Multidisciplinary, multi-modal nutritional care in acute hip fracture inpatients - results of a pragmatic intervention

Bell, Jack J., Bauer, Judith D., Capra, Sandra and Pulle, Ranjeev Chrys (2013) Multidisciplinary, multi-modal nutritional care in acute hip fracture inpatients - results of a pragmatic intervention. Clinical Nutrition, 33 6: 1101-1107. doi:10.1016/j.clnu.2013.12.003


Author Bell, Jack J.
Bauer, Judith D.
Capra, Sandra
Pulle, Ranjeev Chrys
Title Multidisciplinary, multi-modal nutritional care in acute hip fracture inpatients - results of a pragmatic intervention
Journal name Clinical Nutrition   Check publisher's open access policy
ISSN 0261-5614
1532-1983
Publication date 2013-12-19
Year available 2013
Sub-type Article (original research)
DOI 10.1016/j.clnu.2013.12.003
Volume 33
Issue 6
Start page 1101
End page 1107
Total pages 7
Place of publication Elsevier
Publisher Amsterdam, Netherlands
Collection year 2014
Language eng
Formatted abstract
Background & aims:  Malnutrition is highly prevalent and resistant to intervention following hip fracture. This study investigated the impact of individualised versus multidisciplinary nutritional care on nutrition intake and outcomes in patients admitted to a metropolitan hospital acute hip fracture unit.

Methods: A prospective, controlled before and after comparative interventional study aligning to the CONSORT guidelines for pragmatic clinical trials. Randomly selected patients receiving individualised nutritional care (baseline) were compared with post-interventional patients receiving a new model of nutritional care promoting nutrition as a medicine, multidisciplinary nutritional care, foodservice enhancements, and improved nutrition knowledge and awareness. Malnutrition was diagnosed using the Academy of Nutrition and Dietetics criteria.

Results: Fifty-eight weighed food records were available for each group across a total of 82 patients (n = 44, n = 38). Group demographics were not significantly different with predominantly community dwelling (72%), elderly (82.2 years), female (70%), malnourished (51.0%) patients prone to co-morbidities (median 5) receiving early surgical intervention (median D1). Multidisciplinary nutritional care reduced intake barriers and increased total 24-h energy (6224 vs. 2957 kJ; p < 0.001) and protein (69.0 vs. 33.8 g; p < 0.001) intakes, reduced nutritional deterioration over admission (5.4 vs. 20.5%; p = 0.049), and increased discharge directly back to the community setting (48.0 vs. 17.6%; p = 0.012). Trends suggested a reduction in median length of stay (D13 vs. D14). Inpatient mortality remained low across groups (5.2%, 2.3%).

Conclusions: Multidisciplinary nutritional care improves nutrition intake and outcomes in acute hip fracture inpatients. Similar pragmatic study designs should be considered in other elderly inpatient populations perceived resistant to nutritional intervention.
Keyword Malnutrition
Hip fractures
Elderly
Hospitals
Pragmatic
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online ahead of print 19 December 2013.

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Human Movement and Nutrition Sciences Publications
 
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Created: Sun, 12 Jan 2014, 18:31:01 EST by Deborah Noon on behalf of School of Human Movement and Nutrition Sciences