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Nutritional status and energy expenditure in elderly patients with recent hip fracture during a 2-month follow-up

Published online by Cambridge University Press:  09 March 2007

Elena Paillaud ,
Phuong-Nhi Bories ,
Jean-Claude Le Parco  and
Bernard Campillo
Elena Paillaud
Affiliation:
Service de Médecine Interne, Assistance Publique-Hôpitaux de Paris, 40 rue de Mesly, Créteil, France
Phuong-Nhi Bories
Affiliation:
Laboratoire de Biochimie, Assistance Publique-Hôpitaux de Paris, 40 rue de Mesly, Créteil, France
Jean-Claude Le Parco
Affiliation:
Service de Médecine Interne, Assistance Publique-Hôpitaux de Paris, 40 rue de Mesly, Créteil, France
Bernard Campillo*
Affiliation:
Service de Rééducation Digestive Hôpital Albert Chenevier, Assistance Publique-Hôpitaux de Paris, 40 rue de Mesly, Créteil, France
*
*Corresponding author: Dr Bernard Campillo, fax +33 1 49 81 30 13, email [email protected]
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Abstract

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A 2-month follow-up of nutritional status was performed in forty elderly patients with recent hip fracture. Patients were nutritionally assessed on admission to our rehabilitation unit (day 0), then monthly (day 30, day 60) by measurement of resting energy expenditure (REE), anthropometric, impedance and biological variables. Patients were defined as undernourished (n 13) or normally nourished (n 27) on the basis of mid-arm circumference (MAC) and triceps skinfold thickness (TST) measurements. Seven patients recovered a walking autonomy and were discharged from the hospital before day 30 (group I) whereas thirteen patients were discharged after day 30 (group II); twenty patients remained in the study at day 60 (group III). MAC and TST decreased in normally nourished patients from group III throughout the study whereas they did not change in group II or in undernourished patients from group III. REE values in relation to fat-free mass were increased compared with normal values and were similar in the three groups on day 0; they did not change during the study. Daily energy intake in relation to body weight was higher in group I and increased in group II and in undernourished patients from group III throughout the study. In contrast, it was below the recommended value at day 0 and it did not significantly improve in normally nourished patients from group III. Serum albumin, transthyretin and transferrin levels on day 0 were below reference intervals in the three groups. Albumin levels increased in group III throughout the study. Inflammatory proteins decreased in groups II and III, with C-reactive protein levels returning to normal values in group II by day 30 and in group III at day 60, while orosomucoid levels did not become completely normal over this period. Our findings indicate no improvement in nutritional status in undernourished patients after surgery for recent hip fracture, despite an adequate energy intake. An insufficient spontaneous energy intake for normally nourished patients was associated with a delayed favourable outcome resulting in a prolonged duration of hospitalization. A hypermetabolic state persisted during the 3 months after surgery.

Keywords

Energy intakeElderlyHip fractureNutritional status
Type
Research Article
Information
British Journal of Nutrition , Volume 83 , Issue 2 , February 2000 , pp. 97 - 103
Copyright
Copyright © The Nutrition Society 2000

