Impaired nutritional status in geriatric trauma patients
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.