Impact of Branched-Chain Amino Acid Supplementation on Postoperative Serum Albumin Recovery in Older Adults with Hip Fracture: A Propensity Score-Matched Study.

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Background/Objectives: Hip fracture patients commonly exhibit impaired nutritional status, including low serum albumin levels related to sarcopenia, which may affect recovery. This study evaluated the effect of branched-chain amino acid (BCAA) supplementation on serum albumin levels in hip fracture patients. Methods: This retrospective analysis was conducted at a single tertiary referral center on a cohort of patients with hip fractures including femoral neck and intertrochanteric fractures who visited the emergency department between January 2022 and November 2023. After propensity score matching, 106 patients were analyzed (BCAA: n = 53; control: n = 53); prior to matching, 67 treated and 110 control patients were eligible. Patients receiving BCAA supplementation were administered three times daily for six weeks postoperatively and they were matched with controls based on clinical and demographic variables. Controls received standard perioperative care without BCAA supplementation, and no placebo was administered. Serum albumin levels were measured before the surgery and 6 weeks postoperatively. After propensity score matching, 53 patients from each cohort were analyzed. The primary outcome was the difference in serum albumin levels; secondary outcomes were the length of hospital stay (LOS), blood transfusions (Tf), and the incidence of delirium. Results: The matched cohorts exhibited comparable baseline characteristics. Analysis revealed a significant increase in serum albumin levels among patients who received BCAA supplementation compared to the matched control group. No differences were found in terms of LOS, Tf, and the incidence of delirium during the index admission. Conclusions: This preliminary study suggests a potential positive effect of BCAA supplementation on serum albumin levels in patients with hip fractures. Further prospective investigations with larger sample sizes are warranted to validate these findings and elucidate the clinical implications for nutritional support in this population.