Predictive Validity of Mortality after Surgically Treated Proximal Femur Fractures Based on Four Nutrition Scores—A Retrospective Data Analysis
Abstract
:1. Introduction
2. Material and Methods
2.1. Statistical Analysis
2.2. Nutrition Scores
2.2.1. NRS (Nutritional Risk Screening)
2.2.2. MNA (Mini Nutritional Assessment)
2.2.3. GMS (Graz Malnutrition Screening)
2.2.4. MUST (Malnutrition Universal Screening Tool)
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Kanis, J.A.; Odén, A.; McCloskey, E.V.; Johansson, H.; Wahl, D.A.; Cooper, C. A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporos. Int. 2012, 23, 2239–2256. [Google Scholar] [CrossRef] [Green Version]
- Zhang, Y.W.; Lu, P.P.; Li, Y.J.; Dai, G.C.; Chen, M.H.; Zhao, Y.K.; Cao, M.M.; Rui, Y.F. Prevalence, Characteristics, and Associated Risk Factors of the Elderly with Hip Fractures: A Cross-Sectional Analysis of NHANES 2005-2010. Clin. Interv. Aging 2021, 16, 177–185. [Google Scholar] [CrossRef]
- Meyer, A.C.; Ek, S.; Drefahl, S.; Ahlbom, A.; Hedström, M.; Modig, K. Trends in Hip Fracture Incidence, Recurrence, and Survival by Education and Comorbidity: A Swedish Register-based Study. Epidemiology 2021, 32, 425–433. [Google Scholar] [CrossRef]
- Veronese, N.; Maggi, S. Epidemiology and social costs of hip fracture. Injury 2018, 49, 1458–1460. [Google Scholar] [CrossRef] [PubMed]
- Haentjens, P.; Lamraski, G.; Boonen, S. Costs and consequences of hip fracture occurrence in old age: An economic perspective. Disabil. Rehabil. 2005, 27, 1129–1141. [Google Scholar] [CrossRef] [PubMed]
- Ramponi, D.R.; Kaufmann, J.; Drahnak, G. Hip Fractures. Adv. Emerg. Nurs. J. 2018, 40, 8–15. [Google Scholar] [CrossRef] [PubMed]
- Bentler, S.E.; Liu, L.; Obrizan, M.; Cook, E.A.; Wright, K.B.; Geweke, J.F.; Chrischilles, E.A.; Pavlik, C.E.; Wallace, R.B.; Ohsfeldt, R.L.; et al. The aftermath of hip fracture: Discharge placement, functional status change, and mortality. Am. J. Epidemiol. 2009, 170, 1290–1299. [Google Scholar] [CrossRef] [Green Version]
- Bhandari, M.; Swiontkowski, M. Management of Acute Hip Fracture. N. Engl. J. Med. 2017, 377, 2053–2062. [Google Scholar] [CrossRef]
- Malafarina, V.; Reginster, J.Y.; Cabrerizo, S.; Bruyère, O.; Kanis, J.A.; Martinez, J.A.; Zulet, M.A. Nutritional Status and Nutritional Treatment Are Related to Outcomes and Mortality in Older Adults with Hip Fracture. Nutrients 2018, 10, 555. [Google Scholar] [CrossRef] [Green Version]
- Pincus, D.; Ravi, B.; Wasserstein, D.; Huang, A.; Paterson, J.M.; Nathens, A.B.; Kreder, H.J.; Jenkinson, R.J.; Wodchis, W.P. Association Between Wait Time and 30-Day Mortality in Adults Undergoing Hip Fracture Surgery. JAMA 2017, 318, 1994–2003. [Google Scholar] [CrossRef] [Green Version]
- Pioli, G.; Barone, A.; Giusti, A.; Oliveri, M.; Pizzonia, M.; Razzano, M.; Palummeri, E. Predictors of mortality after hip fracture: Results from 1-year follow-up. Aging Clin. Exp. Res. 2006, 18, 381–387. [Google Scholar] [CrossRef] [PubMed]
- Mariconda, M.; Costa, G.G.; Cerbasi, S.; Recano, P.; Aitanti, E.; Gambacorta, M.; Misasi, M. The determinants of mortality and morbidity during the year following fracture of the hip: A prospective study. Bone Jt. J. 2015, 97-b, 383–390. [Google Scholar] [CrossRef] [PubMed]
- Avenell, A.; Smith, T.O.; Curtain, J.P.; Mak, J.C.; Myint, P.K. Nutritional supplementation for hip fracture aftercare in older people. Cochrane Database Syst. Rev. 2016, 11, Cd001880. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Blanco, J.F.; Da Casa, C.; Pablos-Hernández, C.; González-Ramírez, A.; Julián-Enríquez, J.M.; Díaz-Álvarez, A. 30-day mortality after hip fracture surgery: Influence of postoperative factors. PLoS ONE 2021, 16, e0246963. [Google Scholar] [CrossRef]
