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Abstract：
The objective of our study is to determine the prevalence of malnutrition in elderly patients with fragility hip fractures through different diagnostic tools and to determine which nutritional assessment tool better predicts mortality.
METHODS: This is a prospective study in patients over 65 years of age hospitalized with a diagnosis of hip fracture. A nutritional assessment was performed using several tools: the Mini Nutritional Assessment Short Form (MNA-SF), the Subjective Global Assessment (SGA), and the GLIM criteria. For the definition of low muscle mass, four different methods were used: hand grip strength (HGS), calf circumference (CC), anthropometry, and bioelectrical impedance (BIA). Mortality was registered at three, six and twelve months.
RESULTS: 300 patients were included, 79.3% female, mean age 82.9 ± 7.1 years. The MNA-SF found 42% at risk of malnutrition, and 37.3% malnourished. Using SGA, there were 44% with moderate malnutrition, and 21.7% with severe malnutrition. In application of the GLIM criteria, 84.3%, 47%, 46%, and 72.7% of patients were malnourished when HGS, anthropometry, BIA, and CC were used, respectively. Mortality was 10%, 16.3% and 22% at 3, 6 and 12 months, respectively. In malnourished patients according to MNA-SF, mortality was 5.7 times greater [95%CI 1.3-25.4; p = 0.022] at 6 months and 3.8 times greater [95%CI 1.3-11.6; p = 0.018] at 12 months. In malnourished patients according to SGA, mortality was 3.6 times greater [95%CI 1.02-13.04; p = 0.047] at 3 months, 3.4 times greater [95%CI 1.3-8.6; p = 0.012] at 6 months and 3 times greater [95%CI 1.35-6.7; p = 0.007] at 12 months.
CONCLUSIONS: The prevalence of malnutrition in patients admitted for fragility hip fracture is high. The SGA and MNA-SF are postulated as adequate tools to diagnose malnutrition in these patients, with predictive value for mortality at three, six, and twelve months.
METHODS: This is a prospective study in patients over 65 years of age hospitalized with a diagnosis of hip fracture. A nutritional assessment was performed using several tools: the Mini Nutritional Assessment Short Form (MNA-SF), the Subjective Global Assessment (SGA), and the GLIM criteria. For the definition of low muscle mass, four different methods were used: hand grip strength (HGS), calf circumference (CC), anthropometry, and bioelectrical impedance (BIA). Mortality was registered at three, six and twelve months.
RESULTS: 300 patients were included, 79.3% female, mean age 82.9 ± 7.1 years. The MNA-SF found 42% at risk of malnutrition, and 37.3% malnourished. Using SGA, there were 44% with moderate malnutrition, and 21.7% with severe malnutrition. In application of the GLIM criteria, 84.3%, 47%, 46%, and 72.7% of patients were malnourished when HGS, anthropometry, BIA, and CC were used, respectively. Mortality was 10%, 16.3% and 22% at 3, 6 and 12 months, respectively. In malnourished patients according to MNA-SF, mortality was 5.7 times greater [95%CI 1.3-25.4; p = 0.022] at 6 months and 3.8 times greater [95%CI 1.3-11.6; p = 0.018] at 12 months. In malnourished patients according to SGA, mortality was 3.6 times greater [95%CI 1.02-13.04; p = 0.047] at 3 months, 3.4 times greater [95%CI 1.3-8.6; p = 0.012] at 6 months and 3 times greater [95%CI 1.35-6.7; p = 0.007] at 12 months.
CONCLUSIONS: The prevalence of malnutrition in patients admitted for fragility hip fracture is high. The SGA and MNA-SF are postulated as adequate tools to diagnose malnutrition in these patients, with predictive value for mortality at three, six, and twelve months.
摘要：
我们研究的目的是通过不同的诊断工具确定老年脆性髋部骨折患者营养不良的患病率，并确定哪种营养评估工具更好地预测死亡率。
方法：这是一项对65岁以上诊断为髋部骨折住院患者的前瞻性研究。使用几种工具进行营养评估：迷你营养评估简表（MNA-SF），主观全球评估(SGA)，和GLIM标准。对于低肌肉质量的定义，使用了四种不同的方法：手握力(HGS)，小腿周长(CC),人体测量学,和生物电阻抗(BIA)。死亡率是在三点登记的，六个月和十二个月。
结果：包括300例患者，79.3%女性，平均年龄82.9±7.1岁。MNA-SF发现42％的人有营养不良的风险，37.3%营养不良。使用SGA，有44%的人患有中度营养不良，21.7%患有严重营养不良。在GLIM标准的应用中，84.3%,47%,46%,72.7%的患者在HGS时营养不良，人体测量学,BIA,和CC被使用，分别。死亡率是10%,在3、6和12个月时分别为16.3%和22%，分别。根据MNA-SF，在营养不良的患者中，6个月时死亡率为5.7倍[95CI1.3-25.4;p=0.022],12个月时死亡率为3.8倍[95CI1.3-11.6;p=0.018].根据SGA，在营养不良的患者中，3个月时死亡率高3.6倍[95CI1.02-13.04;p=0.047]，6个月时增加3.4倍[95CI1.3-8.6;p=0.012]，12个月时增加3倍[95CI1.35-6.7;p=0.007]。
结论：脆性髋部骨折患者营养不良发生率较高。SGA和MNA-SF被认为是诊断这些患者营养不良的适当工具，具有3岁时死亡率的预测价值，六,还有十二个月.
方法：这是一项对65岁以上诊断为髋部骨折住院患者的前瞻性研究。使用几种工具进行营养评估：迷你营养评估简表（MNA-SF），主观全球评估(SGA)，和GLIM标准。对于低肌肉质量的定义，使用了四种不同的方法：手握力(HGS)，小腿周长(CC),人体测量学,和生物电阻抗(BIA)。死亡率是在三点登记的，六个月和十二个月。
结果：包括300例患者，79.3%女性，平均年龄82.9±7.1岁。MNA-SF发现42％的人有营养不良的风险，37.3%营养不良。使用SGA，有44%的人患有中度营养不良，21.7%患有严重营养不良。在GLIM标准的应用中，84.3%,47%,46%,72.7%的患者在HGS时营养不良，人体测量学,BIA,和CC被使用，分别。死亡率是10%,在3、6和12个月时分别为16.3%和22%，分别。根据MNA-SF，在营养不良的患者中，6个月时死亡率为5.7倍[95CI1.3-25.4;p=0.022],12个月时死亡率为3.8倍[95CI1.3-11.6;p=0.018].根据SGA，在营养不良的患者中，3个月时死亡率高3.6倍[95CI1.02-13.04;p=0.047]，6个月时增加3.4倍[95CI1.3-8.6;p=0.012]，12个月时增加3倍[95CI1.35-6.7;p=0.007]。
结论：脆性髋部骨折患者营养不良发生率较高。SGA和MNA-SF被认为是诊断这些患者营养不良的适当工具，具有3岁时死亡率的预测价值，六,还有十二个月.
