Introduction: Malnutrition is common among older hip fracture patients and associated with adverse outcomes. We examined Mini Nutritional Assessment short (MNA-SF) and long form (MNA-LF) and serum albumin as prognostic indicators of mobility, living arrangements and mortality after hip fracture.Methods: Population-based prospective data were collected on 594 hip fracture patients aged 65 and over. MNA-SF, MNA-LF and serum albumin were assessed on admission. Outcomes were poorer mobility; transfer to more assisted living accommodation and mortality one month, four months and one year post fracture. Logistic regression analyses for mobility and living arrangements with odds ratios (OR) and Cox proportional hazards model for mortality with hazard ratios (HR) and 95% confidence intervals (CI) were used, adjusted for age, gender, ASA grade and fracture type.Results: All measures predicted mortality at all time-points. Risk of malnutrition and malnutrition measured by MNA-LF predicted mobility and living arrangements within four months of hip fracture. At one year, risk of malnutrition predicted mobility and malnutrition predicted living arrangements, when measured by MNA-LF. Malnutrition, but not risk thereof, measured by MNA-SF predicted living arrangements at all time-points. None of the measures predicted one-month mobility.Conclusions: All measures were strong indicators of short-and long-term mortality after hip fracture. MNA-LF was superior in predicting mobility and living arrangements, particularly at four months. All measures were relatively poor in predicting short-term outcomes of mobility and living arrangements.

Background: previous trials have shown that perioperative immunonutrition could protect patients from infectious complications after gastrointestinal cancer operations. the purpose of this study was to determine whether perioperative immunonutrition decreases postoperative morbidity,especially infection complications, mortality and length of hospital stay in patients undergoing major gastrointestinal tract surgery.Methods: one hundred patients with ap lanned elective operation for benign or malignant gastrointestinal illness were randomized into two groups: group 1) oral supplementation for five days before and five days after surgery with 900 mL/day of aformula enriched with arginine, gamma-3-fatty acid and rna +liquid diet ad libitum on one and two postoperative day and then solid food (immunonutrition group; n=50) or group 2) no artificial nutrition before and after surgery,onone and two postoperativeday intravenous solution of 5% glucoseand electrolytes and then normal diet (conventional group; n=50).Results: the groups were comparable for all key baseline and surgical characteristics. there were nine (18%) infectious complications in both groups. overall complication rates were 28% (n =14) in the immunonutrition group and 24% (n =12) in the conventional group. No significant difference between the groups was found in complication rates, mortality or length of hospital stay.Conclusion: routine perioperative immunonutrition to the patients undergoing major gastrointestinal surgery is not beneficial.

Intravenous glucose infusion does not decrease the sense of thirst and hunger as effectively as a carbohydrate-rich drink but does alleviate the feelings of weakness and tiredness compared with fasting.

MNA-SF is superior to NRS2002 in predicting short-term hip fracture outcomes.

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