Department of Rehabilitation, Kowloon Hospital, Rehabilitation Building, 147A Argyle Street, Kowloon, Hong Kong.
Age Ageing. 2013 Jan;42(1):39-45. doi: 10.1093/ageing/afs078. Epub 2012 Jun 8.
malnutrition is an important risk factor for poor outcome in patients recovering after hip fracture surgery. This study aimed to investigate the clinical, nutritional and rehabilitation effects of an oral nutritional supplementation (ONS) in an inpatient rehabilitation setting.
this was an observer-blinded randomised controlled trial of elderly post-surgical proximal femoral fracture patients. A ready-to-use oral liquid nutritional supplementation (18-24 g protein and 500 kcal per day) in addition to hospital diet was compared with hospital diet only. Both groups received usual rehabilitation therapy and oral calcium and vitamin D supplements. Outcomes were compared at discharge from rehabilitation and after 4 weeks of discharge. The primary outcome parameters were the serum albumin level, the body mass index (BMI), the functional independence measure (FIM) and the elderly mobility scale (EMS). Secondary outcome parameters were frequency of complications, inpatient length of stay, mortality and acute hospital use within 6 months after discharge.
a total of 126 patients were recruited, 65 in the supplementation arm and 61 in the control arm. There was a significant difference in change in BMI with a decrease of 0.25 and 0.03 kg/m(2) in the ONS group and 0.72 and 0.49 kg/m(2) in the control group at hospital discharge and follow-up, respectively (P = 0.012). The length of stay in rehabilitation ward was shortened by 3.80 (SE = 1.81, P = 0.04) days favouring the ONS group. The total number of infection episodes was also reduced significantly. No difference was observed in the rate of change of the serum albumin level, the FIM and the EMS.
clinical and nutritional benefits were seen in this trial but rehabilitation benefits could not be demonstrated.
营养不良是髋部骨折手术后患者康复不良的一个重要危险因素。本研究旨在探讨口服营养补充（ONS）在住院康复环境中的临床、营养和康复效果。
这是一项对接受髋关节手术后的老年股骨近端骨折患者进行的观察者盲法随机对照试验。在医院饮食的基础上，比较了一种即用型口服液体营养补充剂（每天 18-24 克蛋白质和 500 千卡）与单纯医院饮食。两组均接受常规康复治疗和口服钙及维生素 D 补充剂。在康复出院时和出院后 4 周时比较了结果。主要结局参数为血清白蛋白水平、体重指数（BMI）、功能独立性测量（FIM）和老年人移动量表（EMS）。次要结局参数为并发症发生率、住院时间、死亡率以及出院后 6 个月内急性住院使用情况。
共招募了 126 名患者，补充组 65 名，对照组 61 名。补充组和对照组出院时和随访时 BMI 的变化差异有统计学意义，分别为 ONS 组下降 0.25 和 0.03 kg/m2，对照组下降 0.72 和 0.49 kg/m2（P = 0.012）。ONS 组在康复病房的住院时间缩短了 3.80 天（SE = 1.81，P = 0.04）。感染发作次数也显著减少。血清白蛋白水平、FIM 和 EMS 的变化率无差异。
本试验观察到临床和营养获益，但未能证明康复获益。
