The following is a summary of “Implications of Poor Nutritional Status on Outcomes of Geriatric Trauma Patients,” published in the July 2024 issue of Surgery by Hosseinpour et al. 

Malnutrition significantly impacts surgical outcomes, and its effects on patients with trauma, particularly those discharged, remain underexplored. This study aimed to evaluate the effects of nutritional status on both the index admission and post-discharge outcomes of patients with geriatric trauma.

This study is a secondary analysis of the prospective observational American Association of Surgery for Trauma Frailty Multi-institutional Trial, encompassing geriatric patients (≥65 years) admitted to 17 Level I/II/III trauma centers between 2019 and 2021. Nutritional status was assessed using the simplified Geriatric Nutritional Risk Index (sGNRI), which combines albumin levels (g/dL) and body mass index (BMI) to categorize patients into severe (<5), moderate (5 to <5.5), mild (5.5 to <6), and good nutritional status (≥6). The study analyzed differences in outcomes based on these nutritional risk categories.

Out of 1,321 patients, 22% were classified as at risk for poor nutritional status: mild (13%), moderate (7%), and severe (3%). The average age of the cohort was 77 ± 8 years, and the median Injury Severity Score was 9 [5–13]. Patients identified with poor nutritional status exhibited higher rates of sepsis, pneumonia, discharge to skilled nursing or rehabilitation facilities, index-admission mortality, and 3-month mortality (P < .05). Multivariable analyses revealed that severe nutritional risk was independently associated with increased likelihood of sepsis (adjusted odds ratio [OR] 6.21, 95% confidence interval [CI] 1.68–22.90, P = .006), pneumonia (OR 4.40, 95% CI 1.21–16.1, P = .025), index-admission mortality (OR 3.16, 95% CI 1.03–9.68, P = .044), and 3-month mortality (OR 8.89, 95% CI 2.01–39.43, P = .004) compared to patients with good nutritional status.

Approximately one-quarter of patients with geriatric trauma were at risk for poor nutritional status, which independently predicted adverse outcomes both at index admission and 3 months post-discharge. These findings highlight the critical need for routine nutritional screening and management upon admission to improve outcomes in this vulnerable patient population.

Source: sciencedirect.com/science/article/abs/pii/S0039606024004719