In this article, we will discuss prognostic supplements for hip fractures in the elderly.
One of the most common fracture sites in the elderly is the hip joint.Fractures in this area not only interfere with daily activities such as walking, but also worsen nutritional status.The following is a review of the effects of oral supplements on nutritional status during and after treatment. Here is a review of the studies.
The study
This is a review of 41 studies that included 3881 participants.
Most of the nutritional supplementation interventions were started within one month of hip fracture.However, because the studies had methodological flaws that could have affected the validity of the results, some of the evidence was of very low quality, meaning that the results were very uncertain.Eighteen studies examined the use of orally available supplements to provide additional protein, vitamins, and minerals.There was low-quality evidence that these multinutrient oral supplements may not reduce mortality, but may reduce complications (e.g., pressure ulcers, infections, venous thrombosis, pulmonary embolism, confusion).There was also very low quality evidence that oral multinutrient supplements may reduce unfavorable outcomes (death, complications) and that they did not increase side effects of ingestion (vomiting, diarrhea).
Four studies looked at nasogastric tube feeding.
In this case, liquid food, along with non-protein energy, protein, and some vitamins and minerals, is delivered through a tube that is inserted into the nose and delivered to the stomach.These studies provided very poor quality evidence that tube feeding had no effect on mortality or complications.Adverse outcomes were not documented and there was insufficient evidence on adverse events.One study provided very low quality evidence that nasogastric tube feeding and oral feeding may have no effect on mortality or complications.
Tube feeding was reported to be poorly tolerated.
Increasing protein intake with oral supplements was tested in four studies.
These provided low-quality evidence of no clear effect on mortality or complications, and low-quality evidence of reduced unfavorable outcomes.Study supplements testing intravenous vitamin B1 and other water-soluble vitamins, oral 1-alpha-hydroxycholecalciferol (vitamin D), high-dose bolus vitamin D, different oral doses or sources of vitamin D, intravenous or oral iron, ornithine alpha-ketoglutarate versus isonitrogenic peptides, and Taurine versus placebo, and supplements containing vitamins, minerals, and amino acids provided low or very low quality evidence of no clear effect on mortality or complications, if reported.One study that evaluated the use of dietary supplements to help with feeding provided low quality evidence that this may reduce mortality, but not the number of people with complications.
Reviewer's conclusion
There is low-quality evidence that oral multinutrient supplements started before or soon after surgery may prevent complications within There is very low-quality evidence that oral multinutrient supplements may reduce 'unfamiliarity' with hip fracture, but that they have no clear effect on mortality. There is very low-quality evidence that oral supplements may reduce 'unfavourable outcome' (death or complications) and that they do not result in an increased incidence of vomiting and diarrhoea. In particular, the role of dietetic assistants, and peripheral venous feeding or nasogastric feeding In particular, the role of dietary assistants, and peripheral venous feeding or nasogastric feeding in very malnourished people require further evaluation.
Avenell A, Smith TO, Curtain JP, Mak JCS, Myint PK. Nutritional supplementation for hip fracture aftercare in older people: Cochrane Database of Systematic Reviews 2016, Issue 11. Art. No.: CD001880. DOI: 10.1002/14651858.CD001880.pub6.
Conclusion
Although it is not certain, it seems that any form of nutritional support does not lead to poor outcomes.I am not sure if this is limited to people with compromised nutritional status or if the results are similar for everyone, but I am curious to see how changes in circumstances, such as taking high doses for a long period of time, would affect the results.