References

Allegra, A, Corica, F, Buemi, M, Corsonello, A, Rubino, F, Raffaele Addamo, F, Bonanzinga, S, Nicita Mauro, V and Ceruso, D (1998) Plasma interleukin-2 levels and thyroid function in elderly patients with nonthyroidal illness. Archives of Gerontology and Geriatrics 26, 275–282.CrossRefGoogle ScholarPubMed
Barrett-Connor, E (1995) The economic and human costs of osteoporotic fracture. American Journal of Medicine 98(Suppl. 2A), 3S–8S.CrossRefGoogle ScholarPubMed
Boelen, A, Platvoet-Ter Schiphorst, MC and Wiersinga, WM (1993) Association between serum interleukin-6 and serum 3,5,3′-triiodothyronine in non thyroidal illness Journal of Clinical Endocrinology and Metabolism 77, 1695–1699.Google Scholar
Boelen, A, Platvoet-Ter Schiphorst, MC and Wiersinga, WM (1995) Soluble cytokine receptors and the low 3,5,3′-triiodothyronine syndrome in patients with nonthyroidal disease Journal of Clinical Endocrinology and Metabolism 80, 971–976.Google ScholarPubMed
Bonjour, JP, Schurch, MA and Rizzoli, R (1996) Nutritional aspects of hip fracture Bone 18, 139S–144S.CrossRefGoogle Scholar
Burness, R, Horne, G and Purdie, G (1996) Albumin levels and mortality in patients with hip fractures New Zealand Medical Journal 109, 56–57.Google ScholarPubMed
Cals, MJ, Bories, PN, Devanlay, M, Desveaux, N, Luciani, L, Succari, M, Duche, JC, de Jaeger, C, Blonde-Cynober, F and Coudray-Lucas, C (1994) Extensive laboratory assessment of nutritional status in fit, health-conscious, elderly people living in the Paris area Journal of the American College of Nutrition 13, 646–657.CrossRefGoogle ScholarPubMed
Campillo, B, Bories, PN, Devanlay, M, Pornin, B, Le Parco, JC, Gaye-Bareyt, E and Fouet, P (1992) Aging, energy expenditure and nutritional status: evidence for denutrition-related hypermetabolism Annals of Nutrition and Metabolism 36, 265–272.CrossRefGoogle ScholarPubMed
Chumlea, WC, Roche, AF and Steinbaugh, ML (1985) Estimating stature from knee height for persons 60 to 90 years of age Journal of the American Geriatrics Society 33, 116–120.CrossRefGoogle ScholarPubMed
Danforth, E and Burger, AG (1989) The impact of nutrition on thyroid hormone physiology and action Annual Review of Nutrition 9, 201–227.CrossRefGoogle ScholarPubMed
de Weir, JBV (1949) New methods for calculating metabolic rate with special to protein metabolism Journal of Physiology 109, 1–9.CrossRefGoogle Scholar
Delmi, M, Rapin, CH, Bengoa, JM, Delmas, PD, Vasey, H and Bonjour, JP (1990) Dietary supplementation in elderly patients with fractured neck of the femur Lancet 335, 1013–1016.CrossRefGoogle ScholarPubMed
Ferry, MAlix, EBrockerConstans, PLesourd, TB & Vellas, B (1996) Epidemiology of malnutrition. In Nutrition de la Personne Agée [Ferry, M, editor]. Paris: Berger-Levrault.Google Scholar
Goichot, B, Schlienger, JL, Grunenberger, F, Pradignac, A and Sapin, R (1994) Thyroid hormone status and nutrient intake in free-living elderly. Interest of reverse triiodothyronine assessment European Journal of Endocrinology 130, 244–252.CrossRefGoogle ScholarPubMed
Harris, JA & Benedict, FG (1919) A Biometric Study of Basal Metabolism in Man. Carnegie Institute of Washington Publication no. 279. Washington, DC: Carnegie Institute.Google Scholar
Jallut, D, Tappy, L, Kohut, M, Bloesch, D, Munger, R, Schutz, Y, Chiolero, R, Felber, JP, Livio, JJ and Jequier, E (1990) Energy balance in elderly patients after surgery for a femoral neck fracture Journal of Parenteral and Enteral Nutrition 14, 563–568.CrossRefGoogle ScholarPubMed
Jensen, JE, Jensen, TG, Smith, TK, Johnston, DA and Dudrick, SJ (1982) Nutrition in orthopaedic surgery Journal of Bone and Joint Surgery 64, 1263–1272.CrossRefGoogle ScholarPubMed
Lohman, TGRoche, AF & Martorell, R (1988) Anthropometric Standardization Manual. Illinois: Human Kinetic Books.Google Scholar
Nelson, KM, Richards, EW, Long, CL, Martin, KR, Geiger, JW, Brooks, SW, Gandy, RE and Blakemore, WS (1995) Protein and energy balance following femoral neck fracture in geriatric patients Metabolism 44, 59–66.CrossRefGoogle ScholarPubMed
Ostrowski, ZL (editor) (1978) Nutrients. Food Composition Tables. Paris: J. Lanore.Google Scholar
Patterson, BM, Cornell, CN, Carbone, B, Levine, B and Chapman, D (1992) Protein depletion and metabolic stress in elderly patients who have a fracture of the hip Journal of Bone and Joint Surgery 74, 251–260.CrossRefGoogle ScholarPubMed
Poehlman, E (1996) Energy intake and energy expenditure in the elderly American Journal of Human Biology 8, 199–206.3.0.CO;2-Y>CrossRefGoogle ScholarPubMed
Pomposelli, JJ, Flores, EA and Bistrian, BR (1988) Role of biochemical mediators in clinical nutrition and surgical metabolism Journal of Parenteral and Enteral Nutrition 12, 212–218.CrossRefGoogle ScholarPubMed
Reilly, JJ, Lord, A, Bunker, VW, Prentice, AM, Coward, WA, Thomas, AJ and Briggs, RS (1993) Energy balance in healthy elderly women British Journal of Nutrition 69, 21–27.CrossRefGoogle ScholarPubMed
Roberts, SB, Young, VR, Fuss, P, Heyman, MB, Fiatarone, M, Dallal, GE, Cortiella, J and Evans, WJ (1992) What are the dietary energy needs of elderly adults? International Journal of Obesity 16, 969–976.Google ScholarPubMed
Szabolcs, I, Ploenes, C, Beyer, M, Bernard, W and Herrmann, J (1993) Factors affecting the serum free thyroxine levels in hospitalized chronic geriatric patients Journal of the American Geriatrics Society 41, 742–746.CrossRefGoogle ScholarPubMed
Vaughan, L, Zurlo, F and Ravussin, E (1991) Aging and energy expenditure American Journal of Clinical Nutrition 53, 821–825.CrossRefGoogle ScholarPubMed
Vellas, B, Baumgartner, RN, Wayne, SJ, Conceicao, J, Lafont, C, Albarede, JL and Garry, PJ (1992) Relationship between malnutrition and falls in the elderly Nutrition 8, 105–108.Google ScholarPubMed
World Health Organization (1986) Energy and Protein Requirements. Technical Report Series no. 724. Geneva: WHO.Google Scholar