liu.seSearch for publications in DiVA
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Nutritional status and functional capacity after femoral neck fractures: a prospective randomized one-year follow-up study
Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Orthopaedics. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
Show others and affiliations
2000 (English)In: Aging, ISSN 1945-4589, E-ISSN 1945-4589, Vol. 12, no 5, 366-374 p.Article in journal (Refereed) Published
Abstract [en]

The primary aim of this study was to evaluate the effect of two different surgical methods on nutritional status and functional capacity during the first postoperative year in patients with displaced femoral neck fractures. A further aim was to evaluate the effect of nutritional support. One hundred patients were randomly assigned to treatment with either primary total hip arthroplasty (THA) or osteosynthesis. Half of the patients in each treatment group received protein- and energy-enriched food in the hospital in addition to individual nutritional advice in order to optimize their intake of protein- and energy-rich food. Nutritional state and functional capacity were examined at baseline, one and three months, and one year after the operation. Pain was examined at three months and one year. The effect of nutritional intervention was equal within both surgical groups. Logistic regression showed that the dependent variable "living at one year" was significantly associated with serum albumin levels at one month. Advanced age, mental impairment and deteriorated nutritional status were predominant in the non-survivors. Overall, the primary THA group performed better compared with the osteosynthesis group concerning weight change over time, locomotion and pain. This study also showed that primary THA could safely be performed in the elderly without an increased postoperative mortality rate.

Place, publisher, year, edition, pages
2000. Vol. 12, no 5, 366-374 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-13730PubMedID: 11126523OAI: oai:DiVA.org:liu-13730DiVA: diva2:21218
Available from: 2002-05-12 Created: 2002-05-12 Last updated: 2017-12-13Bibliographically approved
In thesis
1. Displaced Femoral Neck Fractures: A prospective randomized study of clinical outcome, nutrition and costs
Open this publication in new window or tab >>Displaced Femoral Neck Fractures: A prospective randomized study of clinical outcome, nutrition and costs
2002 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Displaced femoral neck fractures comprise more than a third of all hip fractures. There is controversy as to the optimal treatment. Despite attempts to improve the methods for internal fixation, complication rates have been almost unchanged: 20-40% non-union and late segmental collapse in another 10-20%. Internal fixation has been the preferred treatment in Scandinavia, whereas primary hemi- or total arthroplasty have been more prevalent in the rest of Europe and North America.

In this study, patients 75 years or older, including those with mental impairment, were randomized to either internal fixation or cemented primary total hip arthroplasty (THA). A total of 146 hips in 143 patients were followed for two years. After one year 23% had died, and after two years 29%. Mortality was about the same in both groups. The accumulated mortality was pronounced among the mentally impaired patients.

In the internal fixation group, 44% underwent further surgery. In the THA group, 18% dislocated. The dislocation rate was higher for the mentally impaired patients. The Harris hip scores were higher in the THA group, whereas pain was more common in the internal fixation group.

The first 50 patients in each treatment group were studied concerning heterotopic ossification (HO), a well-known complication after THA. The incidence of HO in the THA group was similar to what is found after THA due to osteoarthritis. However, only 1/39 developed severe symptoms.

A subgroup of 100 patients was included in a study concerning nutritional status and functional capacity using the Modified Norton scale, Katz index of ADL and a questionnaire measuring instrumental activities of daily living. The THA group fared better concerning weight change over time, locomotion and pain. The nutritional intervention did not show any measurable effects.

All patients were followed until two years postoperatively and all fracturerelated hospital costs, including reoperations, were calculated. We found no difference in total costs between the treatment groups. Costs to the municipality were calculated comparing the baseline cost before surgery with the average cost per month during the first postoperative year. No difference was found between the treatment groups.

On the basis of our results, we recommend arthroplasty for patients in this age group with normal mental function and high functional demands.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2002. 55 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 731
Keyword
Arthroplasty, replacement, hip, adverse effects, economics, fracture fixation, internal, femoral neck fractures, surgery, ossification, heterotropic, etiology, nutritional support
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-5233 (URN)91-7373-180-3 (ISBN)
Public defence
2002-05-17, Berzeliussalen, Campus US, Linköpings universitet, Linköping, 13:00 (English)
Opponent
Supervisors
Available from: 2002-05-12 Created: 2002-05-12 Last updated: 2012-01-25Bibliographically approved
2. Nutritional status and functional capacity in elderly people with hip fracture
Open this publication in new window or tab >>Nutritional status and functional capacity in elderly people with hip fracture
2000 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim was to study nutritional status and functional capacity in elderly men and women admitted to hospital with a hip fractnre, and to evaluate the effect of nutritional intervention and surgical method. A total of 176 patients participated in the study. Of them 84 received protein- and energy-enriched meals at hospital and nutritional advice on discharge and at home. A total of 100 patients with displaced femoral neck fracture were randomised to treatment with either total hip arthroplasty or osteosynthesis with Olmed® screws.

The patients were examined and interviewed the first time within 4-6 days after surgery, as well as one and three months aud one year after surgery. The nutritional status was assessed with body mass index, measures of triceps skinfold thickness, estimation of muscle mass and body composition. Serum albumin, insulin-like growth factor-I and hormones were measured. Functional capacity was assessed with the Modified Norton scale, Katz index of ADL and a questionnaire measuring instrumental activities of daily living.

Mentally impaired patients had worse nutritional status aud functional condition compared with the lucid group at inclusion, deteriorated more in activity and mobility fimctions and had a higher one-year mortality rate. The nutritional intervention was not powerful enough to have effect on anthropometric or biochemical measurements. The patients treated with total hip arthroplasty had reduced pain, better locomotion ability and a slight weight gain compared with the osteosynthesis group.

In conclusion, a marked deterioration of nutritional and functional status was found after a hip fracture. Studies of the effect of a more powerful nutritional intervention on nutritional status and functional capacity in this group are warranted. Patients treated with total hip arthroplasty had a more favourable rehabilitation period with regard to nutritional status and locomotion ability.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet, 2000. 61 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 649
Keyword
elderly people, functional capacity, hip fractnre, mental impairment, nutritional status
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-27458 (URN)12111 (Local ID)91-7219-750-1 (ISBN)12111 (Archive number)12111 (OAI)
Public defence
2000-11-18, Berzeliussalen, Universitetssjukhuset, Linköping, 09:00 (Swedish)
Opponent
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2012-08-15Bibliographically approved

Open Access in DiVA

No full text

PubMed

Authority records BETA

Bachrach-Lindström, MargaretaJohansson, TorstenUnosson, MitraEk, Anna-ChristinaWahlström, Ola

Search in DiVA

By author/editor
Bachrach-Lindström, MargaretaJohansson, TorstenUnosson, MitraEk, Anna-ChristinaWahlström, Ola
By organisation
Nursing ScienceFaculty of Health SciencesOrthopaedics
In the same journal
Aging
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar

pubmed
urn-nbn

Altmetric score

pubmed
urn-nbn
Total: 284 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf