Increased Energy Intake in Hip Fracture Patients Affects Nutritional Biochemical Markers

Abstract

Background and Aims:We have previously shown that nutritional guidelines decreased the incidence of pressure ulcers in hip fracture patients. In the present study, we evaluate whether the nutritional biochemical markers s-Igf-1 (Insulin-like growth factor 1), stransthyretin and s-albumin are affected by patients' energy intake, and whether the markers are useful as predictors of postoperative complications.Material and Methods: Quasi-experimental design, with one intervention and one control group, as well as pre-and post-study measurements. eighty-eight hip fracture patients were included: 42 in the control group and 46 in the intervention group. the control group received regular nutritional support pre-and postoperatively, while the intervention group received nutritional support that followed new, improved clinical guidelines from admission to five days postoperatively. s-albumin, s-transthyretin, c-reactive protein (s-crp) and s-Igf-1 were analysed at admission and five days postoperatively as well as complications like pressure ulcer and infection.Results: the intervention group had a significantly higher energy intake; for example, 1636 kcal versus 852 kcal postoperative day 1. s-Igf-1 levels decreased significantly in the control group, while no decrease in the intervention group. s-albumin and s-transthyretin decreased and s-crp increased significantly in both groups, indicating that those markers were not affected short-term by a high-energy intake. there was no correlation between short-term postoperative complications and s-Igf-1, s-transthyretin or s-albumin at admission.Conclusion: the results of our study showed that s-Igf-1 can be used as a short-term nutritional biochemical marker, as it was affected by a five-day high-energy regimen. however, neither s-Igf-1, s-transthyretin or s-albumin were useful in predicting postoperative complications within five days postoperatively.

Surgical Technical Evidence Review of Hip Fracture Surgery Conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery

“… 13 , 18 The AAOS guidelines recommend postoperative nutritional supplementation to reduce mortality and improve postoperative outcomes ( Table 3 ). 8 …”

“…The AAOS provides health policy and educational support in the treatment of musculoskeletal patients. 8 The NICE guidelines are intended to provide evidence-based guidance to promote integrated care for the National Health Service of the United Kingdom. 9 …”

Association of Insulin‐like Growth Factor‐1, Bone Mass and Inflammation to Low‐energy Distal Radius Fractures and Fracture Healing in Elderly Women Attending Emergency Care

“…Low serum IGF1 level has previously been reported in patients with hip fractures and a low total BMD. IGF1 can be used as a short‐term nutritional biomarker.…”

Drug discovery in spinal cord injury-induced osteoporosis: a text mining-based study

“…promote bone formation and growth rate (32). On the other hand, it is positively correlated with low bone mineral density, suggesting that a low level of IGF1 is an indirect risk factor for fracture (33,34). IL-6 overexpression was found to be associated with SCI-induced OP.…”

“…On the one hand, a high level of IGF1 could promote bone formation and growth rate ( 32 ). On the other hand, it is positively correlated with low bone mineral density, suggesting that a low level of IGF1 is an indirect risk factor for fracture ( 33 , 34 ).…”