{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T01:31:48Z","timestamp":1793323908616,"version":"4.5.0"},"reference-count":30,"publisher":"Open Medical Publishing","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec id=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hip fracture in elderly patients represents a major clinical challenge, with recovery influenced not only by surgical factors but also by frailty, nutritional vulnerability, inflammation and postoperative pain trajectories. While acute postoperative pain is well studied, determinants of pain persistence and chronification remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate associations between nutritional screening tools, selected inflammatory and metabolic biomarkers, and postoperative pain outcomes in elderly patients undergoing hip fracture surgery. Secondary objectives included examining relationships with frailty and postoperative functional independence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Eighty patients aged \u226580 years undergoing surgical repair of femoral neck or intertrochanteric fractures were prospectively enrolled. Preoperative assessments included frailty evaluation, Mini Nutritional Assessment\u2013Short Form (MNA-SF), modified Nutrition Risk in the Critically Ill (mNUTRIC) score, APACHE and SOFA scores, and laboratory biomarkers (albumin, CRP, RDW, LDH, ferritin and calcium). Pain intensity was assessed using the Visual Analog Scale preoperatively, acutely postoperatively, at 30 days and at six months. Functional independence was evaluated after discharge. Associations were analyzed using Spearman\u2019s rank correlation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Acute postoperative pain was weakly associated with preoperative pain. Pain at 30 days and six months showed stronger associations with frailty, hypoalbuminemia, inflammatory markers and higher APACHE\/SOFA scores. Lower MNA-SF and higher mNUTRIC scores were moderately associated with 30-day pain and strongly associated with chronic pain. Better nutritional status correlated with greater postoperative functional independence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"conclusion\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Chronic postsurgical pain in elderly hip fracture patients reflects frailty, nutritional depletion and metabolic stress rather than surgical injury alone. Integrating nutritional screening into perioperative care may improve recovery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.52965\/001c.158945","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:08:49Z","timestamp":1773878929000},"source":"Crossref","is-referenced-by-count":0,"title":["From Frailty to Chronic Pain: Nutritional Status and Pain Trajectories After Hip Fracture in the Elderly"],"prefix":"10.52965","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7963-9462","authenticated-orcid":true,"given":"Rafail","family":"Ioannidis","sequence":"first","affiliation":[{"name":"General Hospital of Drama","department":["Department of Anesthesiology and Pain Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4810-3829","authenticated-orcid":false,"given":"Despoina","family":"Sarridou","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01q1jaw52","id-type":"ROR","asserted-by":"publisher"}],"name":"AHEPA University Hospital of Thessaloniki\/School of Health Sciences, Faculty of Medicine, Aristotle University of Thessaloniki","department":["Department of Anesthesiology and Intensive Care"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adamantios","family":"Bampoulas","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05m7pjf47","id-type":"ROR","asserted-by":"publisher"}],"name":"University College Dublin","department":["School of Computer Science"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Tsigalou","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03bfqnx40","id-type":"ROR","asserted-by":"publisher"}],"name":"Democritus University of Thrace","department":["Laboratory of Hygiene and Environmental Protection-Faculty of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pelagia-Paraskevi","family":"Chloropoulou","sequence":"additional","affiliation":[{"name":"University Hospital of Alexandroupolis\/School of Health Sciences, Faculty of Medicine, Democritus University of Thrace","department":["Department of Anesthesiology and Pain Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"30777","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"issue":"10206","key":"ref1","doi-asserted-by":"publisher","first-page":"1365","DOI":"10.1016\/S0140-6736(19)31785-4","article-title":"Management of frailty","volume":"394","author":"E. 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Dorner","year":"2018","journal-title":"J Acad Nutr Diet"},{"issue":"1","key":"ref19","doi-asserted-by":"publisher","first-page":"18964","DOI":"10.1038\/s41598-020-75888-8","article-title":"Polypharmacy, hospitalization, and mortality risk: a nationwide cohort study","volume":"10","author":"T. I. Chang","year":"2020","journal-title":"Sci Rep"},{"key":"ref20","first-page":"268","article-title":"Postoperative delirium: a 2017 update","volume":"318","author":"E. R. Marcantonio","year":"2017","journal-title":"JAMA"},{"issue":"6","key":"ref21","doi-asserted-by":"publisher","first-page":"917","DOI":"10.1016\/j.clnu.2012.03.010","article-title":"The relationship between nutritional status of hip fracture operated elderly patients and their functioning, comorbidity and outcome","volume":"31","author":"T. 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Schug","year":"2017","journal-title":"Pain Rep"},{"issue":"8","key":"ref25","doi-asserted-by":"publisher","first-page":"1273","DOI":"10.1001\/jamainternmed.2014.2362","article-title":"Survival and functional outcomes after hip fracture among nursing home residents","volume":"174","author":"M. D. Neuman","year":"2014","journal-title":"JAMA Intern Med"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"i1","DOI":"10.1093\/ageing\/afs200","article-title":"British Geriatric Society. Guidance on the management of pain in older people","volume":"42 Suppl 1","author":"A. Abdulla","year":"2013","journal-title":"Age Ageing"},{"issue":"9978","key":"ref27","doi-asserted-by":"publisher","first-page":"1623","DOI":"10.1016\/S0140-6736(14)62409-0","article-title":"Comprehensive geriatric care for patients with hip fractures: a prospective, randomised, controlled trial","volume":"385","author":"A. 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