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MALNUTRITION IN HIP FRACTURE PATIENTS. EFFECT ON LENGTH OF STAY, OPERATIVE DELAY AND MORTALITY.



Abstract

Aim. To validate the implementation of relatively inexpensive and reliable laboratory tests in everyday clinical practice for the early recognition of malnutrition in patients with a hip fracture. Correlation of malnutrition with clinical parameters.

Method. Retrospective study including all elderly patients operated for a hip fracture during a five year period. Patients were evaluated according to two laboratory parameters: serum albumin and total lymphocyte count. Both parameters are established and widely used nutritional indexes. Based on the results, patients were divided into four groups: Patients in group A had both parameters within normal limits. Group B had a low total lymphocyte count and a normal albumin level. Reversibly, patients in group C had a low albumin level and a normal total lymphocyte count. In group D both values were abnormal. The groups were compared according to three clinical parameters: waiting time to operation, duration of hospital stay and one year postoperative mortality.

Results. Three hundred and twenty nine patients were included in the study. Statistically important differences were found for all three clinical parameters between malnourished patients (group D) and those with normal values (group A).

Conclusion. Serum albumin levels and a total lymphocyte count are reliable nutritional indexes in patients with a hip fracture. Their implementation in clinical practice can contribute to the early recognition and appropriate treatment of patients with a worse prognosis.

The abstracts were prepared by Eleni Koutsoukou. Correspondence should be addressed to him at the Hellenic Association of Orthopaedic Surgery and Traumatology (HAOST), 20, A. Fleming str, 15123 Marousi, Athens, Greece.