Effect of oral nutritional supplements on mortality and hospital admissions in older hip fracture patients at nutritional risk: secondary analysis of a randomised controlled trial.
Alberte Jensen, Elna Dalsgaard Ninh, Anne Wilkens Knudsen, Tina Munk, Anne Marie Beck
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引用次数: 0
Abstract
ObjectiveTo examine the association between increased energy and protein intake through oral nutritional supplements and mortality and hospital admissions in older hip fracture patients at nutritional risk, using a preplanned secondary analysis of a randomised controlled trial.SettingDepartment of Orthopaedic Surgery, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark.ParticipantsHip fracture patients aged ≥65 at nutritional risk.InterventionParticipants were randomised to receive two cans daily of high-energy, high-protein oral nutritional supplements enriched with vitamin D and omega-3 fatty acids for 12 weeks after discharge or standard care.Main MeasuresAll-cause mortality and hospital admissions during a pre-planned 38-week follow-up after discharge, including time to first admission and length of hospital stay.ResultsAll-cause mortality was low, with no difference between intervention and control groups 2 (3%) versus 3 (5%). During follow-up, 31% (n = 19) of intervention participants was admitted to hospital compared with 47% (n = 29) in the control group. The difference approached significance in the intention-to-treat analysis (Risk ratio 0.72, 95% CI 0.51-1.03, p = 0.075) and was statistically significant in the per-protocol analysis (18% vs. 44%; Risk ratio 0.69, 95% CI 0.52-0.92, p = 0.019). No significant differences were observed in admissions frequency, length of hospital stay, or time to first admission.ConclusionPost-discharge oral nutritional supplementation was associated with a trend towards fewer hospital admission, with the strongest effect among adherent participants. No significant effects were observed in mortality, admission frequency, length of hospital stay or time to admission.ClinicalTrials.gov: NCT05556876. Date of registration: 2022-09-23.URL: https://clinicaltrials.gov/study/NCT05556876.
目的通过一项随机对照试验的预先计划的二次分析，研究通过口服营养补充剂增加能量和蛋白质摄入量与有营养风险的老年髋部骨折患者的死亡率和住院率之间的关系。哥本哈根大学医院矫形外科- Herlev和Gentofte， Herlev，丹麦。年龄≥65岁有营养风险的骨折患者。参与者被随机分配，在出院或标准治疗后的12周内，每天服用两罐高能量、高蛋白、富含维生素D和omega-3脂肪酸的口服营养补充剂。主要指标：出院后预先计划的38周随访期间的全因死亡率和住院率，包括首次入院的时间和住院时间。结果全因死亡率低，干预组2（3%）与对照组3（5%）无差异。在随访期间，31% （n = 19）的干预参与者入院，而对照组为47% （n = 29）。意向治疗分析的差异接近显著性（风险比0.72,95% CI 0.51-1.03, p = 0.075），按方案分析的差异具有统计学意义（18%对44%；风险比0.69,95% CI 0.52-0.92, p = 0.019）。在入院频率、住院时间或首次入院时间方面没有观察到显著差异。结论出院后口服营养补充与住院率降低的趋势相关，在坚持治疗的参与者中效果最强。在死亡率、入院频率、住院时间或入院时间方面未观察到显著影响。注册日期：2022-09-23。URL: https://clinicaltrials.gov/study/NCT05556876。
期刊介绍：
Clinical Rehabilitation covering the whole field of disability and rehabilitation, this peer-reviewed journal publishes research and discussion articles and acts as a forum for the international dissemination and exchange of information amongst the large number of professionals involved in rehabilitation. This journal is a member of the Committee on Publication Ethics (COPE)
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