrition Population with Hip Fractures: A FracNut Study.

BACKGROUND: Hip fractures are prevalent among older people, often leading to reduced mobility, muscle loss, and bone density decline. Malnutrition exacerbates the prognosis post surgery. This study aimed to evaluate the impact of a 12-week regimen of a high-calorie, high-protein oral supplement with ß-hydroxy-ß-methylbutyrate (HC-HP-HMB-ONS) on nutritional status, daily activities, and compliance in malnourished or at-risk older patients with hip fractures receiving standard care. SUBJECTS AND METHODS: A total of 270 subjects ≥75 years of age, residing at home or in nursing homes, malnourished or at risk of malnutrition, and post hip fracture surgery, received HC-HP-HMB-ONS for 12 weeks. Various scales and questionnaires assessed outcomes. RESULTS: During the 12 weeks of follow-up, 82.8% consumed ≥75% of HC-HP-HMB-ONS. By week 12, 62.4% gained or maintained weight (+0.3 kg), 29.2% achieved normal nutritional status (mean MNA score +2.8), and 46.8% improved nutritional status. Biochemical parameters improved significantly. Subjects reported good tolerability (mean score 8.5/10), with 87.1% of healthcare providers concurring. CONCLUSIONS: The administration of HC-HP-HMB-ONS markedly enhanced nutritional status and biochemical parameters in older hip-fracture patients, with high compliance and tolerability. Both patients and healthcare professionals expressed satisfaction with HC-HP-HMB-ONS.

[Validation of nutritional screening Malnutrition Screening Tool compared to other screening tools and the nutritional assessment in different social and health areas]. / Validación del cribado nutricional Malnutrition Screening Tool comparado con la valoración nutricional completa y otros cribados en distintos ámbitos sociosanitarios.

INTRODUCTION: nutritional screenings are used to detect nutritional risk, allow early intervention and influence the prognosis. The Malnutrition Screening Tool (MST) is only validated in hospitalized patients and oncology outpatients. OBJECTIVES: to analyze the nutritional screening MST, Malnutrition Universal Screening Tool (MUST) and Mini Nutritional Assessment-Short Form (MNA-sf) compared to the nutritional assessment gold standard according to socio-sanitary areas and age groups; and to assess the utility of the MST in those areas where it has not been validated. MATERIAL AND METHODS: a total of 815 outpatient, hospitalized and institutionalized subjects were included in this study. MUST and MST screenings, and nutritional assessment were performed in all subjects. MNA-sf was also performed in subjects ≥ 65 years of age. Nutritional diagnosis was performed according to the SENPE-SEDOM consensus. RESULTS: in the outpatient cohort, three screenings have a validity (AUC ROC) greater than 0.8 compared to nutritional assessment. In the institutionalized, the MNA-sf generates false positives and the MUST is more valid than MST (AUC ROC = 0.815 and 0.763, respectively). In hospitalized patients, there are excellent results with MUST and MST. In all socio-sanitary areas the MST obtains a better positive predictive value. By age groups, MUST and MST are valid tools. CONCLUSIONS: in our study, the MST correctly diagnoses more than 80% of the patients (S = 69.4%, E = 94.2%), and has a good reliability and validity with respect to nutritional assessment not only in hospitalized patients and oncology outpatients, where it has already been validated. In our population, the MST was found to be valid in outpatient, institutionalized and hospitalized subjects.