Management of malnutrition in geriatric trauma patients: results of a nationwide survey

Abstract

Prevalence of malnutrition in geriatric trauma patients ranges between 30 and 50% in Germany. Malnutrition is associated with impaired wound healing, a prolonged in-hospital stay, reduced post-traumatic mobility, as well as a higher mortality. Thus, detection and improvement of nutritional status could be a fundamental contribution in optimizing the treatment of these patients. We sent a web-based questionnaire to 579 German hospitals with traumatological expertise, seeking information on the institutional care level, number of beds, use of nutritional assessments, and use of defined laboratory parameters for the detection of malnutrition. Furthermore, we focused on the presence and frequency of nutrition ward rounds on the intensive care unit. We received 151 answers. Nutritional status was analysed in one-third (N=50). The half of these 50 clinics (54%, N=27) were using the body mass index (BMI), 20% (N=10) were using the nutritional risk screening (NRS), and 14% (N=7) used the mini nutritional assessment. 38 hospitals indicated a regular nutrition ward round; 63% of them occurred daily, 13% had a weekly frequency, and 24% were on demand. Laboratory parameters were used inhomogeneously. Except for the more frequent use of the NRS (p=0.026) in local trauma centres, we found no significant difference in the detection of malnutrition according to the care level. Although we know malnutrition is a frequent condition in geriatric patients, a minority of clinics considered it. The BMI and the NRS showed acceptance in practice; other parameters were used inhomogeneously. Although these findings may be limited in their significance, they indicate that the detection of malnutrition needs further investigation.