Dietary supplementation in elderly patients with fractured neck of the femur

Delmi, Marino; Rapin, Charles‐Henri; Bengoa, J M; Delmas, P.D.; Vasey, H; Bonjour, Jean‐Philippe

doi:10.1016/0140-6736(90)91073-j

Cited by 751 publications

(378 citation statements)

References 16 publications

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“…We found 12 eligible studies, involving 898 participants (Bastow et al, 1983b;Stableforth, 1986;Delmi et al, 1990;Brown & Seabrook, 1992;Gallagher et al, 1992;Tkatch et al, 1992;Madigan, 1994;Hankins, 1996;Hartgrink et al, 1998;Schurch et al, 1998;Sullivan et al, 1998;Espaulella et al, 2000). Details of the trials are provided in Table 2.…”

Section: Resultsmentioning

confidence: 99%

“…Many of the studies excluded patients with medical conditions (dementia, stroke, endocrine disease, cancer, kidney or liver failure). Six trials failed to provide any nutritional assessment of trial participants by anthropometry, for example, weight or mid-arm circumference (Delmi et al, 1990;Gallagher et al, 1992;Tkatch et al, 1992;Hartgrink et al, 1998;Sullivan et al, 1998;Espaulella et al, 2000). Four studies specifically examined nutritional supplementation in malnourished participants, each study assessing nutritional status differently; three used anthropometric criteria (Bastow et al, 1983b;Brown & Seabrook, 1992;Hankins, 1996;) and one used serum albumin values (Gallagher et al, 1992).…”

Section: Resultsmentioning

confidence: 99%

“…Eight studies (Delmi et al, 1990;Tkatch et al, 1992;Madigan, 1994;Hankins, 1996;Hartgrink et al, 1998;Schurch et al, 1998;Sullivan et al, 1998;Espaulella et al, 2000) gave clear details of the exact nutritional content, and of the protocol for application, of the supplement. Comparable care programmes, other than the trial interventions, were confirmed in three trials (Stableforth, 1986;Hartgrink et al, 1998;Espaulella et al, 2000).…”

Section: Resultsmentioning

confidence: 99%

“…However, only five studies followed participants up for 6 months or more (Delmi et al, 1990;Tkatch et al, 1992;Schurch et al, 1998;Sullivan et al, 1998;Espaulella et al, 2000), and no study reported patients' perceived quality of life after discharge. Economic outcomes were also not reported.…”

Section: Resultsmentioning

confidence: 99%

“…However, we also accepted the slightly different definition of 'unfavourable outcome' (mortality or survivors with a major complication or two or more minor complications) used in three trials (Delmi et al, 1990;Tkatch et al, 1992;Hankins, 1996). In these trials bedsores, pneumonia, pyelonephritis, severe anaemia, deep vein thrombosis, acute renal failure, pulmonary embolism and heart failure were defined as 'major complications'.…”

Section: Outcomes Assessedmentioning

confidence: 99%

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A systematic review of protein and energy supplementation for hip fracture aftercare in older people

Avenell

Handoll

2003

Eur J Clin Nutr

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Objectives: To evaluate whether protein and energy supplementation influences recovery after hip fracture. Design: Systematic review of randomised and quasi-randomised trials in people aged 65 y and over. Data sources: We searched seven electronic databases from 1966 to April 2002, four journals and reference lists of relevant articles. We contacted trial investigators and experts for details of other trials. Main outcome measures: Mortality, complications and unfavourable outcome (mortality or survivors with complications) were the primary outcomes. We also sought data on length of hospital stay, functional status after hip fracture, quality of life and compliance with supplementation. Results: In total, 12 randomised trials involving 898 participants were included. Nine trials evaluated protein and energy supplementation (five oral and four nasogastric feeding), and a further three trials tested oral protein supplementation. Potential biases resulting from inadequate allocation concealment and lack of assessor blinding and intention-to-treat analysis, as well as the limited outcome data, mean that the results must be interpreted with caution. Pooled data from eight of the nine trials evaluating protein and energy supplements showed no evidence for an effect on mortality (relative risk 0.92, 95% CI 0.56-1.50). Limited data from only three trials showed that oral protein and energy supplements may reduce unfavourable outcome (relative risk 0.52, 95% CI 0.32-0.84). Conclusion: Based on limited evidence, oral protein and energy supplementation after hip fracture may reduce unfavourable outcome. Further evidence from good-quality randomised trials is required to inform clinical practice.

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