Impact of Rehabilitation Dose on Nutritional Status at Discharge from a Convalescent Rehabilitation Ward in Malnourished Patients with Hip Fracture

Ito, Yusuke; Wakabayashi, Hidetaka; Nishioka, Shinta; Nomura, Shin; Momosaki, Ryo

doi:10.3390/healthcare9060722

Cited by 4 publications

(5 citation statements)

References 23 publications

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“…The post-hip fracture LOS in the present study (~67 days) is far longer than the reported 34 days in Japan; this difference may be attributable in part to our inclusion of only older adults (≥65 years). Ito et al (2021) reported a similar median LOS (71 days) for older adults in Japan. The LOS in the present patient series thus appears to be typical for older adults in Japan.…”

Section: Discussionmentioning

confidence: 65%

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Post‐hip‐fracture knee pain in older adults prolongs their hospital stays: A retrospective analysis using propensity score matching

Kaizu,

Miyata,

Arii

2024

Physiotherapy Res Intl

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Background and PurposePost‐hip‐fracture knee pain (PHFKP) occurs in ∼28%–37% of patients and contributes to a prolonged length of hospital stay (LOS). Analyses of LOS prolongation due to PHFKP have been limited to univariate analyses that do not consider important confounding factors. After adjusting for important confounding factors, we investigated whether the presence or absence of PHFKP makes a difference in LOS in patients with hip fractures.MethodsWe conducted a retrospective review of the medical records of patients who had undergone postoperative rehabilitation after surgery for a hip fracture. Demographic and clinical information, discharge parameters, and PHFKP development information were collected from the medical records. Using propensity score matching, we performed a two‐group comparison of LOS, the functional independence measure (FIM) motor score (FIMm), FIMm gain, and FIMm effectiveness in patients with and without PHFKP. Six variables were included in the calculation of propensity scores: age, sex, body mass index, fracture type, American Society of Anesthesiologists physical status, and independence in activities of daily living at discharge. One‐way analysis of variance was used to examine the details of the relationships between LOS and (i) the time of PHFKP development and (ii) pain intensity.ResultsWe analyzed the cases of 261 patients, of whom 87 (33.3%) developed PHFKP. In propensity score matching, 80 patients were each matched to a patient in the PHFKP or non‐PHFKP group. After propensity score matching, a between‐group comparison revealed that the PHFKP group had a longer LOS (+11 days) than the non‐PHFKP group, and there were no differences in FIMm gain or FIMm effectiveness. The timing of PHFKP development and pain intensity were not related to the LOS.DiscussionEven after adjusting for confounders, the development of PHFKP was found to prolong LOS. Clinicians should be aware of possible LOS prolongation in hip fracture patients with PHFKP.

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Section: Discussionmentioning

confidence: 65%

“…Ito et al. (2021) reported a similar median LOS (71 days) for older adults in Japan. The LOS in the present patient series thus appears to be typical for older adults in Japan.…”

Section: Discussionmentioning

confidence: 75%

Post‐hip‐fracture knee pain in older adults prolongs their hospital stays: A retrospective analysis using propensity score matching

Kaizu,

Miyata,

Arii

2024

Physiotherapy Res Intl

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“…The standard deviation of the FIM-motor score upon admission for patients with fractures in the convalescent rehabilitation ward was 16. 25 ) If the true difference between the groups was 14, 25 ) an estimated minimum of 51 patients in each group was needed to reject the null hypothesis with a power of 0.95 and an error of 0.05.…”

Section: Methodsmentioning

confidence: 99%

Association of Phase Angle Dynamics with Sarcopenia and Activities of Daily Living in Osteoporotic Fracture Patients

