Impaired nutritional status in geriatric trauma patients

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

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.

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).

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.