Dietetic assistants improved postoperative clinical outcomes in older women with hip fracture.

M e t h o d s Design: Randomized controlled trial. Allocation: Concealed.* Blinding: Blinded (outcome assessors).* Follow-up period: Up to 4 months. Setting: A teaching hospital in Wales, United Kingdom. Patients: 318 women > 65 years of age with acute nonpathologic hip fracture in a single trauma ward. Intervention: Personal attention of DAs (n = 153) or conventional pattern of nurseand dietitian-led care, including routine provision of oral nutritional supplements (n = 165). DAs provided appropriate help to ensure that patients met their nutritional needs: checking personal and cultural food preferences; coordinating appropriate meal orders with catering staff; ordering nutritional supplements when necessary; providing appropriate feeding aids; assisting with food choice, portion size, and positioning at mealtimes; sitting with, encouraging, and feeding the frailest patients at mealtimes; and collecting information to aid nutritional assessment by the dietitian. Outcomes: Postoperative mortality in the acute trauma unit. Secondary outcomes were inpatient and 4-month mortality, length of stay (LOS), acute ward complications, energy intake, and nutritional status. Patient follow-up: 95% (intention-to-treat analysis).