Tight calorie control in geriatric patients following hip fracture decreases complications: a randomized, controlled study.
Clin Nutr
; 33(1): 23-8, 2014 Feb.
Article
em En
| MEDLINE
| ID: mdl-23642400
ABSTRACT
BACKGROUND & AIMS:
Optimizing nutritional intake has been recommended for geriatric patients undergoing hip-fracture surgery. Whether nutritional support guided by repeated measurements of resting energy requirements (REE) improves outcomes in these patients is not known.METHODS:
A randomized, controlled, unblinded, prospective, cohort study comparing provision of energy with a goal determined by repeated REE measurements using indirect calorimetry, with no intervention. Oral nutritional supplements were started 24 h after surgery and the amount adjusted to make up the difference between energy received from hospital food and measured energy expenditure.RESULTS:
50 Geriatric patients were included in the study. Patients in the intervention group (n = 22) received significantly higher daily energy intake than the control group (n = 28) (1121.3 ± 299.0 vs. 777.1 ± 301.2 kcal, p = 0.001). This was associated with a significantly less negative cumulative energy balance (-1229.9 ± 1763 vs. -4975.5 ± 4368 kcal, p = 0.001). A significant negative correlation was found between the cumulative energy balance and total complication rate (r = -0.417, p = 0.003) as well as for length of hospital stay (r = -0.282, p = 0.049).CONCLUSION:
We have demonstrated that nutritional support actively supervised by a dietician and guided by repeated measurements of REE was achievable and improved outcomes in geriatric patients following surgery for hip fractures. Clinicaltrials.gov Identifier NCT017354435.Palavras-chave
CAM; CCI; CIRS-G; Charlson's comorbidity index; Confusion Assessment Method; Cumulative Illness Rating Scale for Geriatrics; Energy expenditure; FIM; Functional Independence Measure; Geriatric; Hip fracture; IC; MAC; MMSE; MNA; Mini-Mental State Examination; ONS; Tight calorie control; indirect calorimetry; mid-arm circumference; mini-nutritional assessment; oral nutritional supplements
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Ingestão de Energia
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Avaliação Geriátrica
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Desnutrição
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Fraturas do Quadril
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Aspecto:
Determinantes_sociais_saude
Limite:
Aged
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Aged80
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Female
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Humans
/
Male
Idioma:
En
Revista:
Clin Nutr
Ano de publicação:
2014
Tipo de documento:
Article
País de afiliação:
Israel