Nutritional status of elderly trauma patients presenting to a South Dublin Teaching Hospital

Abstract

Background It has been hypothesised that elderly orthopaedic trauma patients may be malnourished when compared to the general population. We conducted an observational study to identify if this was the case. Methods Thirty elderly trauma patients (≥ 65 years) admitted to the orthopaedic unit were recruited. Serum markers (albumin, urea, creatinine, sodium, potassium, haemoglobin, white cell count, platelets, lymphocytes, C-reactive protein, magnesium, calcium) anthropometric measurements (triceps skin-fold thickness, mid-arm circumference, body mass index) and short form mini-nutritional assessment (MNA-SF ®) were carried out at presentation and at 3 months postoperation. Serum markers were also repeated at day 1 and day 3 postoperation. Results Sixty percent had an initial mini-nutritional assessment (MNA-SF ®) score of less or equal to 11 points indicating that they were at risk from possible malnutrition. However, median BMI at presentation was normal at 22.79 kg/m 2 (WHO guidelines) (Interquartile range [IQR] 19.8–28). Interestingly, a higher proportion of the group (67%) were below the 50th centile for age related BMI centiles. At follow-up (15 patients), there was no significant difference in anthropometric measures. The mean MNA-SF ® had increased, but not significantly ( P = 0.121). Conclusions It could be extrapolated from this study that elderly trauma patients may be at risk of malnutrition regardless of their BMI at presentation and should be screened using validated nutrition screening tools and monitored. The use of age specific centiles is also recommended. Further research is needed using larger sample sizes to confirm these findings.