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Vulnerable patients with a fractured neck of femur: nutritional status and support in hospital

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Abstract Background and aim 

Malnutrition has serious consequences for recovery and increases the risk of complications in hospital patients. Fractured neck of femur (NOF) patients may be particularly at risk because of their old age and frail state of health. We conducted an observational study to evaluate the nutritional state and the nutritional support, which was provided to this group during their stay in hospital. Methods 

Twenty-five consecutive people admitted to an orthopaedic ward with a fractured NOF at Charing Cross Hospital, London were recruited. Anthropometric measures, biochemical indices, 3 days dietary intake and dietetic referral rates were collected. Results 

Patients had a significantly lower body mass index (BMI) compared with the mean BMI for sex and age in an elderly UK population (21.97 ± 1.06 versus 26.73 ± 0.03 kg m−2; P < 0.005). They took just 58.6% of their energy requirements in hospital (4219 ± 319 versus 7199 ± 202 kJ mean−1 daily intake over 3 days in week 2). Using the hospitals own nutritional risk assessment tool 56% of patients were found to be at risk of malnutrition on admission, which increased to 68% after 2–3 weeks. Of these 64% were referred to a dietitian and were given nutritional supplements. Nutritional assessment revealed that their nutritional status worsened during stay. Conclusions 

This group of patients with fractured NOF is likely to be malnourished on admission and to show a rapid deterioration in its nutrition status during admission. Energy needs were not met in up to 50% of patients. These results reinforce the need to screen, supplement and monitor fractured NOF patients.

Keywords: elderly; fractured neck of femur; hospital; hospital malnutrition; nutritional status; nutritional support

Document Type: Research Article


Affiliations: 1: Nutrition and Dietetic Research Group, Imperial College London, Hammersmith Hospitals Trust, London W12 0HS, UK 2: School of Biosciences, University of Westminster, London W1W 6UW, UK

Publication date: 2006-06-01

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