XR is currently conducting pilot studies in evaluating the impact of perioperative nutritional supplementation on hip fracture outcomes.

Nutritional status is an important influencing factor for postoperative complications and mortality in geriatric patients undergoing surgery*.

The prevalence of malnutrition and sarcopenia in this population are up 40% and 45% respectively. Serum albumin level is highly associated with nutritional status and has long been used as a marker for malnutrition. Clinical data has demonstrated the link between that hypoalbuminemia is associated with a higher prevalence of complications, longer hospital stays, and higher prevalence of readmission and mortality after surgery*.

TNS has been used to improve albumin levels, mitigate post-op complications and enhance recovery outcomes.

Hip Fracture Studies:

  • ENHANCED RECOVERY POST HIP FRACTURE

    Patients who received Essential Amino Acids after hip fracture surgery had significantly improved functional recovery:

    *Supplemented group out-performed the Control group by:

    62% IN A 6-MIN WALKING DISTANCE TEST

    (CLICK HERE TO READ THE STUDY)

    Aquilani ACER 2018

  • IMPROVED ALBUMIN LEVELS POST HIP FRACTURE

    Patients who received EAA supplementation after hip fracture had significantly improved malnutrition status {albumin <3.5 g/dL} in comparison to the placebo group:

    *42% Improvement in hypoALB Levels

    VS

    *25% Reduced Infection Rates

    (CLICK HERE TO READ THE STUDY)

    Aquilani 2017

  • IMPROVED RECOVERY POST HIP FRACTURE

    Patients who received HMB supplementation post hip fracture had improved body composition and functional recovery, as well as preserved muscle mass:

    *BMI and aLM were stable in IG patients

    VS

    *These parameters decreased in the CG

    (CLICK HERE TO READ THE STUDY)

    Maturitas 2017

  • NUTRITIONAL INTERVENTION IS EFFECTIVE ON FUNCTIONING POST HIP FRACTURE

    32 hip fracture patients (mean aged 79.03 ± 7.80 years) were allocated into two groups: group A & B:

    *All participants had significant differences in all outcomes at T1(p < 0.017).

    *Sarcopenic patients in group A (n = 10) had significant differences in all primary outcomes at T1(p < 0.017)

    *Sarcopenic patients group B (n = 13) showed a significant reduction of ILOA only

    (CLICK HERE TO READ THE STUDY)

    Invernizzi 2018

  • Perioperative ONS for elderly post hip surgery promotes early rehabilitation with reduced complications and infection rate.

    The combined trials showed:

    *ONS had a Positive effect on the serum total protein (P<0.00001)

    *Decreased Complications (P=0.0005).

    Subgroups had decreased:

    *Wound infection (P=0.02)

    *Respiratory infection (P=0.04)

    *Urinary tract infection (P=0.03)

    (CLICK HERE TO READ THE STUDY)

    Liu M 2015

*References

  1. Bohl DD, Shen MR, Hannon CP, Fillingham YA, Darrith B, Della Valle CJ. Serum albumin predicts survival and postoperative course following surgery for geriatric hip fracture. J Bone Joint Surg Am 2017;99:2110–8
  2. Bachrach-Lindstrom M, Johansson T, Unosson M, Ek AC, Wahlstrom O. Nutritional status and functional capacity after femoral neck fractures: a prospective randomized one-year follow-up study. Aging (Milano) 2000;12:366–74
  3. Malafarina V, Reginster JY, Cabrerizo S, et al. Nutritional status and nutritional treatment are related to outcomes and mortality in older adults with hip fracture. Nutrients 2018;10:05
  4. Foss NB, Kehlet H. Mortality analysis in hip fracture patients: implications for design of future outcome trials. Br J Anaesth 2005;94:24–9
  5. Anbar R, Beloosesky Y, Cohen J, et al. Tight calorie control in geriatric patients following hip fracture decreases complications: a randomized, controlled study. Clin Nutr 2014;33:23–8
  6. Koren-Hakim T, Weiss A, Hershkovitz A, et al. The relationship between nutritional status of hip fracture operated elderly patients and their functioning, comorbidity and outcome. Clin Nutr 2012;31:917–21
  7. Cabrerizo S, Cuadras D, Gomez-Busto F, Artaza-Artabe I, Marin-Ciancas F, Malafarina V. Serum albumin and health in older people: review and meta analysis. Maturitas 2015;81:17–27
  8. Malafarina, Vincenzo et al. “Effectiveness of nutritional supplementation on sarcopenia and recovery in hip fracture patients. A multi-centre randomized trial.”Maturitasvol. 101 (2017): 42-50. doi:10.1016/j.maturitas.2017.04.010
  9. Malafarina V, Uriz-Otano F, Malafarina C, Martinez JA, Zulet MA. Effectiveness of nutritional supplementation on sarcopenia and recovery in hip fracture patients. A multi-centre randomized trial. Maturitas. 2017 Jul;101:42-50. doi: 10.1016/j.maturitas.2017.04.010. Epub 2017 Apr 22. PMID: 28539168.
  10. Willey MC, Owen EC, Miller A, Glass N, Kirkpatrick T, Fitzpatrick D, Wilken J, Marsh JL, Reider L. Substantial Loss of Skeletal Muscle Mass Occurs After Femoral Fragility Fracture. J Bone Joint Surg Am. 2023 Sep 22. doi: 10.2106/JBJS.23.00353. Epub ahead of print. PMID: 37738373.
  11. Invernizzi M, de Sire A, D'Andrea F, Carrera D, Renò F, Migliaccio S, Iolascon G, Cisari C. Effects of essential amino acid supplementation and rehabilitation on functioning in hip fracture patients: a pilot randomized controlled trial. Aging Clin Exp Res. 2019 Oct;31(10):1517-1524. doi: 10.1007/s40520-018-1090-y. Epub 2018 Dec 11. PMID: 30539540.
  12. Liu M, Yang J, Yu X, Huang X, Vaidya S, Huang F, Xiang Z. The role of perioperative oral nutritional supplementation in elderly patients after hip surgery. Clin Interv Aging. 2015 May 11;10:849-58. doi: 10.2147/CIA.S74951. PMID: 26005339; PMCID: PMC4433048.

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