{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T05:06:24Z","timestamp":1784696784909,"version":"3.55.0"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"\n Background<\/jats:title>\n Older patients with malnutrition who undergo hip arthroplasty for femoral neck fracture are at high risk of delayed postoperative recovery. This retrospective study aimed to examine the association of early oral nutritional supplementation (ONS) with postoperative nutrition-related laboratory indicators, recovery outcomes, and in-hospital complications in this population.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We retrospectively analyzed consecutive patients aged 60\u202fyears or older with malnutrition who underwent hemiarthroplasty or total hip arthroplasty for femoral neck fracture between January 2022 and December 2025. Patients were classified into an early ONS group if structured ONS was initiated within 24\u202fh after surgery and into a control group otherwise. Primary outcomes included postoperative changes in serum albumin, prealbumin, hemoglobin, total protein, lymphocyte count, length of hospital stay, time to first ambulation, and time to first flatus. Secondary outcomes were postoperative complications during the index hospitalization.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 294 included patients, 118 received early ONS and 176 served as controls. At discharge, the early ONS group showed more favorable laboratory profiles, including higher serum albumin [\n \u03b2<\/jats:italic>\n \u202f=\u202f1.42, 95% confidence interval (CI): 0.66 to 2.18;\n p<\/jats:italic>\n \u202f&lt;\u202f0.001], prealbumin (\n \u03b2<\/jats:italic>\n \u202f=\u202f13.58, 95% CI: 5.92 to 21.24;\n p<\/jats:italic>\n \u202f&lt;\u202f0.001), total protein (\n \u03b2<\/jats:italic>\n \u202f=\u202f1.76, 95% CI: 0.54 to 2.98;\n p<\/jats:italic>\n \u202f=\u202f0.005), and lymphocyte count (\u03b2\u202f=\u202f0.11, 95% CI: 0.04 to 0.18;\n p<\/jats:italic>\n \u202f=\u202f0.002). Early ONS was also associated with shorter time to first ambulation (\n \u03b2<\/jats:italic>\n \u202f=\u202f\u22125.38\u202fh, 95% CI: \u22127.56 to \u22123.20;\n p<\/jats:italic>\n \u202f&lt;\u202f0.001), shorter time to first flatus (\n \u03b2<\/jats:italic>\n \u202f=\u202f\u22126.84\u202fh, 95% CI: \u22129.53 to \u22124.15;\n p<\/jats:italic>\n \u202f&lt;\u202f0.001), and shorter hospital stay (\n \u03b2<\/jats:italic>\n \u202f=\u202f\u22121.29\u202fdays, 95% CI: \u22121.98 to \u22120.60;\n p<\/jats:italic>\n \u202f&lt;\u202f0.001). Lower odds of pulmonary infection were observed (odds ratio\u202f=\u202f0.46, 95% CI: 0.16 to 0.93;\n p<\/jats:italic>\n \u202f=\u202f0.041), although this finding should be interpreted cautiously because of the limited number of events.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Early ONS after hip arthroplasty in older patients with malnutrition and femoral neck fracture was associated with more favorable short-term nutrition-related laboratory profiles and faster postoperative recovery. The association with pulmonary infection warrants cautious interpretation and further validation in prospective studies.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fnut.2026.1840514","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T04:43:03Z","timestamp":1784695383000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Early oral nutritional supplementation and postoperative recovery after hip arthroplasty in malnourished older adults with femoral neck fracture"],"prefix":"10.3389","volume":"13","author":[{"given":"Jia-Hui","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Orthopedics, Suzhou Kowloon Hospital, Shanghai Jiao Tong University School of Medicine","place":["Suzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing-Xin","family":"Niu","sequence":"additional","affiliation":[{"name":"Department of International Medical Center, Suzhou Kowloon Hospital, Shanghai Jiao Tong University School of Medicine","place":["Suzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Suzhou Kowloon Hospital, Shanghai Jiao Tong University School of Medicine","place":["Suzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Feng","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Suzhou Kowloon Hospital, Shanghai Jiao Tong University School of Medicine","place":["Suzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1186\/s12891-023-06455-1","article-title":"Reducing complications of femoral neck fracture management: a retrospective study on the application of multidisciplinary team","volume":"24","author":"Liang","year":"2023","journal-title":"BMC Musculoskelet Disord"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"632","DOI":"10.2340\/17453674.2025.44354","article-title":"An Acta Orthopaedica educational article: femoral neck fractures in adults with emphasis on surgical treatment","volume":"96","author":"Rogmark","year":"2025","journal-title":"Acta Orthop"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"584","DOI":"10.1186\/s13063-024-08406-0","article-title":"Postoperative physical rehabilitation in the elderly patient after