- Goisser, S.; Schrader, E.; Singler, K.; Bertsch, T.; Gefeller, O.; Biber, R.; Bail, H.J.; Sieber, C.C.; Volkert, D. Malnutrition According to Mini Nutritional Assessment Is Associated With Severe Functional Impairment in Geriatric Patients Before and up to 6 Months After Hip Fracture. J. Am. Med. Dir. Assoc. 2015, 16, 661–667. [Google Scholar] [CrossRef]
- Soeters, P.B.; Reijven, P.L.; Van Bokhorst-de van der Schueren, M.A.; Schols, J.M.; Halfens, R.J.; Meijers, J.M.; van Gemert, W.G. A rational approach to nutritional assessment. Clin. Nutr. 2008, 27, 706–716. [Google Scholar] [CrossRef]
- Kondrup, J.; Rasmussen, H.H.; Hamberg, O.; Stanga, Z. Nutritional risk screening (NRS 2002): A new method based on an analysis of controlled clinical trials. Clin. Nutr. 2003, 22, 321–336. [Google Scholar] [CrossRef]
- Guigoz, Y. The Mini Nutritional Assessment (MNA) review of the literature—What does it tell us? J. Nutr. Health Aging 2006, 10, 466–485; discussion 485–487. [Google Scholar]
- Roller, R.E.; Eglseer, D.; Eisenberger, A.; Wirnsberger, G.H. The Graz Malnutrition Screening (GMS): A new hospital screening tool for malnutrition. Br. J. Nutr. 2016, 115, 650–657. [Google Scholar] [CrossRef] [Green Version]
- Stratton, R.J.; Hackston, A.; Longmore, D.; Dixon, R.; Price, S.; Stroud, M.; King, C.; Elia, M. Malnutrition in hospital outpatients and inpatients: Prevalence, concurrent validity and ease of use of the ‘malnutrition universal screening tool’ (‘MUST’) for adults. Br. J. Nutr. 2004, 92, 799–808. [Google Scholar] [CrossRef] [Green Version]
- Kondrup, J.; Allison, S.P.; Elia, M.; Vellas, B.; Plauth, M. ESPEN guidelines for nutrition screening 2002. Clin. Nutr. 2003, 22, 415–421. [Google Scholar] [CrossRef]
- Van Wissen, J.; Van Stijn, M.F.; Doodeman, H.J.; Houdijk, A.P. Mini Nutritional Assessment and Mortality after Hip Fracture Surgery in the Elderly. J. Nutr. Health Aging 2016, 20, 964–968. [Google Scholar] [CrossRef] [PubMed]
- Zhang, Z.; Pereira, S.L.; Luo, M.; Matheson, E.M. Evaluation of Blood Biomarkers Associated with Risk of Malnutrition in Older Adults: A Systematic Review and Meta-Analysis. Nutrients 2017, 9, 829. [Google Scholar] [CrossRef]
- Bauer, J.M.; Kaiser, M.J.; Anthony, P.; Guigoz, Y.; Sieber, C.C. The Mini Nutritional Assessment—Its history, today’s practice, and future perspectives. Nutr. Clin. Pract. 2008, 23, 388–396. [Google Scholar] [CrossRef] [PubMed]
- Li, S.; Zhang, J.; Zheng, H.; Wang, X.; Liu, Z.; Sun, T. Prognostic Role of Serum Albumin, Total Lymphocyte Count, and Mini Nutritional Assessment on Outcomes After Geriatric Hip Fracture Surgery: A Meta-Analysis and Systematic Review. J. Arthroplast. 2019, 34, 1287–1296. [Google Scholar] [CrossRef] [PubMed]
- Nuotio, M.; Tuominen, P.; Luukkaala, T. Association of nutritional status as measured by the Mini-Nutritional Assessment Short Form with changes in mobility, institutionalization and death after hip fracture. Eur. J. Clin. Nutr. 2016, 70, 393–398. [Google Scholar] [CrossRef]
- Schaller, F.; Sidelnikov, E.; Theiler, R.; Egli, A.; Staehelin, H.B.; Dick, W.; Dawson-Hughes, B.; Grob, D.; Platz, A.; Can, U.; et al. Mild to moderate cognitive impairment is a major risk factor for mortality and nursing home admission in the first year after hip fracture. Bone 2012, 51, 347–352. [Google Scholar] [CrossRef]
- Dubljanin-Raspopović, E.; Marković-Denić, L.; Marinković, J.; Nedeljković, U.; Bumbaširević, M. Does early functional outcome predict 1-year mortality in elderly patients with hip fracture? Clin. Orthop. Relat. Res. 2013, 471, 2703–2710. [Google Scholar] [CrossRef] [Green Version]
- Miyanishi, K.; Jingushi, S.; Torisu, T. Mortality after hip fracture in Japan: The role of nutritional status. J. Orthop. Surg. 2010, 18, 265–270. [Google Scholar] [CrossRef]
