This prospective observational study will evaluate whether nutritional risk and reduced muscle mass are associated with postoperative outcomes in adults aged 65 years or older undergoing surgery for hip fracture.
Nutritional risk will be assessed using the Geriatric Nutritional Risk Index (GNRI), which is calculated from routine preoperative serum albumin, body weight, and ideal body weight. Rectus femoris muscle thickness will be measured before surgery using a brief, noninvasive ultrasound examination of the non-fractured thigh.
Participants will receive routine clinical care, and no treatment or anesthesia method will be assigned by the study. Clinical information will be collected from hospital records, including postoperative length of hospital stay, surgical site infection, and mortality. Survival status will be evaluated at 30 and 90 days after surgery using hospital records and/or telephone follow-up.
Age 65 years or older
Scheduled to undergo surgical treatment for hip fracture
Provision of informed consent by the participant or, when applicable, a legally authorized representative
Pathological fracture or fracture related to malignancy
Advanced neuromuscular disease
Active infection
Planned revision surgery
The study population will consist of consecutive patients aged 65 years or older who are admitted to Fatih Sultan Mehmet Training and Research Hospital with a hip fracture and are scheduled to undergo surgical treatment. Eligible participants of both sexes will be enrolled after informed consent is obtained. Participants will receive routine perioperative clinical care without any treatment allocation by the study.
Cohort
Prospective
Geriatric Nutritional Risk Index Assessment
Other interventionPreoperative nutritional risk will be assessed using the Geriatric Nutritional Risk Index (GNRI), calculated from routine serum albumin, current body weight, and ideal body weight. Participants will be categorized as having no nutritional risk (GNRI greater than 98), low nutritional risk (GNRI 92 to 98), or moderate/severe nutritional risk (GNRI less than 92). The assessment will not alter routine clinical care.
Number of Participants With Prolonged Postoperative Hospital Stay
Postoperative hospital length of stay will be calculated as the number of days from the date of surgery to the date of discharge. Prolonged postoperative hospital stay will be defined as a length of stay exceeding the 75th percentile of the postoperative length-of-stay distribution in the completed study cohort. The outcome will be reported as the number and percentage of participants meeting this criterion.
Number of Participants With Surgical Site Infection
Surgical site infection will be assessed according to the Centers for Disease Control and Prevention criteria. Superficial and deep incisional infections will be identified using clinical findings, microbiological culture results, radiological findings, and/or a clinical diagnosis made by an infectious diseases or orthopedic specialist. The outcome will be reported as the number and percentage of participants with a surgical site infection.
Number of Participants With 30-Day All-Cause Mortality
Vital status will be determined using hospital records and/or telephone follow-up. The outcome will be reported as the number and percentage of participants who die from any cause within 30 days after surgery.
Number of Participants With 90-Day All-Cause Mortality
Vital status will be determined using hospital records and/or telephone follow-up. The outcome will be reported as the number and percentage of participants who die from any cause within 90 days after surgery.
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