Nutritional differences in patients with proximal femoral fractures

Background: the reason why elderly human hips tend to break in one of two a natomical regions is uncertain. Nutritional factors may affect the site of fracture. Objective: to assess possible nutritional differences in patients with prox imal femoral fractures. Design: prospective observational cohort study. Setting: university teaching hospital. Subjects: 119 consecutive patients over the age of 65 with a hip fracture a dmitted to the trauma wards in a single centre. Methods: one researcher measured triceps, biceps and supra-iliac skinfold t hickness, and mid upper arm circumference on admission and on the fifth pos t-operative day. Body mass index was calculated for each patient, and used to classify patients as severely, moderately or mildly malnourished, normal , overweight or obese. Logistic regression was used to determine the influe nce of various factors on fracture site. Results: according to their body mass index, 31% of patients were classifie d as malnourished and 11% as severely malnourished. Patients with intracaps ular fractures were significantly more malnourished than patients with troc hanteric fractures (P < 0.008). Nutritional status was not related to post- operative complications. Ability to weigh a patient on the fifth post-opera tive day was the single most important prognostic indicator for complicatio ns. Conclusions: patients with intracapsular fractures are more malnourished. T hose with trochanteric fractures tend to be overweight.