Postoperative Dietary Quality is Poor after Major Musculoskeletal Trauma

Abstract

Abstract Objectives Musculoskeletal trauma often leads to prolonged functional deficits. Adequate dietary intake and supplementation improves clinical outcomes after surgical fixation of hip fracture in older adults. The role of post-operative nutrition after acute fracture has not been elucidated. Our objective was to describe dietary deficiencies after operative fixation of acute fracture in young adults. Methods An observational, cohort study identified patients aged 18–55 years presenting to a Level 1 trauma center with pelvic or extremity fracture indicated for operative fixation. Dietary intake was measured using Automated Self- Administered 24-hour dietary recall (ASA24®) in weeks 1, 2, and 4 postoperatively. Individual macro- and micro-nutrients for each subject were summarized using arithmetic means. Inadequate nutritional intake was determined using Dietary Reference Intake (DRI) values reported by the Institute of Medicine. The Healthy Eating Index 2015 (HEI-2015) score was calculated based on ASA24® data as described by the USDA. Results Most subjects were healthy preoperatively, 98% had ≤1 comorbidity. Eighty-four % of injures were to the lower extremities, and 59% were isolated. The majority of subjects (78%) discharged home. An average of 3.9 surveys were filled out per subject. Dietary intake overall was inadequate; 72% did not meet calorie needs. Protein intake was inadequate in 66%. All subjects did not meet DRIs for fiber, vitamin E, or potassium. More than 50% did not meet DRI for calcium, iron, magnesium, folate, vitamins C, A, or K. Added sugar and saturated fat intake exceeded recommendations in 38% and 41% of subjects respectively. Intake of beneficial foods such as whole grains and vegetables were inadequate in 100% of subjects; fruit intake was inadequate in 88%. The mean HEI-2015 score was 44.7 (±11.4 SD) across all time points. Conclusions In a population of previously healthy, young adults with major musculoskeletal trauma, dietary quality was poor compared to the average for the US population, 44.7 vs 59 HEI-2015. Diet analysis revealed a concerning lack of vegetables, whole grains, multiple micronutrients, and total calories. This data provides goals for adequate nutritional supplementation after musculoskeletal trauma. Funding Sources No payments were received to conduct this research study.