emergency surgery. Influence on functional, cognitive and quality of live recovery: study protocol for a randomized clinical trial","volume":"25","author":"Esquiroz Lizaur","year":"2024","journal-title":"Trials"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1016\/j.bja.2025.04.026","article-title":"Postoperative outcomes in older patients living with frailty and multimorbidity in the UK: SNAP-3, a snapshot observational study","volume":"135","author":"Swarbrick","year":"2025","journal-title":"Br J Anaesth"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"5662","DOI":"10.3390\/jcm14165662","article-title":"Malnutrition in older hip fracture patients: prevalence, pathophysiology, clinical outcomes, and treatment-a systematic review","volume":"14","author":"Meermans","year":"2025","journal-title":"J Clin Med"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1273","DOI":"10.1007\/s00198-024-07088-3","article-title":"Nutritional status as independent prognostic factor of outcome and mortality until five years after hip fracture: a comprehensive prospective study","volume":"35","author":"Dagnelie","year":"2024","journal-title":"Osteoporos Int"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"551","DOI":"10.1007\/s41999-025-01156-5","article-title":"Defining optimal orthogeriatric hip fracture care: a delphi consensus approach","volume":"16","author":"van Bremen","year":"2025","journal-title":"Eur Geriatr Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"555","DOI":"10.3390\/nu10050555","article-title":"Nutritional status and nutritional treatment are related to outcomes and mortality in older adults with hip fracture","volume":"10","author":"Malafarina","year":"2018","journal-title":"Nutrients"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"2764","DOI":"10.3390\/nu13082764","article-title":"Malnutrition in older adults-recent advances and remaining challenges","volume":"13","author":"Norman","year":"2021","journal-title":"Nutrients"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"2297","DOI":"10.26355\/eurrev_202303_31763","article-title":"Association between nutritional indices and mortality after hip fracture: a systematic review and meta-analysis","volume":"27","author":"Liu","year":"2023","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"941","DOI":"10.2147\/cia.S518366","article-title":"Preoperative prognostic nutritional index is a predictive factor for postoperative delirium in elderly patients with femoral neck fracture","volume":"20","author":"Xu","year":"2025","journal-title":"Clin Interv Aging"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"634","DOI":"10.1186\/s12877-025-06278-w","article-title":"Association between prognostic nutritional index and risk of moderate-to-severe basic activities of daily living dependence two years after hip fracture surgery in older adults","volume":"25","author":"Wu","year":"2025","journal-title":"BMC Geriatr"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1016\/j.afos.2024.05.006","article-title":"Relationship between the perioperative prognostic nutritional index and postoperative gait function in elderly hip fractures","volume":"10","author":"Yotsuya","year":"2024","journal-title":"Osteoporos Sarcopenia"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"5580","DOI":"10.3390\/jcm13185580","article-title":"Efficacy of postoperative oral nutritional supplements in geriatric hip fracture patients undergoing Total hip arthroplasty","volume":"13","author":"Kim","year":"2024","journal-title":"J Clin Med"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"775","DOI":"10.1002\/ncp.10980","article-title":"Effects of the use of oral nutrition supplements on clinical outcomes among patients who have undergone surgery for hip fracture: a literature review","volume":"38","author":"Rempel","year":"2023","journal-title":"Nutr Clin Pract"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"21514593231155828","DOI":"10.1177\/21514593231155828","article-title":"What postoperative nutritional interventions Lead to better outcomes in fragility hip fractures? A systematic review","volume":"14","author":"Oberstar","year":"2023","journal-title":"Geriatr Orthop Surg Rehabil"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"964","DOI":"10.1007\/s12603-015-0630-9","article-title":"Mini nutritional assessment and mortality after hip fracture surgery in the elderly","volume":"20","author":"van Wissen","year":"2016","journal-title":"J Nutr Health Aging"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1267","DOI":"10.2147\/cia.S534553","article-title":"Development of a clinical management pathway for perioperative nutritional risk in elderly patients with hip fractures","volume":"20","author":"Pan","year":"2025","journal-title":"Clin Interv Aging"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"7756605","DOI":"10.1155\/bmri\/7756605","article-title":"The current status of frailty and influencing factors in elderly patients with hip fractures: a meta-analysis","volume":"2025","author":"Shou","year":"2025","journal-title":"Biomed Res