Undernutrition, Sarcopenia, and Frailty in Fragility Hip Fracture: Advanced Strategies for Improving Clinical Outcomes.

Tatsuro Inoue,Akio Shimizu,Atsuhiro Tsubaki,Junko Ueshima,Kenta Murotani,Keisuke Sato,Ayano Nagano,Keisuke Maeda

doi:10.3390/nu12123743

Abstract

Geriatric patients with hip fractures often experience overlap in problems related to nutrition, including undernutrition, sarcopenia, and frailty. Such problems are powerful predictors of adverse responses, although few healthcare professionals are aware of them and therefore do not implement effective interventions. This review aimed to summarize the impact of undernutrition, sarcopenia, and frailty on clinical outcomes in elderly individuals with hip fractures and identify successful strategies that integrate nutrition and rehabilitation. We searched PubMed (MEDLINE) and Cochrane Central Register of Controlled Trials (CENTRAL) for relevant literature published over the last 10 years and found that advanced interventions targeting the aforementioned conditions helped to significantly improve postoperative outcomes among these patients. Going forward, protocols from advanced interventions for detecting, diagnosing, and treating nutrition problems in geriatric patients with hip fractures should become standard practice in healthcare settings.

Highlights

Hip fractures are a global public health problem and result in hospitalization, disability, and death [1]
In a study comparing the Mini Nutritional Assessment-Full Form (MNA-FF) and NRS-2002 [28], only the Mini Nutritional (MNA)-FF could predict walking ability and mortality after six months. These results suggested that the use of the Mini Nutritional Assessment-Short Form (MNA-SF) or MNA-FF is appropriate for predicting clinical outcomes in patients with hip fracture
To improve clinical outcomes effectively, medical professionals should be aware of geriatric nutritional problems in hip fracture patients (Figure 2)

Summary

Introduction

Hip fractures are a global public health problem and result in hospitalization, disability, and death [1]. As the population ages, the number of hip fractures is increasing, and it is expected that 6.3 million people will suffer from hip fracture in 2050 [2]. Hip fracture patients have high mortality [3], experience prolonged disability [4], and require substantial costs for postoperative management [5]. Management after hip fracture is a critical issue to be resolved. Hip fracture patients experience multiple geriatric nutritional problems, often including undernutrition, sarcopenia, and frailty at admission, all of which overlap (Figure 1),

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