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[Nutritional management in orthogeriatrics : Current evidence and recommendations for the practice]
R Speer1, K Singler2,3, R Eckardt-Felmberg4
1Klinik für Geriatrie, Klinikum Nürnberg, Paracelsus Medizinische Privatuniversität Nürnberg, Nürnberg, Deutschland. robert.speer@klinikum-nuernberg.de.
Background:
Orthogeriatric patients show a high prevalence of malnutrition or risk thereof. This is associated with increased complication rates, delayed wound healing, functional decline and higher mortality. A structured nutritional assessment and treatment are therefore essential but are still insufficiently implemented in daily practice.
Aim Of The Work:
Presentation of evidence-based strategies for optimizing nutritional management across the entire orthogeriatric care pathway, from preoperative assessment to perioperative interventions and continuation after discharge.
Material And Method:
Narrative review of current guidelines, studies and practice-oriented care concepts. A clinical case illustrates screening, Global Leadership Initiative on Malnutrition (GLIM)-based diagnostics and nutritional interventional measures in the context of proximal femoral fractures.
Results:
Malnutrition arises from multifactorial mechanisms and is diagnosed using validated screening tools and the GLIM criteria. Early individualized nutritional therapy, including energy-rich and protein-rich diets, oral nutritional supplements and systematic monitoring, improves mortality, functional outcomes and rehabilitation trajectories. Additional measures such as prehabilitation, carbohydrate loading and standardized postoperative nutritional regimens further enhance the probability of a successful outcome.
Discussion:
Despite clear guideline recommendations, gaps persist in screening coverage, interdisciplinary collaboration and integration of qualified dietitians. A continuous, cross-sectoral nutritional care concept can significantly positively influence the clinical course and should be an integral component of orthogeriatric treatment.
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