ORIGINAL RESEARCH article
Front. Nutr.
Sec. Clinical Nutrition
3-month oral nutritional supplementation adherence impacts positively on survival in malnourished older patients following hip fracture. A real-life study
Francisco José Sánchez-Torralvo 1,2,3
Verónica Pérez del Río 1,2,3
Luis Ignacio Navas Vela 4,1,2
María García-Olivares 1,2
Nuria Porras 1,2
Jose Abuín Fernández 1,2
Gabriel Olveira 1,2,3,5
1. Hospital Regional Universitario de Malaga, Málaga, Spain
2. Instituto de Investigacion Biomedica de Malaga, Málaga, Spain
3. Universidad de Malaga Facultad de Medicina, Málaga, Spain
4. Torrecárdenas University Hospital, Almería, Spain
5. Centro de Investigacion Biomedica en Red de Diabetes y Enfermedades Metabolicas Asociadas, Madrid, Spain
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Abstract
Introduction Several factors influence mortality and survival after hip fracture, including nutritional status, which is associated with both incidence and prognosis. However, there is little evidence on the impact of oral nutritional supplements (ONS) on the survival of these patients, and the available results are mixed. Our aim was to analyze the effect of adherence to ONS treatment on post-hospital mortality, with the hypothesis that this would be lower in an adherent group. Methods Prospective study of patients aged 65 years or older, admitted for fragility hip fracture. Follow-up was carried out at 3, 6 and 12 months to evaluate retrieval of ONS in pharmacies and survival. Adherence was considered if ONS were withdrawn for 3 months or longer. The sample was divided into four groups: (1) well-nourished patients without prescription of ONS, (2) moderately malnourished patients without prescription of ONS, (3) moderate or severely malnourished patients with prescription of ONS but without adherence, and (4) moderately or severely malnourished patients with prescription of ONS and adherence. Mortality between groups was compared by means of a Cox regression, adjusted for confounding variables. Results 300 patients were included (mean age 82.9 years; 79.3% female), with severe malnutrition in 19.7%. Non-adherent malnourished patients showed a significantly higher risk of death than adherent malnourished patients (HR = 3.67; 95% CI: 1.41-9.57; p = 0.008). Non-adherent malnourished patients had a significantly higher risk of death compared to well-nourished patients (HR = 2.95; 95% CI: 1.31–6.65; p = 0.009). Malnourished patients without ONS had a non-significant higher mortality risk than well-nourished patients (HR = 1.66; 95% CI: 0.72–3.84, p = 0.236). Adherent malnourished patients showed a non-significant trend toward lower mortality than well-nourished patients (HR = 0.80; 95% CI: 0.25–2.56; p = 0.712). Conclusion In our study, 3-month adherence to ONS is associated with a reduction in 3, 6 and 12-month mortality in older patients with a hip fracture when compared to non-adherent patients and shows a trend towards an improved survival rate than that of well-nourished patients.
Summary
Keywords
adherence, Aged, Hip Fractures, Mortality, Oral nutritional supplement
Received
29 November 2025
Accepted
20 February 2026
Copyright
© 2026 Sánchez-Torralvo, Pérez del Río, Navas Vela, García-Olivares, Porras, Abuín Fernández and Olveira. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Luis Ignacio Navas Vela; Gabriel Olveira
Disclaimer
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.