serum IgA, IgG, IgM levels, total protein (TP) , albumin (ALB) changes in Elderly Hip Fracture Patients After Surgery and Nutritional Support

serum IgA, IgG, IgM levels, total protein (TP) , albumin (ALB) changes

  • Qin Zhang the Second Hospital of Jiaxing, No.1518 Huancheng North Road, Jiaxing 314000, Zhejiang, China
Keywords: serum IgA, IgG, IgM levels, total protein (TP) , albumin (ALB) changes ,Delirium, Delirium Risk Assessment, Elderly, Hip Fracture, Nutritional Support,

Abstract


Aim: Nutritional support combined with stratified nursing under delirium risk assessment reduced postoperative delirium and improved outcomes in elderly hip fracture patients.

Methods:A total of 112 patients were divided into control and study groups. The study group received stratified nursing along with enteral nutrition, while the control group received routine nursing and a normal diet. serum IgA, IgG, IgM levels, total protein (TP) , albumin (ALB) changes were evaluated.

Results: Compared to the control group, the study group had shorter postoperative bed rest and hospital stays, and lower incidences of delirium and adverse events. The study group also showed reduced depression and anxiety scores, increased levels of hemoglobin, albumin, and total protein, elevated levels of immunoglobulins A, M, and G, better sleep quality, and lower pain scores postoperatively. Nursing satisfaction was higher in the study group.

Conclusion: Nutritional support and stratified nursing improved immune function and reduced delirium in elderly hip fracture patient’s post-surgery.

References

1. LeBlanc KE, Muncie HL, Jr., LeBlanc LL. Hip fracture: diagnosis, treatment, and secondary prevention. Am Fam Physician. 2014;89(12):945-51.
2. Pech-Ciau BA, Lima-Martínez EA, Espinosa-Cruz GA, Pacho-Aguilar CR, Huchim-Lara O, Alejos-Gómez RA. [Hip fracture in the elderly: epidemiology and costs of care]. Acta Ortop Mex. 2021;35(4):341-7.
3. Wu J, Yin Y, Jin M, Li B. The risk factors for postoperative delirium in adult patients after hip fracture surgery: a systematic review and meta-analysis. Int J Geriatr Psychiatry. 2021;36(1):3-14.
4. Swarbrick CJ, Partridge JSL. Evidence-based strategies to reduce the incidence of postoperative delirium: a narrative review. Anaesthesia. 2022;77 Suppl 1:92-101.
5. Shin HJ, Woo Nam S, Kim H, Yim S, Han SH, Hwang JW, et al. Postoperative Delirium after Dexmedetomidine versus Propofol Sedation in Healthy Older Adults Undergoing Orthopedic Lower Limb Surgery with Spinal Anesthesia: A Randomized Controlled Trial. Anesthesiology. 2023;138(2):164-71.
6. Li T, Li J, Yuan L, Wu J, Jiang C, Daniels J, et al. Effect of Regional vs General Anesthesia on Incidence of Postoperative Delirium in Older Patients Undergoing Hip Fracture Surgery: The RAGA Randomized Trial. Jama. 2022;327(1):50-8.
7. Jin Z, Hu J, Ma D. Postoperative delirium: perioperative assessment, risk reduction, and management. Br J Anaesth. 2020;125(4):492-504.
8. Cai S, Li J, Gao J, Pan W, Zhang Y. Prediction models for postoperative delirium after cardiac surgery: Systematic review and critical appraisal. Int J Nurs Stud. 2022;136:104340.
9. Gusmao-Flores D, Salluh JI, Chalhub R, Quarantini LC. The confusion assessment method for the intensive care unit (CAM-ICU) and intensive care delirium screening checklist (ICDSC) for the diagnosis of delirium: a systematic review and meta-analysis of clinical studies. Crit Care. 2012;16(4):R115.
10. Bhandari M, Swiontkowski M. Management of Acute Hip Fracture. N Engl J Med. 2017;377(21):2053-62.
11. Malafarina V, Reginster JY, Cabrerizo S, Bruyère O, Kanis JA, Martinez JA, et al. Nutritional Status and Nutritional Treatment Are Related to Outcomes and Mortality in Older Adults with Hip Fracture. Nutrients. 2018;10(5).
12. Tang Q, Cheng Y. Enteral Nutrition: Based on the Combination of Nutrison Fibre and TPF-DM with A Marine Biological-Based Active Polysaccharide Preparation. Comput Math Methods Med. 2022;2022:6213716.
13. Yin X, Gou M, Xu J, Dong B, Yin P, Masquelin F, et al. Efficacy and safety of acupuncture treatment on primary insomnia: a randomized controlled trial. Sleep Med. 2017;37:193-200.
14. Rollo E, Della Marca G, Scala I, Buccarella C, Rozera T, Vollono C, et al. Validation Study of the Richards-Campbell Sleep Questionnaire in Patients with Acute Stroke. J Pers Med. 2022;12(9).
15. Zhang C, Feng J, Wang S, Gao P, Xu L, Zhu J, et al. Incidence of and trends in hip fracture among adults in urban China: A nationwide retrospective cohort study. PLoS Med. 2020;17(8):e1003180.
16. Xiang PY, Boyle L, Short TG, Deng C, Campbell D. Incidence of postoperative delirium in surgical patients: An observational retrospective cohort study. Anaesth Intensive Care. 2023;51(4):260-7.
17. Sumner M, Deng C, Evered L, Frampton C, Leslie K, Short T, et al. Processed electroencephalography-guided general anaesthesia to reduce postoperative delirium: a systematic review and meta-analysis. Br J Anaesth. 2023;130(2):e243-e53.
18. Kotfis K, Marra A, Ely EW. ICU delirium - a diagnostic and therapeutic challenge in the intensive care unit. Anaesthesiol Intensive Ther. 2018;50(2):160-7.
19. Unal N, Guvenc G, Naharci M. Evaluation of the effectiveness of delirium prevention care protocol for the patients with hip fracture: A randomised controlled study. J Clin Nurs. 2022;31(7-8):1082-94.
20. Inoue T, Maeda K, Nagano A, Shimizu A, Ueshima J, Murotani K, et al. Undernutrition, Sarcopenia, and Frailty in Fragility Hip Fracture: Advanced Strategies for Improving Clinical Outcomes. Nutrients. 2020;12(12).
21. Baiu I, Spain DA. Enteral Nutrition. Jama. 2019;321(20):2040.
22. Pash E. Enteral Nutrition: Options for Short-Term Access. Nutr Clin Pract. 2018;33(2):170-6.
23. Wobith M, Weimann A. Oral Nutritional Supplements and Enteral Nutrition in Patients with Gastrointestinal Surgery. Nutrients. 2021;13(8).
24. Kasapoğlu ES, Enç N. Role of multicomponent non-pharmacological nursing interventions on delirium prevention: A randomized controlled study. Geriatr Nurs. 2022;44:207-14.
25. Ma BQ, Chen SY, Jiang ZB, Wu B, He Y, Wang XX, et al. Effect of postoperative early enteral nutrition on clinical outcomes and immune function of cholangiocarcinoma patients with malignant obstructive jaundice. World J Gastroenterol. 2020;26(46):7405-15.
26. Dong QT, Zhang XD, Yu Z. [Integrated Chinese and Western medical treatment on postoperative fatigue syndrome in patients with gastric cancer]. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2010;30(10):1036-40.
Published
2025/03/09
Section
Original paper