Int"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1016\/j.gerinurse.2024.07.011","article-title":"Comorbidity burden and nutritional status are associated with short-term improvement in functional independence and pain intensity after hip fracture surgery in older adults with in-hospital rehabilitation","volume":"59","author":"N\u00fa\u00f1ez-Cort\u00e9s","year":"2024","journal-title":"Geriatr Nurs"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1069","DOI":"10.3390\/nu16071069","article-title":"Malnutrition-related health outcomes in older adults with hip fractures: a systematic review and Meta-analysis","volume":"16","author":"Chiavarini","year":"2024","journal-title":"Nutrients"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1016\/j.clnu.2025.08.029","article-title":"ESPEN guideline on clinical nutrition in surgery - update 2025","volume":"53","author":"Weimann","year":"2025","journal-title":"Clin Nutr"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1815","DOI":"10.1016\/j.clnu.2024.06.020","article-title":"Nutrition for the older adult - current concepts. report from an ESPEN symposium","volume":"43","author":"Volkert","year":"2024","journal-title":"Clin Nutr"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1223","DOI":"10.3390\/nu16081223","article-title":"A prospective, observational study of the effect of a high-calorie, high-protein oral nutritional supplement with HMB in an old and malnourished or at-risk-of-malnutrition population with hip fractures: a FracNut study","volume":"16","author":"Pareja Sierra","year":"2024","journal-title":"Nutrients"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1016\/j.clnesp.2025.05.025","article-title":"Impact of an oral nutritional supplement on the recovery of the nutritional status of older patients with fragility hip fracture: controlled and randomized clinical trial","volume":"68","author":"Fern\u00e1ndez Jim\u00e9nez","year":"2025","journal-title":"Clin Nutr ESPEN"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1186\/s12877-026-07125-2","article-title":"Development and multicenter validation of a dynamic nomogram for early postoperative neurocognitive disorder in older adults with hip fracture","volume":"26","author":"Wei","year":"2026","journal-title":"BMC Geriatr"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-026-07579-4","article-title":"Repetitive transcranial magnetic stimulation to prevent postoperative delirium in elderly arthroplasty patients: study protocol for a single-Centre, prospective, randomized controlled trial","author":"Zhao","year":"2026","journal-title":"BMC Geriatr"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1388","DOI":"10.1016\/j.clnu.2020.08.031","article-title":"Reduced mortality risk in malnourished hospitalized older adult patients with COPD treated with a specialized oral nutritional supplement: sub-group analysis of the NOURISH study","volume":"40","author":"Deutz","year":"2021","journal-title":"Clin Nutr"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1879","DOI":"10.1016\/j.clnu.2020.10.015","article-title":"Impact of specialized oral nutritional supplement on clinical, nutritional, and functional outcomes: a randomized, placebo-controlled trial in community-dwelling older adults at risk of malnutrition","volume":"40","author":"Chew","year":"2021","journal-title":"Clin Nutr"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"2157","DOI":"10.3390\/healthcare12212157","article-title":"Oral nutritional supplementation in older adults with a hip fracture-findings from a bi-National Clinical Audit","volume":"12","author":"Bell","year":"2024","journal-title":"Healthcare (Basel)"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"2773","DOI":"10.2147\/cia.S562166","article-title":"Enhancing perioperative Oral nutritional supplements in elderly hip fracture patients: a pilot project on evidence-based practice","volume":"20","author":"Xie","year":"2025","journal-title":"Clin Interv Aging"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1038\/s41430-024-01513-w","article-title":"Narrative review: nutritional strategies for ageing populations - focusing on dysphagia and geriatric nutritional needs","volume":"79","author":"Cava","year":"2025","journal-title":"Eur J Clin Nutr"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"2528","DOI":"10.3390\/nu12092528","article-title":"Hip fracture patients in geriatric rehabilitation show poor nutritional status, dietary intake and muscle health","volume":"12","author":"Groenendijk","year":"2020","journal-title":"Nutrients"}],"container-title":["Frontiers in Nutrition"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2026.1840514\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T04:43:08Z","timestamp":1784695388000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2026.1840514\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,22]]},"references-count":33,"alternative-id":["10.3389\/fnut.2026.1840514"],"URL":"https:\/\/doi.org\/10.3389\/fnut.2026.1840514","relation":{},"ISSN":["2296-861X"],"issn-type":[{"value":"2296-861X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,22]]},"article-number":"1840514"}}