Prevalence of malnutrition in a cohort of 509 patients with acute hip fracture: the importance of a comprehensive assessment

BACKGROUNDS/OBJECTIVES: Malnutrition is very common in acute hip fracture (HF) patients. Studies differ widely in their findings, with reported prevalences between 31 and 88% mainly because of small sample sizes and the use of different criteria. The aim of this study was to learn the prevalence of malnutrition in a large cohort of HF patients in an comprehensive way that includes the frequency of protein-energy malnutrition, vitamin D deficiency and sarcopenia. SUBJECTS/METHODS: A 1-year consecutive sample of patients admitted with fragility HF in a 1300-bed public University Hospital, who were assessed within the first 72 h of admission. Clinical, functional, cognitive and laboratory variables were included. Energy malnutrition (body mass index (BMI) < 22 kg/m(2)), protein malnutrition (serum total protein < 6.5 g/dl or albumin < 3.5 g/dl), vitamin D deficiency (serum 25-OH-vitamin D < 30 ng/dl) and sarcopenia (low muscle mass plus low grip strength) were considered. RESULTS: Five hundred nine HF patients were included. The mean age was 85.6 +/- 6.9 years and 79.2% were women. Ninety-nine (20.1%) patients had a BMI < 22 kg/m(2). Four hundred nine patients (81.2%) had protein malnutrition. Eighty-seven (17.1%) patients had both energy and protein malnutrition. Serum vitamin D was < 30 ng/ml in 466 (93%) patients. The prevalence of sarcopenia was 17.1%. CONCLUSIONS: Protein malnutrition and vitamin D deficiency are the rule in acute HF patients. Energy malnutrition and sarcopenia are also common. A nutritional assessment in these patients should include these aspects together.