When older adults break their hip, their body needs extra nutrition to heal properly. Researchers tested whether giving patients special nutrition drinks before and after surgery could help them recover better. They trained hospital staff about nutrition and made sure patients got these supplements. After 10 months, patients who received the nutrition program had better nutrition levels, shorter hospital stays, and fewer complications. The study shows that a simple nutrition plan, combined with staff training, can make a real difference in helping elderly hip fracture patients heal faster and stronger.

The Quick Take

  • What they studied: Whether giving elderly hip fracture patients special nutrition drinks before and after surgery, combined with staff training, helps them recover better
  • Who participated: 93 elderly patients (49 before the program, 44 after) who had hip fracture surgery at one hospital in China
  • Key finding: After the nutrition program was started, hospital staff knowledge about nutrition improved dramatically (from 61 to 86 out of 100), patients had better nutrition levels when they left the hospital, and fewer patients had nutrition problems
  • What it means for you: If you or an older family member needs hip surgery, asking about nutrition support drinks and making sure medical staff are trained on nutrition may help with faster recovery. However, this was a small pilot study, so more research is needed before making this standard practice everywhere

The Research Details

Researchers used a quality improvement approach, which means they looked at the best scientific evidence about nutrition for hip fracture patients, then created a plan to use that evidence in their hospital. They trained all the medical staff about nutrition and made sure patients received nutrition drinks before and after surgery. They compared how things worked before they started the program (49 patients) with how things worked after 10 months of the program (44 patients). They measured things like how well staff understood nutrition, patients’ nutrition levels, how long patients stayed in the hospital, and how many problems patients had.

This type of study is called a quality improvement project rather than a traditional research experiment. It’s designed to test whether good scientific evidence can actually work in a real hospital setting with real patients and real staff.

Hip fractures are very serious for older adults and can lead to long hospital stays and complications. Good nutrition is known to help healing, but hospitals don’t always use the best nutrition practices. This study shows how to actually put good nutrition science into practice in a hospital, which is just as important as discovering new treatments.

This study has some strengths: it measured many important outcomes, compared before and after carefully, and showed clear improvements in staff knowledge and patient nutrition. However, it has limitations: it was done at only one hospital, the groups were relatively small, and some improvements (like shorter hospital stays) didn’t reach the level of certainty researchers usually want. The study is called a ‘pilot project,’ which means it’s a first test to see if the idea works before doing larger studies.

What the Results Show

After the nutrition program started, hospital staff knowledge about nutrition improved significantly. Staff test scores jumped from an average of 61 points to 86 points out of 100, which is a very large improvement. This shows that training really works.

Patients who received the nutrition program had much better nutrition status when they left the hospital. The number of patients at nutritional risk dropped significantly, and their nutrition scores improved. This is important because good nutrition helps prevent complications and speeds healing.

The program also improved how well hospitals followed nutrition care guidelines. Before the program, hospitals were only following these guidelines 0-11% of the time. After the program, they were following them 25-100% of the time depending on which guideline. This means the program actually changed how doctors and nurses work.

Patients also showed improvements in a measurement called the Prognostic Nutritional Index (PNI), which combines information about protein levels and immune function. Better PNI scores suggest patients’ bodies were in better condition to heal.

The study also looked at other outcomes that improved but weren’t quite as clear-cut. Patients’ blood protein levels (albumin) were higher when they left the hospital, which is good for healing. Hospital stays were shorter on average, and patients had fewer complications like infections. However, these improvements were smaller and didn’t reach the level of certainty that researchers usually require to say ’this definitely works.’ This could mean the program does help with these things, but the study wasn’t large enough to prove it clearly.

Previous research has shown that nutrition problems are very common in elderly hip fracture patients and that good nutrition helps healing. However, many hospitals don’t use nutrition support well. This study adds to that knowledge by showing that when you combine good nutrition science with staff training and a clear plan, you can actually improve how hospitals care for these patients. It bridges the gap between what research says works and what actually happens in hospitals.

This study was done at only one hospital, so results might be different at other hospitals with different staff or patient populations. The groups were relatively small (93 patients total), so some improvements might have happened by chance. The study didn’t have a control group that didn’t receive the program, so we can’t be 100% sure the program caused all the improvements. Some improvements (like shorter hospital stays) were in the right direction but not strong enough to be certain. The study only lasted 10 months, so we don’t know if benefits continue longer term.

The Bottom Line

If you or an older family member is facing hip fracture surgery, ask the hospital about perioperative nutrition support (nutrition drinks before and after surgery). Make sure medical staff are trained on nutrition care. This approach appears to help with recovery based on this pilot study, though larger studies are still needed. Confidence level: Moderate - the study shows promise but is relatively small.

This research is most relevant for elderly patients (65+) facing hip fracture surgery, their families, and hospital staff who care for these patients. It’s especially important for hospitals that want to improve their nutrition care. People with other types of surgery or injuries should not assume these results apply to them without talking to their doctor. Younger, healthier patients may have different nutrition needs.

Based on this study, improvements in nutrition status appeared within the hospital stay (usually a few weeks). Staff knowledge improved immediately with training. However, long-term benefits for healing and recovery may take several weeks to months to fully appear. Don’t expect overnight changes, but consistent nutrition support should help within the first month after surgery.

Want to Apply This Research?

  • Track daily nutrition drink consumption (number of servings) and nutrition-related symptoms (appetite, energy level, wound healing progress) using a simple daily checklist. Rate appetite and energy on a 1-10 scale each day.
  • Set reminders to consume nutrition drinks at specific times (e.g., with meals and as snacks). Log each drink consumed and any side effects. Share progress with your healthcare team weekly to adjust the plan if needed.
  • Track nutrition intake weekly, monitor weight monthly if possible, and note any changes in energy, appetite, or healing progress. Keep a simple log of hospital visits and any complications. Share this information with your doctor at follow-up appointments to ensure the nutrition plan is working for your specific situation.

This research describes a hospital quality improvement project and should not be considered medical advice. Hip fracture care and nutrition needs vary greatly between individuals based on age, overall health, medications, and other factors. Before starting any nutrition supplement program, especially if you have kidney disease, diabetes, or other chronic conditions, consult with your doctor or a registered dietitian. This study was conducted at one hospital and results may not apply to all settings. Always follow your healthcare team’s specific recommendations for your individual situation.