Association Between Nutritional Status and Activities of Daily Living in Super-elderly Patients With Proximal Femoral Fractures After Surgery in a Rehabilitation Ward During the Convalescent Phase.

Background This study aimed to investigate the relationship between nutritional status and improvement in activities of daily living (ADLs) in super-elderly patients with proximal femoral fractures who underwent surgery in a rehabilitation ward during the convalescent phase. Methodology A retrospective study was conducted among patients with proximal femoral fractures who were discharged from the convalescent rehabilitation ward of Sakura-Koseien Hospital. This study included 21 patients aged 90 years or older and 43 patients aged 75-89 years. Nutritional assessment items included the Mini Nutritional Assessment-Short Form (MNA-SF) at admission and calf circumference. Body mass index (BMI), serum albumin (Alb), Controlling Nutritional Status (CONUT), and Geriatric Nutritional Risk Index (GNRI) were extracted from the medical records at admission, one month after admission, and at the final evaluation. Furthermore, the correlation between Functional Independence Measure (FIM) gain (difference in the total score of the FIM motor items between admission and discharge) and nutritional assessment items was investigated. Results In the super-elderly group, the correlation between each nutritional assessment item at admission and FIM gain was as follows: MNA-SF (p = 0.533), lower leg circumference (p = 0.300), BMI (p = 0.440), Alb (p = 0.050), CONUT (p = 0.129), and GNRI (p = 0.192). No significant correlations were found (p < 0.05). One month after admission, CONUT (correlation coefficient (r) = -0.587, confidence interval (CI) = -0.813 to -0.209) and Alb (r = 0.505, CI = 0.093 to 0.769) showed correlations with FIM improvement. At the final evaluation, CONUT (r = -0.525, CI = -0.780 to -0.121) and Alb (r = 0.466, CI = 0.043 to 0.747) showed a significant correlation with FIM improvement (all p < 0.05). Conclusions In super-elderly patients with proximal femoral fractures, the CONUT score and Alb levels one month after hospitalization were suggested to be associated with improvement in ADLs.