Effect of oral nutritional supplements on mortality and hospital admissions in older hip fracture patients at nutritional risk: secondary analysis of a randomised controlled trial
Abstract
ObjectiveTo examine the association between increased energy and protein intake through oral nutritional supplements and mortality and hospital admissions in older hip fracture patients at nutritional risk, using a preplanned secondary analysis of a randomised controlled trial.SettingDepartment of Orthopaedic Surgery, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark.ParticipantsHip fracture patients aged ≥65 at nutritional risk.InterventionParticipants were randomised to receive two cans daily of high-energy, high-protein oral nutritional supplements enriched with vitamin D and omega-3 fatty acids for 12 weeks after discharge or standard care.Main MeasuresAll-cause mortality and hospital admissions during a pre-planned 38-week follow-up after discharge, including time to first admission and length of hospital stay.ResultsAll-cause mortality was low, with no difference between intervention and control groups 2 (3%) versus 3 (5%). During follow-up, 31% (n = 19) of intervention participants was admitted to hospital compared with 47% (n = 29) in the control group. The difference approached significance in the intention-to-treat analysis (Risk ratio 0.72, 95% CI 0.51-1.03, p = 0.075) and was statistically significant in the per-protocol analysis (18% vs. 44%; Risk ratio 0.69, 95% CI 0.52-0.92, p = 0.019). No significant differences were observed in admissions frequency, length of hospital stay, or time to first admission.ConclusionPost-discharge oral…
How strong is the evidence?
Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 29 participants or records.
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