- Kimura, A.; Sugimoto, T.; Kitamori, K.; Saji, N.; Niida, S.; Toba, K.; Sakurai, T. Malnutrition is Associated with Behavioral and Psychiatric Symptoms of Dementia in Older Women with Mild Cognitive Impairment and Early-Stage Alzheimer’s Disease. Nutrients 2019, 11, 1951. [Google Scholar] [CrossRef] [Green Version]
- Xu, B.Y.; Yan, S.; Low, L.L.; Vasanwala, F.F.; Low, S.G. Predictors of poor functional outcomes and mortality in patients with hip fracture: A systematic review. BMC Musculoskelet. Disord. 2019, 20, 568. [Google Scholar] [CrossRef] [Green Version]
- Koren-Hakim, T.; Weiss, A.; Hershkovitz, A.; Otzrateni, I.; Anbar, R.; Gross Nevo, R.F.; Schlesinger, A.; Frishman, S.; Salai, M.; Beloosesky, Y. Comparing the adequacy of the MNA-SF, NRS-2002 and MUST nutritional tools in assessing malnutrition in hip fracture operated elderly patients. Clin. Nutr. 2016, 35, 1053–1058. [Google Scholar] [CrossRef] [PubMed]
- Anthony, P.S. Nutrition screening tools for hospitalized patients. Nutr. Clin. Pract. 2008, 23, 373–382. [Google Scholar] [CrossRef]
- Bohl, D.D.; Shen, M.R.; Hannon, C.P.; Fillingham, Y.A.; Darrith, B.; Della Valle, C.J. Serum Albumin Predicts Survival and Postoperative Course Following Surgery for Geriatric Hip Fracture. J. Bone Jt. Surg. 2017, 99, 2110–2118. [Google Scholar] [CrossRef] [PubMed]
- Keller, U. Nutritional Laboratory Markers in Malnutrition. J. Clin. Med. 2019, 8, 775. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Kieffer, W.K.; Rennie, C.S.; Gandhe, A.J. Preoperative albumin as a predictor of one-year mortality in patients with fractured neck of femur. Ann. R. Coll. Surg. Engl. 2013, 95, 26–28. [Google Scholar] [CrossRef] [Green Version]
Malnutrition | Risk of Malnutrition | |||||
---|---|---|---|---|---|---|
MNA 0–7 | MUST ≥ 2 | GMS ≥ 3 | NRS ≥ 3 | MNA 8–11 | MUST = 1 | |
1. Month | ||||||
postoperative | 5.03 | 3.06 | 2.34 | 2.65 | 1.68 | 2.29 |
Odds Ratio | Odds Ratio | Odds Ratio | Odds Ratio | Odds Ratio | Odds Ratio | |
(p < 0.01) | (p < 0.01) | (p < 0.01) | (p < 0.01) | (p > 0.05) | (p < 0.01) | |
2. Month | ||||||
postoperative | 7.28 | 3.48 | 2.70 | 2.79 | 2.35 | 1.82 |
Odds Ratio | Odds Ratio | Odds Ratio | Odds Ratio | Odds Ratio | Odds Ratio | |
(p < 0.01) | (p < 0.01) | (p < 0.01) | (p < 0.01) | (p < 0.01) | (p < 0.01) | |
6. Month | ||||||
postoperative | 7.44 | 3.40 | 2.96 | 2.74 | 2.73 | 2.05 |
Odds Ratio | Odds Ratio | Odds Ratio | Odds Ratio | Odds Ratio | Odds Ratio | |
(p < 0.01) | (p < 0.01) | (p < 0.01) | (p < 0.01) | (p < 0.01) | (p < 0.01) | |
12. Month | ||||||
postoperative | 7.77 | 2.94 | 2.93 | 2.67 | 3.35 | 2.12 |
Odds Ratio | Odds Ratio | Odds Ratio | Odds Ratio | Odds Ratio | Odds Ratio | |
(p < 0.01) | (p < 0.01) | (p < 0.01) | (p < 0.01) | (p < 0.01) | (p < 0.01) |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Popp, D.; Nia, A.; Biedermann, G.; Schmoelz, L.; Silvaieh, S.; Tiefenboeck, T.M.; Hajdu, S.; Widhalm, H.K. Predictive Validity of Mortality after Surgically Treated Proximal Femur Fractures Based on Four Nutrition Scores—A Retrospective Data Analysis. Nutrients 2023, 15, 3357. https://doi.org/10.3390/nu15153357
Popp D, Nia A, Biedermann G, Schmoelz L, Silvaieh S, Tiefenboeck TM, Hajdu S, Widhalm HK. Predictive Validity of Mortality after Surgically Treated Proximal Femur Fractures Based on Four Nutrition Scores—A Retrospective Data Analysis. Nutrients. 2023; 15(15):3357. https://doi.org/10.3390/nu15153357
Chicago/Turabian StylePopp, Domenik, Arastoo Nia, Gregor Biedermann, Lukas Schmoelz, Sara Silvaieh, Thomas M. Tiefenboeck, Stefan Hajdu, and Harald K. Widhalm. 2023. "Predictive Validity of Mortality after Surgically Treated Proximal Femur Fractures Based on Four Nutrition Scores—A Retrospective Data Analysis" Nutrients 15, no. 15: 3357. https://doi.org/10.3390/nu15153357