Simultaneous hip and upper-limb fractures are associated with lower Geriatric Nutritional Index scores than isolated hip fractures: a cross-sectional study of 858 women

Background and aims: Factors associated with simultaneous fractures at hip and upper limb have scarcely been investigated. Our aim was to assess the association between Geriatric Nutritional Risk Index (GNRI) scores and concurrent upper-limb fractures in women with a fall-related hip fracture. Methods: We investigated 858 of 907 women admitted to our Physical and Rehabilitation Medicine ward following a fall-related hip fracture. Results: GNRI scores were significantly lower in the 41 women with a simultaneous upper-limb fracture than in the 817 with an isolated hip fracture: median (interquartile range) were 85.9 (80.6–94.1) ad 90.3 (83.4–98.0), respectively, in the two groups (p = 0.021). After adjustment for age, height, body mass index, 25-hydroxyvitamin D, parathyroid hormone, femoral-neck bone mineral density, cognitive impairment, neurologic impairment and type of hip fracture we confirmed a significant association between GNRI scores and the concomitant upper-limb fractures (p = 0.001). The adjusted odds ratio for suffering a concomitant fracture was 7.53 (95% CI from 1.79 to 31.72; p = 0.006) for the 190 women of the GNRI lowest class (GNRI score < 82) versus the 213 women of the highest class (GNRI score > 98). Conclusions: Data show that GNRI scores were significantly lower in the subgroup of women with hip fracture and concurrent upper-extremity fracture than in the controls with isolated hip fracture. Although caution is needed in interpreting our results due to the cross-sectional design of the study, we suggest that low GNRI scores may have a role in the genesis of the concurrent fractures.