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Updated: Oct 5, 2025
Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
Association of Nutritional Status with New-Onset Delirium in Elderly, Acute Care, Orthopaedic Trauma Patients: A
Susan S Maher1, Esteban Franco-Garcia2,3, Carmen Zhou4
1Department of Anesthesiology, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA.
Objective:
To determine whether nutritional status at hospital admission is independently associated with new-onset delirium (NOD) in elderly, orthopaedic trauma patients.
Design:
Single-center, retrospective, cross-sectional study.
Setting:
Data from patients at a large teaching hospital in Boston, MA, were analyzed.
Patients:
All patients were ≥65 years and hospitalized for acute surgical management of their major fractures after trauma.
Intervention:
None.
Main Outcome Measurement:
Nutritional status was assessed at admission using the Mini Nutritional Assessment-Short Form (MNA-SF). Delirium was assessed using the Confusion Assessment Method within 24 hours of admission and daily throughout hospitalization.
Results:
The incidence of delirium was 20% (94/471). Each unit decrement in MNA-SF was associated with a 14% higher risk of NOD (adjusted OR 1.14; 95% CI 1.05-1.28). Moreover, malnourished patients (MNA-SF score 0-7) were twice as likely to develop NOD (adjusted OR 2.07; 95% CI 1.01-4.35) compared with patients who were not malnourished (MNA-SF score 8-14).
Conclusions:
In hospitalized, elderly, orthopaedic trauma patients, poor nutritional status may be a modifiable risk factor for NOD. Future studies are needed to determine whether aggressive nutritional interventions can reduce the incidence of NOD and improve outcomes in this cohort of patients.
Level Of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
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