Clinical Nutrition

Impaired nutritional status in geriatric trauma patients

F S Müller1,2,3, O W Meyer1,2,4, P Chocano-Bedoya1,2, S Schietzel1,2,4, M Gagesch1,2,4, G Freystaetter1,2,4, V Neuhaus4,5, H-P Simmen4,5, W Langhans3 and H A Bischoff-Ferrari1,2,4

1Department of Geriatrics and Aging Research, University Hospital Zurich, Zurich, Switzerland

2Centre on Aging and Mobility, University Hospital Zurich, Zurich, Switzerland

3Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland

4Centre for Geriatric Traumatology, University Hospital Zurich, Zurich, Switzerland

5Department of Trauma Surgery, University Hospital Zurich, Zurich, Switzerland

Background/Objectives:

Malnutrition is an established risk factor for adverse clinical outcomes. Our aim was to assess nutritional status among geriatric trauma patients.

Subjects/Methods:

We enrolled 169 consecutive patients (greater than or equal to70 years) admitted to the Geriatric Traumatology Centre (University Hospital Zurich, Switzerland). On admission to acute care, nutritional status was assessed with the mini nutritional assessment (score<17=malnourished (M), less than or equal to23.5=at risk of malnutrition (ARM), >23.5=normal). At the same examination, we assessed mental (Geriatric Depression Scale; GDS) and cognitive function (Mini-Mental State Examination; MMSE), frailty status (Fried Scale), and number of comorbidities and medications. Further, discharge destination was documented. All analyses were adjusted for age and gender.

Results:

A total of 7.1% of patients were malnourished and 49.1% were ARM. Patients with reduced mental health (GDSgreater than or equal to5: 30.5 vs 11.5%; P=0.004), impaired cognitive function (MMSEless than or equal to26: 23.6±0.5 vs 26.0±0.6; P=0.004), prevalent frailty (32.5 vs 8%; P<0.001), more comorbidities (2.3±0.1 vs 1.3±0.2; P<0.0001) and medications (5.6±0.3 vs 3.4±0.4; P<0.0001) were more likely to have an impaired nutritional status (M+ARM). Further, M+ARM patients were twice as likely to be discharged to destinations different to home (odds ratio=2.08; confidence interval 1.07−4.05).

Conclusions:

In this consecutive sample of geriatric trauma patients, 56.2% had an M+ARM upon admission to acute care, which was associated with indicators of worse physical, mental and cognitive health and predicted a more than twofold greater odds of being discharged to a destination other than home.

European Journal of Clinical Nutrition (2017) 71, 602–606; doi:10.1038/ejcn.2017.25; published online 22 March 2017

https://www.nature.com/ejcn/journal/v71/n5/full/ejcn201725a.html

Md. PhD. Patricia Chocano. Ex miembro del GII.