| Objective: To analyze the effect of nutritional support therapy on the prognosis of elderly patients with hip fracture and to provide a theoretical basis for prospective research in the later period.Methods: This study collected data of elderly patients with hip fracture who were operated in the Zhongda Hospital from July 2013 to December 2018.According to the inclusion criteria,patients undergoing enteral or parenteral nutritional support during hospitalization are in the nutritional support group,and patients without nutritional support treatment are in the non-nutritional support group.Their general data,hematological indicators and hip functional score within 1 year after surgery are analyzed,including 15 factors such as age,gender,preoperative complications,postoperative complications,etc.Chi-square test was used to compare the differences of clinical baseline between the groups.The relevant hematological indicators of the patients,and the FRS and Harris scores of postoperative follow-up were analyzed by analysis of variance with repeated measurement design.P <0.05 was considered statistically significant.Results: 816 cases met the inclusion criteria in this study.There were362 cases in the non-nutritional support group and 454 cases in the nutritional support group.The average age of the patients was(79.48 ± 6.76)years,the average age of the male patients was(79.44 ± 7.0)years,the average age of the female patients was(79.50 ± 6.67)years,and the age of high incidence was 75～84 years(a total of 409 cases,accounting for 50.1% of the total number),male to female ratio was 1: 2.59.Fracture type: femoral neck fractures 486 cases(59.6%),femoral intertrochanteric fractures 330 cases(40.4%),their ratio is 1.47: 1.There was no statistically significant difference in gender,age and fracture type among the patients in the group(P>0.05).The incidence of malnutrition was 45.7%,and the incidence of malnutrition in the two groups was not statistically significant(P>0.05).The hospitalization cost of patients of non-nutritional support group was 57044.07 ± 30898.86 yuan,and the cost of patients of nutritional support group was 53490.28 ± 14958.29 yuan.The difference between the two groups was statistically significant(P<0.05).The hospitalization time of the patients of non-nutritional support group was14.96 ± 5.19 days,and the hospitalization time of the patients of nutritional support group was 14.16 ± 6.13 days.The difference between the two groups was statistically significant(P<0.05).The preoperative comorbidity rate of patients of non-nutritional support group was 67.3%,and the rate of patients of nutritional support group was 69.1%,there was no statistical difference(P>0.05).The postoperative complication rate of the patients of non-nutritional support group was 28.18%,and the rate of the patients of nutritional support group was 28.85%.There was no statistical difference between the two groups(P=0.831).Comparing the hematological indexes of patients in the non-nutritional support group and the nutritional support group before and after the operation,the differences of albumin concentration and total cholesterol concentration between the two groups were statistically significant before operation(P<0.05).However,There was no statistically significant difference in these two blood indexes between the two groups after operation(P>0.05).There was no statistically significant difference in hemoglobin concentration,lymphocyte count and prealbumin concentration(P>0.05).The patients were followed up three times within one year after operation.The difference between the FRS score and Harris score of the two groups was statistically significant(P <0.05),and the score of the nutritional support group was higher,except for the FRS score at 12 months after surgery.Conclusions: 1.There are more women than men in the elderly patients with hip fractures.The high incidence of fractures is 75～84 years old.The incidence of femoral neck fractures is higher than that of intertrochanteric fractures.2.Nearly half of elderly hip fracture patients have nutritional risk or malnutrition at admission.3.Nutritional support treatment can reduce the length of hospital stay,reduce hospitalization costs,increase the content of albumin protein and total cholesterol in patients during perioperative period and speed up the patient’s ability of daily life and recovery of hip function. |
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