Nutritional supplementation affects postoperative oxidative stress and duration of hospitalization in patients with hip fracture.

Objective: The objective of this prospective randomized controlled study was to investigate the effect of nutritional supplementation on postoperative oxidative stress and duration of hospitalization in elderly patients with hip fracture.

Methods: A total of fourteen women (= SG) with hip fracture received individually adapted supplements enriched with protein and antioxidants postoperatively, nine served as unsupplemented controls (= CG). Blood samples were taken preoperatively (T1), on the day of discharge from hospital (T2) and three weeks thereafter (T3). Plasma concentrations of albumin and total protein (TP) were measured by autoanalysis, advanced oxidation protein products (AOPP) and the total antioxidant capacity (TAC) were determined photometrically. Malondialdehyde (MDA) levels were analyzed by HPLC.

Results: Postoperatively, there was a significant (T1 > T2, p< 0.01) decrease in plasma albumin, TP and TAC, followed by a significant (p< 0.05) increase in the period T2-T3 in the CG, but not in the SG. This resulted in significant differences in TP (T2: SG > CG, p< 0.05) and TAC (T2: SG > CG, p< 0.01) between the investigated groups. Postoperatively, the plasma levels of AOPP and MDA increased significantly (T1 < T2, p< 0.01) in both groups, and remained at the significantly (AOPP: T1 < T3, p< 0.05; MDA: T1 < T3, p< 0.01) elevated level in the CG, but not in the SG (T2 > T3, p< 0.01). Consequently, the oxidant markers MDA and AOPP were significantly positively (p< 0.01), TAC and albumin significantly negatively (p< 0.05) related to duration of hospital stay in both groups.

Conclusions: Individualized nutritional supplementation may reduce postoperative oxidative stress and shorten duration of hospitalization in patients with hip fracture.