Nutritional status according to the short-form mini nutritional assessment (MNA-SF) as predictors of perioperative myocardial injury among older hip fracture surgery patients: A prospective cohort study

The incidence of perioperative myocardial injury (PMI) in older patients undergoing hip fracture surgery remains high, significantly affecting postoperative recovery and mortality. Malnutrition is a known risk factor for cardiovascular complications, but the relationship between preoperative nutritional status and PMI risk in older hip fracture patients has not been fully clarified. This was a prospective cohort study conducted at a single tertiary care center from 2018 to 2021. A total of 1,291 patients aged ≥65 years undergoing hip fracture surgery were enrolled. Patients were stratified based on their Mini Nutritional Assessment-Short Form (MNA-SF) scores into normal nutritional status (NNS) and impaired nutritional status (INS) groups, with the INS group further subdivided into malnourished (MNA-SF ≤7) and at risk of malnutrition (8 ≤ MNA-SF ≤12) categories. Perioperative myocardial injury occurred in 42 patients (3.25%), with a significantly higher incidence in the INS group (5.58%) compared to the NNS group (0.66%). Multivariate logistic regression analysis showed that malnutrition (OR: 20.93, 95% CI: 5.99–73.16, p < 0.001) and risk of malnutrition (OR: 6.55, 95% CI: 2.26–18.98, p < 0.001) were independent predictors of PMI. Malnutrition was also independently associated with increased 30-day postoperative and in-hospital mortality. The MNA-SF is a simple and effective preoperative screening tool for identifying elderly hip fracture patients at high risk for perioperative myocardial injury and short-term mortality.