Hyperosmolar dehydration (HD) may cause severe complications in hip fractures in older patients. Yet, evidence for recommending dehydration screening is insufficient, and its association with frailty and mortality is unclear. The present study tested the hypothesis that postoperative HD is associated with frailty and increased mortality. It recruited 625 older (>65 years) patients surgically treated for hip fractures and co-managed by an orthogeriatric team over one year. It diagnosed Pre- and postoperative HD (serum osmolarity > 300 mmol/L) and assessed Frailty and associated mortality risk by the Multidimensional Prognostic Index (MPI).

The study observed-

• 20.4% prevalence of preoperative HD.
• Compared with no-HD, Similar MPI in HD patients despite a higher prevalence of polypharmacy, arterial hypertension, diabetes, chronic kidney disease, and heart failure.
• A decrease in the incidence of HD to 16.5% after surgery, yet an increase in the MPI high-risk subgroup.
• Association of Postoperative HD with more complications, which was confirmed to be an independent determinant of adjusted hospital length of stay (LOS) and of 60- to 365-day mortality.

This study shows that older frail patients with hip fractures are predisposed to developing postoperative HD, independently predicting prolonged hospital LOS and mortality. It is thus advised to systematically screen older patients for frailty and dehydration to tailor hydration management in high-risk individuals.

Nutrients. 2022 Feb 16;14(4):820. doi: 10.3390/nu14040820. PMID: 35215470; PMCID: PMC8880665.