The Predictive Efficacy of Different Nutritional Screening Tools on Postoperative Outcomes of Elderly Hip Fractures
[Objective]To explore the predictive efficacy of different nutritional screening tools on the post-operative outcomes of elderly hip fractures.[Methods]Clinical data of 314 patients who were hospitalized in the orthopedics department of the Zhangjiakou Second Hospital from January 2017 to December 2019 were col-lected.All patients were evaluated for their nutritional status using the Nutrition Risk Screening 2002(NRS-2002),the malnutrition universal screening tool(MUST),the mini nutrition assessment-short form(MNA-SF),and the geriatric nutrition risk index(GNRI)before surgery.All patient clinical data were recorded,and the function independent measure(FIM)scale was used to evaluate daily living activities on the first day after surgery and at discharge.The FIM rehabilitation efficacy was calculated[(difference in FIM scores on the first day after surgery and discharge)/postoperative hospital stay],and the average walking speed of 15 meters at 14 days after surgery was evaluated.The correlation analysis between different nutritional status and prognos-tic indicators of various nutritional screening tools was conducted.[Results]A total of 343 patients were admit-ted,of which 29 were excluded and 314 met the inclusion criteria.The age was(81.54±7.34)years old,with 236 females(75.16％).According to MNA-SF nutritional screening,80 cases(25.48％)were well nourished,160 cases(50.96％)were at risk of malnutrition,and 74 cases(23.57％)were at risk of malnutrition;Ac-cording to MUST nutritional screening,145 cases(46.18％)were at low risk,72 cases(22.93％)were at me-dium risk,and 97 cases(30.89％)were at high risk;According to NRS-2002 nutritional screening,135 cases(42.99％)were well nourished,101 cases(32.17％)had moderate risk,and 78 cases(24.84％)had malnutri-tion;According to GNRI nutritional screening,68 cases(21.66％)were at no risk,114 cases(36.31％)had mild risk,and 132 cases(42.04％)had significant risk.There was a statistically significant difference in the proportion of different nutritional status among various screening tools(x2=45.82,P＜0.001).There was a correlation between MNA-SF and discharge FIM score;Compared with good nutrition,both the risk of mal-nutrition and malnutrition had a negative impact on the discharge FIM score,FIM rehabilitation efficacy and average walking speed of 15 meters(P＜0.05).NRS-2002 was only related to the discharge FIM score.When using GNRI evaluation,compared with no risk,minor and major risks only had a negative impact on the aver-age walking speed of 15 meters(P＜0.05),and were not correlated with the rehabilitation efficacy of FIMs and the average walking speed of 15 meters(P＞0.05).There was no correlation between MUST and prog-nostic indicators(P＞0.05).[Conclusion]In the acute phase of elderly patients with hip fractures,MNA-SF is the most relevant nutritional screening tool for early functional prognosis.
Hip Fractures/SUFracture FixationNutritional StatusAged
万方数据
维普
