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Clinical nutrition

Prevalence of malnutrition in a cohort of 509 patients with acute hip fracture: the importance of a comprehensive assessment



Malnutrition is very common in acute hip fracture (HF) patients. Studies differ widely in their findings, with reported prevalences between 31 and 88% mainly because of small sample sizes and the use of different criteria. The aim of this study was to learn the prevalence of malnutrition in a large cohort of HF patients in an comprehensive way that includes the frequency of protein–energy malnutrition, vitamin D deficiency and sarcopenia.


A 1-year consecutive sample of patients admitted with fragility HF in a 1300-bed public University Hospital, who were assessed within the first 72 h of admission. Clinical, functional, cognitive and laboratory variables were included. Energy malnutrition (body mass index (BMI) <22 kg/m2), protein malnutrition (serum total protein <6.5 g/dl or albumin <3.5 g/dl), vitamin D deficiency (serum 25-OH-vitamin D <30 ng/dl) and sarcopenia (low muscle mass plus low grip strength) were considered.


Five hundred nine HF patients were included. The mean age was 85.6±6.9 years and 79.2% were women. Ninety-nine (20.1%) patients had a BMI <22 kg/m2. Four hundred nine patients (81.2%) had protein malnutrition. Eighty-seven (17.1%) patients had both energy and protein malnutrition. Serum vitamin D was <30 ng/ml in 466 (93%) patients. The prevalence of sarcopenia was 17.1%.


Protein malnutrition and vitamin D deficiency are the rule in acute HF patients. Energy malnutrition and sarcopenia are also common. A nutritional assessment in these patients should include these aspects together.

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We thank Rocío Queipo (Preventive Medicine Department, Universidad Autónoma de Madrid, Madrid, Spain) for her invaluable help in statistics. The study was supported in part by a grant (Grant to Emerging Research Groups 2012) from the Instituto de Investigación del Hospital Universitario La Paz (IdiPAZ) PI-1334; a grant from the ISCIII Fondos FEDER (RETICEF RD 06/0013/1013 and RD12/0043/0019) from the Instituto de Investigación Biomédica IdiPAZ, Hospital Universitario La Paz, Madrid, Spain (FONDA Cohort Study, PI-1334 Project) and by a grant from Nestlé Health Science, Barcelona, Spain.

Author contributions

JIG-M and TA designed and directed the FONDA cohort. MDB, TA and AO designed the methodology and carried out the statistical analysis. MDB, JIG-M, RM and RR performed the literature review update. MDB and JIG-M drafted the first version of the manuscript. All co-authors corrected the subsequent versions of the manuscript and approved the final version.

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Correspondence to M Díaz de Bustamante.

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Díaz de Bustamante, M., Alarcón, T., Menéndez-Colino, R. et al. Prevalence of malnutrition in a cohort of 509 patients with acute hip fracture: the importance of a comprehensive assessment. Eur J Clin Nutr 72, 77–81 (2018).

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