Impaired nutritional status in geriatric trauma patients

Eur J Clin Nutr. 2017 May;71(5):602-606. doi: 10.1038/ejcn.2017.25. Epub 2017 Mar 22.

Abstract

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 (⩾70 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), ⩽23.5=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 (GDS⩾5: 30.5 vs 11.5%; P=0.004), impaired cognitive function (MMSE⩽26: 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.

MeSH terms

  • Activities of Daily Living
  • Aged
  • Cognition
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Frailty / epidemiology*
  • Geriatric Assessment*
  • Hand Strength
  • Humans
  • Independent Living
  • Logistic Models
  • Male
  • Malnutrition / diagnosis
  • Malnutrition / epidemiology*
  • Nutrition Assessment
  • Nutritional Status*
  • Prevalence
  • Prospective Studies
  • Risk Factors
  • Switzerland
  • Wounds and Injuries / epidemiology*