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Simultaneous hip and upper-limb fractures are associated with lower Geriatric Nutritional Index scores than isolated hip fractures: a cross-sectional study of 858 women

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Abstract

Background and aims

Factors associated with simultaneous fractures at hip and upper limb have scarcely been investigated. Our aim was to assess the association between Geriatric Nutritional Risk Index (GNRI) scores and concurrent upper-limb fractures in women with a fall-related hip fracture.

Methods

We investigated 858 of 907 women admitted to our Physical and Rehabilitation Medicine ward following a fall-related hip fracture.

Results

GNRI scores were significantly lower in the 41 women with a simultaneous upper-limb fracture than in the 817 with an isolated hip fracture: median (interquartile range) were 85.9 (80.6–94.1) ad 90.3 (83.4–98.0), respectively, in the two groups (p = 0.021). After adjustment for age, height, body mass index, 25-hydroxyvitamin D, parathyroid hormone, femoral-neck bone mineral density, cognitive impairment, neurologic impairment and type of hip fracture we confirmed a significant association between GNRI scores and the concomitant upper-limb fractures (p = 0.001). The adjusted odds ratio for suffering a concomitant fracture was 7.53 (95% CI from 1.79 to 31.72; p = 0.006) for the 190 women of the GNRI lowest class (GNRI score < 82) versus the 213 women of the highest class (GNRI score > 98).

Conclusions

Data show that GNRI scores were significantly lower in the subgroup of women with hip fracture and concurrent upper-extremity fracture than in the controls with isolated hip fracture. Although caution is needed in interpreting our results due to the cross-sectional design of the study, we suggest that low GNRI scores may have a role in the genesis of the concurrent fractures.

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Author information

Authors and Affiliations

  1. Division of Physical and Rehabilitation Medicine, Osteoporosis Research Center, Presidio Sanitario San Camillo, Fondazione Opera San Camillo, Strada Santa Margherita 136, 10131, Turin, Italy

    Marco Di Monaco, Carlotta Castiglioni & Edoardo Milano

  2. Division of Physical and Rehabilitation Medicine, Department of Surgical Sciences, University of Turin, Turin, Italy

    Francesca Bardesono & Giuseppe Massazza

Authors
  1. Marco Di Monaco
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  2. Carlotta Castiglioni
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  3. Francesca Bardesono
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  4. Edoardo Milano
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  5. Giuseppe Massazza
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Contributions

MDM conceived the first idea of the study. He was the main investigator. He interpreted data and wrote the first draft of the manuscript and its final version. CC co-conceived the idea of the study. She was implicated with the management of the patients and collected clinical data. She helped to interpret data and she commented on manuscript drafts. FB was implicated with the management of the patients and collected clinical data. She contributed to plan and perform the study. She commented on manuscript drafts. EM contributed to collect clinical data. He commented on the first draft of the manuscript and on the successive versions. GM co-conceived the idea of the study. He contributed to write the final version. All the authors approved the final version of the manuscript.

Corresponding author

Correspondence to Marco Di Monaco.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (Ethical Committee from City of Health and Science, reference number 52119) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Written informed consent was obtained from all individual participants included in the study.

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Di Monaco, M., Castiglioni, C., Bardesono, F. et al. Simultaneous hip and upper-limb fractures are associated with lower Geriatric Nutritional Index scores than isolated hip fractures: a cross-sectional study of 858 women. Aging Clin Exp Res 32, 1707–1712 (2020). https://doi.org/10.1007/s40520-019-01382-5

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  • DOI: https://doi.org/10.1007/s40520-019-01382-5

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