Efficacy of an oral nutritional supplement in the recovery of elderly patients with spontaneous hip fracture (Irene trial)
2023; Elsevier BV; Volume: 58; Linguagem: Inglês
10.1016/j.clnesp.2023.09.151
ISSN2405-4577
AutoresS. García-Rey, Roberto Eduardo Aguirre Fernández, Rosa María Domínguez, N. Montero-Madrid, Roser De Castellar Sansó, B. Ubierna, J.M. Garcia- Almeida, Pedro Pablo García‐Luna,
Tópico(s)Nutrition and Health in Aging
ResumoRationale: Elderly hip fracture patients(EHFp) undergoing surgery are often malnourished or at risk. Oral nutritional supplements are normally used to help meet postoperative nutritional needs and reduce muscle wasting. This trial assessed the effects of an hypercaloric, high-protein supplement(HHS) on improving muscle mass and nutritional markers in EHFp after surgery. Methods: This double-blind, randomized, placebo-controlled trial included EHFp who were randomized to receive HHS(15g protein, 300kcal), intervention group(IG) or placebo, control group(CG), twice daily for 4month(m) after surgery. Patients’ functional, prognostic and nutritional situation was assessed at pre and post-surgery, 2m and 4m using anthropometrics, Barthel and Charlson index, Mini Nutritional Assessment and muscle ultrasound. Muscle mass morphology (Phase angle, PhA by bioelectrical impedance analysis) and muscle function (handgrip strength, HS) were measured. Results: 86 patients were recruited(44HHS, 42placebo). Regarding anthropometrics, fracture, prothesis types and length of stay, there were no significant differences between groups. Baseline PhA mean was 4.33º±0.83 (IG) and 4.76º±1.06 (CG). Significant PhA improvements were associated to baseline PhA value for the IG(p=0.003) for a cutoff value of 4º. IG EHFp with a PhA≥4º showed significant increase than CG but a PhA<4º did not show favorable evolution. This association was not observed in the CG. After 4m of follow-up, there were no significant differences in muscle function (HS). HHS was well tolerated and there were no differences in rate of adverse events between groups. Image: Conclusion: The energetic protein-based oral supplement demonstrated a beneficial effect associated with the improvement of the PhA as a marker of morphological muscle recovery in elderly HF patients undergoing surgery. Low PhA<4º could associate a lack of muscle mass response. Disclosure of Interest: S. García-Rey: None declared, R. Fernandez : None declared, R. Dominguez: None declared, N. Montero-Madrid: None declared, R. De Castellar Sansó Other: worker at Laboratorios Ordesa SL., B. Ubierna Other: worker at Laboratorios Grand Fontaine, J. Garcia- Almeida: None declared, P. Garcia-Luna: None declared
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