The effect of nutritional status on length of stay in elderly hip fracture patients.

ABSTRACT

BACKGROUND: In this period of cost constraints, any indicator, such as nutritional status, which may predict the outcome of rehabilitation for a common problem, such as hip fractures, merits evaluation. METHODS: Nutritional indices--serum albumin, cholesterol, and body mass index--were assessed in 114 subacute rehabilitation hip fracture patients. RESULTS: Hypoalbuminemia was very common, occurring in 101 of 114 patients (88.6%). Using a forward stepwise regression model which considered age, total protein count, albumin, cholesterol, weight, height, and body mass index, serum albumin was the only variable that was significantly correlated with the length of stay (b=-0.23; p<.015). A scatterplot showed that almost all the albumin values in this elderly group fell between 2.4 mg/dl and 3.2 mg/dl, relatively low values, with a significant negative linear relationship between serum albumin and length of stay in this range. The average length of stay at 3.2 mg/dl was 44 days and at 2.4 mg/dl was 56 days. CONCLUSION: Hypoalbuminemia remains an important indicator of poor health outcome. Early biomedical monitoring of elderly subacute patients may lead to a reduction in length of stay and consequently reduce the costs of rehabilitation.