The Effects of Nutritional Status Assessment by Pre-albumin Level and its Effects on Functional Independence Measures (FIM) in Adult Patients after Fall and Fracture

Abstract

**Please note that the full text is embargoed** ABSTRACT: Background: Fall is leading cause of injury in elderly persons. Nutritional status is an important aspect of elderly life that influences daily activities, quality of life in patients with fall and fractures. Objectives: To evaluate the effects of nutritional assessment by prealbumin level on Functional Independence Measures (FIM) and Length of Stay (LOS)in elderly population with fall and fracture in rehabilitation hospital. Methods: This study design was a one group pretest-posttest without a control group. Seventy one patients (n=71) 65 years or older who were admitted to the rehabilitation hospital with a diagnosis of fall and fracture recruited. Nutritional status was evaluated using the pre-albumin levels upon admission and discharge. Nutritional intervention implemented for participants who had prealbumin level of 18>mg/dl. Interventions were included nutrition education, monitoring food intakes, and nutrition supplements. Outcomes measures were discharge FIM scores and LOS. Results: Fifty four patients (76%) were required nutritional interventions. Prealbumin levels, FIM scores, and food intake were significantly improved from admission to the discharge, for Prealbumin levels, t (71) = 7.53, p<0.01; X= 14.97 versus 19.42, and for total FIM scores, t (71) =21.45, p<0.01; X=l.82 versus 4.41. There was no significant correlation found between prealbumin changes and improved total FIM scores. Improved total FIM scores and self-care has significant negative correlations with LOS (r= -0.46, p<0.01) and (r=-0.47, p<0.01) respectively. Nutritional intakes (r=-0.28, p<0.02) also had a significant negative correlations with LOS. Fifty six patients (78.9%) gained prealbumin with a mean gain of 6.1 mg/dl and remaining (21.1 % ) were declined in prealbumin. Prealbumin gain was associated with higher FIM scores and lower LOS. Documentation of nutritional supplement intake and the percentage of food intake during study were limited, 4.22% and 83.79% respectively. Conclusions: In patients who suffered a fall with resulting fracture, improving nutritional status is associated with improvement of functional levels and a decreased length of stay in rehabilitation hospital.