Ito,

Yoshimura,

Nagano

et al. 2024

Ann Geriatr Med Res

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Background: This study aimed to determine whether changes in phase angle during rehabilitation are associated with clinical outcomes such as activities of daily living (ADL), skeletal muscle index (SMI), and strength in patients with osteoporotic fractures. Methods:This retrospective observational study included patients with osteoporotic fractures admitted to convalescent rehabilitation wards. Changes in phase angle were defined as the difference between the phase angle values at discharge and on admission. The primary outcome was the Functional Independence Measure Motor (FIM-motor) score at discharge. The secondary outcomes were SMI and handgrip strength at discharge. We used multivariate analysis to adjust for confounding factors and examine the association between changes in the phase angle and outcomes. Results:We analyzed a total of 115 patients (97 women, mean age 81.0 ± 10.0 years), with a median change in phase angle of 0.0° during hospitalization. We observed increased phase angles in 49 patients (43%), with a median increase of 0.2°. Multiple regression analysis showed that changes in phase angle were independently associated with FIM-motor score at discharge (β = 0.238, P = 0.027). Changes in phase angle were not significantly associated with SMI (β = 0.059, P = 0.599) or handgrip strength (β = -0.032, P = 0.773) at discharge. Conclusions:An increased phase angle during rehabilitation was positively associated with 5 ADL improvement in patients with osteoporotic fractures. These findings may help clinicians make informed decisions regarding patient care and treatment strategies for better outcomes.

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“…As previous studies shown, 14-65% of patients with hip fracture are malnourished 5 , which increases the incidence of postoperative complications, prolongs the length of hospital stay, and increases mortality.…”

Section: Introductionmentioning

confidence: 98%

GLIM criteria represents a more suitable tool to evaluate the nutritional status and predict postoperative functional recovery of older patients with hip fracture

Wu,

Guo,

et al. 2023

Preprint

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Purpose: Early recognition of malnutrition is of prime importance and essential for improving the prognosis of older patients with hip fracture. The Nutritional Risk Screening 2002 (NRS-2002), The Short-Form Mini Nutritional Assessment (MNA-SF) and The Global Leadership Initiative on Malnutrition (GLIM) are widely used in malnutrition diagnose. However, the criteria for predicting postoperative hip joint function in aging patients with hip fractures during a long-term is still necessary. The objective of this study was to select the most appropriate criteria from the NRS-2002, the MNA-SF and the GLIM in predicting the postoperative recovery of hip joint function in a long-term. Methods: This retrospective observational study included the 161 patients aged ≥65 years with hip fracture. Nutritional states of the patients were determined by the NRS-2002, the MNA-SF and the GLIM. The Harris Hip Joint Score (HHS), the primary outcome of this study, was used to evaluate the hip joint function. The HHS was classified into good recovery (HHS>75) and bad recovery (HHS<=75). Logistic regression models for hip joint function recovery were constructed. Both the ROC and the DCA were used to select the most predictive criteria. Results: The overall mean age of the 161 patients was 77.90 ± 8.17. As a result, all of the NRS-2002 (OR: 0.06, 95%CI [0.01, 0.17]), the MNA-SF (OR: 0.05, 95%CI [0.00, 0.23]) and the GLIM (OR of moderate: 0.03, 95%CI [0.01, 0.11]; OR of severe: 0.02 [0.00, 0.07]) were predictive for recovery of hip joint function. Additionally, both the AUC of ROC (NRS-2002: 81.2 [73.8, 88.6], MNA-SF: 76.3[68.5, 84.2], GLIM: 86.2 [79.6,92.8]) and the DCA showed the GLIM was better than others. Conclusion: Compared with NRS-2002 and MNA-SF, GLIM was a better nutritional assessment criteria to predict the postoperative recovery of hip joint function for older hip fracture patients in a long-term.

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Impact of Rehabilitation Dose on Nutritional Status at Discharge from a Convalescent Rehabilitation Ward in Malnourished Patients with Hip Fracture

Cited by 4 publications

References 23 publications

Post‐hip‐fracture knee pain in older adults prolongs their hospital stays: A retrospective analysis using propensity score matching

Post‐hip‐fracture knee pain in older adults prolongs their hospital stays: A retrospective analysis using propensity score matching

Association of Phase Angle Dynamics with Sarcopenia and Activities of Daily Living in Osteoporotic Fracture Patients

GLIM criteria represents a more suitable tool to evaluate the nutritional status and predict postoperative functional recovery of older patients with hip fracture

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