Gastric Emptying in Elderly With Hip Fracture
Condition: Gastroparesis; Hip Fracture; Mild Insufficient Nutrition
MeSH terms: Gastroparesis; Fractures, Bone; Hip Fractures
Study type: Observational

Summary: 
      The gastric emptying of 400 ml 12.6% carbohydrate rich drink is investigated in elderly
      women, age 75-100, with acute hip fracture. The emptying time will be assessed by the
      paracetamol absorption technique, and lag phase and gastric half-emptying time compared with
      two gender-matched reference groups: elective hip replacement patients, age 45-71, and
      healthy volunteers, age 28-55.
    

Detailed description: 
      Patients with hip fracture are submitted to prolonged fasting before surgery is undertaken.
      This is deleterious for their metabolic condition and slows recovery after surgery.

      A carbohydrate-rich beverage is taken immediately before surgery and gastric emptying rate is
      assessed in elderly (75-100 yo) women prior to surgery for acute hip fracture. As comparator
      another two groups of women are used; one scheduled for elective surgery for hip replacement
      due to osteoarthritis; another healthy female volunteers.

      On the day of surgery the primary study group of acute hip fracture is given a
      carbohydrate-rich beverage 400 ml, total 200 kcal in combination with paracetamol 1.5 g.
      Blood samples are intermittently drawn during 180 minutes to measure recovery of paracetamol
      in plasma and gastric emptying rate calculated according to previously published principles.
      In the same manner a group of women on waiting list for hip replacement surgery due to
      osteoarthritis are enrolled for estimation of gastric emptying rate. In addition, another
      group of completely healthy women are enrolled for assessment of gastric emptying.
    

Intervention name(s): Gastric emptying of carbohydrate-rich beverage; Gastric emptying of carbohydrate-rich beverage; Gastric emptying of carbohydrate-rich beverage
Intervention type(s): Procedure; Procedure; Procedure
Intervention description(s): Old women with acute hip fracture with intake of carbohydrate-rich beverage in order to improve metabolic control. Gastric emptying studied for retention in the elderly with acute trauma.; Old women on waiting list for hip joint replacement with intake of carbohydrate-rich beverage in order to improve metabolic control. Gastric emptying studied as comparator in the elderly without acute trauma..; Young healthy women with intake of carbohydrate-rich beverage in order to improve metabolic control. Gastric emptying studied as comparator in young women.
Other intervention name(s): Gastric emptying of beverage (Nutricia Preop; Numico); Gastric emptying of beverage (Nutricia Preop; Numico); Gastric emptying of beverage (Nutricia Preop; Numico)
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Elderly women with acute hip fracture awaiting surgery within the next 24 hours. Since
        surgery is performed early next morning, patients will be kept fasted for prolonged periods
        of time with only continuous line of glucose 5% or 10% solution. This will not evoke any
        insulin response which is needed for controlled metabolic condition.

        In addition: Patients elective for hip replacement, healthy volunteers.