Application of enhanced recovery after surgery nursing based on nutritional support in elderly patients with hip fracture

Objective To explore the effects of enhanced recovery after surgery based on nutritional support in perioperative nursing of elderly patients with hip fracture and joint replacement. Methods From January 2015 to June 2017, we selected 278 elderly hip fracture patients with nutritional risk (NRS 2002≥3) by convenience sampling. All of the patients were divided into observation group (n=132) and control group (n=146) with the method of envelope. Observation group accepted nutritional support and brought it into enhanced recovery nursing process. Control group applied routine perioperative nursing without standardized nutritional support. We compared the albumin and loss of hemoglobin at the second day after surgery, the score of activity of daily living (ADL) , time of getting out from bed for the first time, hospital stay as well as complications of patients between two groups. Results The albumin at the second day after surgery and score of ADL of patients in observation group were (29.16±1.33) g/dl and (63.90±5.47) respectively higher than those in control group; the loss of hemoglobin after surgery, time of getting out from bed for the first time, hospital stay in observation group were (1.34±0.30) g/dl, (1.56±0.20) d, (7.08±2.23) d respectively lower than those in control group; the differences were all statistical (t=-3.089, -14.881, -13.640, -15.279, -8.480; P<0.05) . The incidence of complications of observation group was 9.09% lower than that of control group (19.18%) with statistical difference (χ2=3.877, P<0.05) . Conclusions Enhanced recovery nursing based on nutritional support can shorten the hospital stay in elderly patients with hip fracture, promote postoperative rehabilitation after hip joint replacement and improve clinical outcomes of patients. Key words: Aged; Hip fractures; Nutritional support; Arthroplasty, replacement, hip; Enhanced recovery after surgery; Nutritional risk