Perioperative oral nutritional supplements in normally or mildly undernourished geriatric patients submitted to surgery for hip fracture: A randomized clinical trial
Perioperative oral nutritional supplements in normally or mildly undernourished geriatric patients submitted to surgery for hip fracture: A randomized clinical trial
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DOI：
10.1016/j.clnu.2010.01.012
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发表时间：
2010-10-01
影响因子：
6.3
通讯作者：
Vazquez, Clotilde
中科院分区：
文献类型：
--
作者：
Botella-Carretero, Jose I.;Iglesias, Borja;Vazquez, Clotilde
背景：建议老年患者在骨科手术后口服营养补充剂。即使对于营养正常或轻度营养不良的老年患者，这也被证明是有效的。围手术期服用这些产品是否也有效和合适尚不清楚。方法：随机、对照、开放、平行双臂临床试验，比较能量蛋白补充剂（每天 40 克蛋白质和 400 kcal），对正常营养或轻度营养不良的患者不进行干预。结果包括血清蛋白、体重指数、术后并发症等。结果：纳入 60 名老年患者。干预组患者 (n = 30) 在手术前 5.8 +/- 1.8 天内每天摄入 52.2 +/- 12.1% 的处方补充剂，直至出院。随访时血清白蛋白存在显着变化（F = 22.536，P < 0.001），两组之间也有显着变化（F = 5.763，P = 0.002），有利于干预。血清前白蛋白也观察到同样的情况（受试者内 F = 6.654，P = 0.001，相互作用 F = 2.865，P = 0.045）。 Logistic回归显示，仅每天补充蛋白质（OR[95%CI] = 0.925[0.869-0.985]）与较少的术后并发症相关（R-2 = 0.323，chi(2) = 11.541，P = 0.003）。结论：接受手术的老年髋部骨折患者围手术期补充显示血浆恢复更好 蛋白质。每日蛋白质摄入量较高与术后并发症较少相关。 (C) 2010 年爱思唯尔有限公司和欧洲临床营养与代谢学会。版权所有。
Background: Oral nutritional supplements have been recommended after orthopedic surgery in geriatric patients. This has been shown to be effective even in normally nourished or mildly undernourished geriatric patients. Whether perioperative administration of these products is also effective and suitable is not known.Methods: Randomized, controlled, open, paralleled two-arms clinical trial, comparing energy-protein supplements (40 g of protein and 400 kcal per day), with no intervention in normally nourished or mildly undernourished patients. Outcomes were serum proteins, body mass index, postoperative complications among others.Results: 60 Elderly patients were included. Patients in the intervention group (n = 30) ingested 52.2 +/- 12.1% of the prescribed supplements per day for 5.8 +/- 1.8 days before surgery and until hospital discharge. There was a significant change in serum albumin at follow-up (F = 22.536, P < 0.001), and between the two groups (F = 5.763, P = 0.002), favouring the intervention. The same was observed for serum prealbumin (F = 6.654, P = 0.001 within subjects, F = 2.865, P = 0.045 for interaction). Logistic regression showed that only supplemented proteins per day (OR[95%CI] = 0.925[0.869-0.985]) were associated with less postoperative complications (R-2 = 0.323, chi(2) = 11.541, P = 0.003).Conclusion: Perioperative supplements in geriatric patients with hip fracture submitted to surgery showed better recovery of plasma proteins. Higher daily protein intakes were associated with less postoperative complications. (C) 2010 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.