Inadequate Postoperative Energy Intake Relative to Total Energy Requirements Diminishes Acute Phase Functional Recovery From Hip Fracture

Abstract Objective To investigate whether postoperative voluntary energy intake (EI) affects functional recovery with hip fracture during the acute phase. Design Prospective cohort study. Setting Three acute care hospitals. Participants Hip fracture patients (N=200) who were consecutively admitted to 3 acute hospitals because of falling. Interventions Not applicable. Main Outcome Measures Patients were stratified into 3 groups based on the ratio of measured EI to estimated total energy expenditure (TEE) as inadequate (EI/TEE Results The median hospital stay was 24 days. The inadequate group comprised 73 (36.5%) patients (median EI/TEE, 0.54; interquartile range, 0.42-0.64); intermediate group comprised 92 (46.0%) patients (median EI/TEE, 0.87; interquartile range, 0.78-0.94), and adequate group comprised 35 (17.5%) patients (median EI/TEE, 1.10; interquartile range, 1.04-1.15). Absolute functional gain (AFG) and efficiency of motor FIM gain (EFG) scores were higher in the adequate group than in the others ( P P =0.03; R 2 for the entire model =0.25). Conclusions Postoperative EI that is less than 70% of TEE diminishes functional recovery with hip fracture.