Evidence map›Paper›PMID 30204859›Full record

Trial reportThe journals of gerontology. Series A, Biological sciences and medical sciences2018

Efficacy of Nutritional Intervention in Elderly After Hip Fracture: A Multicenter Randomized Controlled Trial.

Caroline E Wyers, Petronella L M Reijven, José J L Breedveld-Peters, Karlijn F M Denissen, Martijn G M Schotanus, Martien C J M van Dongen, Simone J P M Eussen, Ide C Heyligers, Piet A van den Brandt, Paul C Willems and 2 more

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The journals of gerontology. Series A, Biological sciences and medical sciences, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 6 syntheses or guidelines pooled it.

  1. Pooled it
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  7. Nutritional status as independent prognostic factor of outcome and mortality until five years after hip fracture: a comprehensive prospective study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024
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  18. A study on the effect of nutrition education based on the goal attainment theory on oral nutritional supplementation after colorectal cancer surgery.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Caroline E WyersDepartment of Epidemiology, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.
Petronella L M ReijvenDepartment of Dietetics, Maastricht University Medical Center, Maastricht, The Netherlands.
José J L Breedveld-PetersDepartment of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands.
Karlijn F M DenissenDepartment of Epidemiology, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.
Martijn G M SchotanusDepartment of Orthopaedic Surgery, Zuyderland Medical Center Sittard-Geleen, The Netherlands.
Martien C J M van DongenDepartment of Epidemiology, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.
Simone J P M EussenDepartment of Epidemiology, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.
Ide C HeyligersDepartment of Orthopaedic Surgery, Zuyderland Medical Center Heerlen, Heerlen, The Netherlands.
Piet A van den BrandtDepartment of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht, The Netherlands.
Paul C WillemsDepartment of Orthopaedic Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
Svenhjalmar van HeldenDepartment of Trauma surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
Pieter C DagnelieDepartment of Epidemiology, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Malnutrition after hip fracture is associated with increased rehabilitation time, complications, and mortality. We assessed the effect of intensive 3 month nutritional intervention in elderly after hip fracture on length of stay (LOS). Methods: Open-label, randomized controlled trial. Exclusion criteria: age < 55 years, bone disease, life expectancy < 1 year, bedridden, using oral nutritional supplements (ONS) before hospitalization, and cognitive impairment. Intervention: weekly dietetic consultation, energy-protein-enriched diet, and ONS (400 mL per day) for 3 months. Control: usual nutritional care. Primary outcome: total LOS in hospital and rehabilitation clinic, including readmissions over 6 months (Cox regression adjusted for confounders); hazard ratio (HR) < 1.0 reflects longer LOS in the intervention group. Secondary outcomes: nutritional and functional status, cognition, quality of life, postoperative complications (6 months); subsequent fractures and all-cause mortality (1 and 5 years). Effect modification by baseline nutritional status was also tested. Results: One hundred fifty-two patients were randomized (73 intervention, 79 control). Median total LOS was 34.0 days (range 4-185 days) in the intervention group versus control 35.5 days (3-183 days; plogrank = .80; adjusted hazard ratio (adjHR): 0.98; 95% CI: 0.68-1.41). Hospital LOS: 12.0 days (4-56 days) versus 11.0 days (3-115 days; p = .19; adjHR: 0.75; 95% CI: 0.53-1.06) and LOS in rehabilitation clinics: 19.5 days (0-174 days) versus 18.5 days (0-168 days; p = .82; adjHR: 1.04; 95% CI: 0.73-1.48). The intervention improved nutritional intake/status at 3, but not at 6 months, and did not affect any other outcome. No difference in intervention effect between malnourished and well-nourished patients was found. Conclusions: Intensive nutritional intervention after hip fracture improved nutritional intake and status, but not LOS or clinical outcomes. Paradigms underlying nutritional intervention in elderly after hip fracture may have to be reconsidered.

Indexed as

Dietary SupplementsAgedAged, 80 and overFemaleHip FracturesHumansLength of StayMaleMalnutritionMiddle AgedNutritional StatusOutcome Assessment, Health CareQuality of LifeTreatment Outcome

Identifiers

PMID30204859
PMCPMC6132112

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.