Nutritional supplementation for hip fracture aftercare in older people
Abstract
BACKGROUND: Older people with hip fractures are often malnourished at the time of fracture, and have poor food intake subsequently.
OBJECTIVES: To review the effects of nutritional interventions in older people recovering from hip fracture.
SEARCH STRATEGY: We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (September 2008), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2008, Issue 3), MEDLINE and other major databases (to July 2008).
SELECTION CRITERIA: Randomised and quasi-randomised controlled trials of nutritional interventions for people aged over 65 years with hip fracture.
DATA COLLECTION AND ANALYSIS: Both authors independently selected trials, extracted data and assessed trial quality. We pooled data for primary outcomes.
MAIN RESULTS: Twenty-four randomised trials involving 1940 participants were included. Outcome data were limited and many trials were methodologically flawed. Results from 23 trials are presented here.Ten trials evaluated oral multinutrient feeds: providing non-protein energy, protein, some vitamins and minerals. Oral feeds had no statistically significant effect on mortality (16/244 versus 21/226; risk ratio (RR) 0.76, 95% confidence interval (CI) 0.42 to 1.37) or 'unfavourable outcome' (combined outcome of mortality and survivors with medical complications) (46/126 versus 41/103; RR 0.76, 95% CI 0.55 to 1.04).Four heterogenous trials examining nasogastric multinutrient feeding showed no…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,940 participants or records.
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