Nutritional status of patients admitted to a metropolitan tertiary care vascular surgery unit.

Abstract

Undernutrition in vascular surgery patients has a significant impact on clinical outcomes. This observational study aimed to investigate the nutritional status of a heterogeneous sample of vascular surgery inpatients and to determine the prevalence of nutritional risk, malnutrition (including nutrient deficiencies) and sarcopenia. All participants were screened for risk of malnutrition using the Malnutrition Universal Screening Tool (MUST) and assessed using the Patient-Generated Subjective Global Assessment (PG-SGA). Micronutrient status was examined via plasma/serum samples. The presence of sarcopenia was explored using an accepted algorithm incorporating gait speed, muscle mass (DEXA) and grip strength. 322 participants (69% male, mean age 67.6±14.1y) consented to the study. 12.5% were identified as at risk of malnutrition by the MUST while 15.8% were deemed malnourished by the PG-SGA. Only 5% were diagnosed as sarcopenic. Prevalence of malnutrition was much higher when micronutrients were examined with 79% showing low vitamin C, 56% low vitamin D and over 40% having low zinc, vitamin B-12 and folate. A smaller proportion were also low in selenium (19%). Patients with vascular disease are a nutritionally vulnerable group. The MUST and PG-SGA did not identify the full extent of nutritional deficiencies. Further investigation is warranted to assess tool validity in this group. A number of micronutrients are crucial in these patients and hence a more comprehensive assessment that encompasses a wider range of parameters, including micronutrient status appears warranted.