BENEFITS OF SUPPLEMENTARY TUBE-FEEDING AFTER FRACTURED NECK OF FEMUR - A RANDOMIZED CONTROLLED TRIAL (REPRINTED FROM BRITISH-MEDICAL-JOURNAL, VOL 287, PG 1589-1592, 1983)

A total of 744 elderly women with fractured neck of femur were classif ied into three groups according to anthropometric measurements on admi ssion: group 1, well nourished; group 2, thin; group 3, very thin. Gro up 1 ate well and had a low mortality and a short rehabilitation time. The thinner the patients the lower their voluntary food intake, the h igher their mortality and the longer their rehabilitation time. A seri es of 122 patients from groups 2 and 3 were entered postoperatively in to a randomised controlled trial of overnight supplementary nasogastri c tube feeding (4.2 MJ (1000 kcal), including 28 g protein) in additio n to their normal ward diet. This treatment was associated with improv ements not only in anthropometric and plasma protein measurements but also in clinical outcome, especially in the very thin group 3 patients . Rehabilitation time and hospital stay were shortened. Mortality in g roup 3 was less in the tube fed patients (8%) than in the controls (22 %) but this difference did not reach statistical significance. One in five patients could not tolerate the nasogastric tube, but in the rema inder the treatment caused no side effects and did not seriously dimin ish voluntary oral food intake by day.