Nutritional intervention in cognitively impaired geriatric trauma patients: a feasibility study

D Eschbach,1 T Kirchbichler,1 T Wiesmann,2 L Oberkircher,1 C Bliemel,1 S Ruchholtz,1 B Buecking1 1Center for Orthopedics and Trauma Surgery, 2Department of Anaesthesiology and Critical Care, University of Marburg, Marburg, Germany Background: Most studies focusing on improving the nutritional stat...

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Autores principales:	Eschbach D, Kirchbichler T, Wiesmann T, Oberkircher L, Bliemel C, Ruchholtz S, Buecking B
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	malnutrition perioperative nutrition management elderly cognitive impaired geriatric trauma patients Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/f7bf8bd245e941e697ccec0e8a1edc10
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spelling	oai:doaj.org-article:f7bf8bd245e941e697ccec0e8a1edc102021-12-02T01:36:16ZNutritional intervention in cognitively impaired geriatric trauma patients: a feasibility study1178-1998https://doaj.org/article/f7bf8bd245e941e697ccec0e8a1edc102016-09-01T00:00:00Zhttps://www.dovepress.com/nutritional-intervention-in-cognitively-impaired-geriatric-trauma-pati-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998D Eschbach,1 T Kirchbichler,1 T Wiesmann,2 L Oberkircher,1 C Bliemel,1 S Ruchholtz,1 B Buecking1 1Center for Orthopedics and Trauma Surgery, 2Department of Anaesthesiology and Critical Care, University of Marburg, Marburg, Germany Background: Most studies focusing on improving the nutritional status of geriatric trauma patients exclude patients with cognitive impairment. These patients are especially at risk of malnutrition at admission and of worsening during the perioperative fasting period. This study was planned as a feasibility study to identify the difficulties involved in including this high-risk collective of cognitively impaired geriatric trauma patients. Patients and methods: This prospective intervention study included cognitively impaired geriatric patients (Mini–Mental State Examination <25, age >65 years) with hip-related fractures. We assessed Mini Nutritional Assessment (MNA), Nutritional Risk Screening (NRS 2002), body mass index, calf circumference, American Society of Anesthesiologists’ classification, and Braden Scale. All patients received parenteral nutritional supplementation of 800 kcal/d for the 96-hour perioperative period. Serum albumin and pseudocholinesterase were monitored. Information related to the study design and any complications in the clinical course were documented. Results: A total of 96 patients were screened, among whom eleven women (median age: 87 years; age range: 74–91 years) and nine men (median age: 82 years; age range: 73–89 years) were included. The Mini–Mental State Examination score was 9.5 (0–24). All patients were manifestly undernourished or at risk according to MNA and NRS 2002. The body mass index was 23 kg/m2 (13–30 kg/m2), the calf circumference was 29.5 cm (18–34 cm), and the mean American Society of Anesthesiologists’ classification status was 3 (2–4). Braden Scale showed 18 patients at high risk of developing pressure ulcers. In all, 12 patients had nonsurgical complications with 10% mortality. Albumin as well as pseudocholinesterase dropped significantly from admission to discharge. The study design proved to be feasible. Conclusion: The testing of MNA and NRS 2002 was feasible. Cognitively impaired trauma patients proved to be especially at risk of malnutrition. Since 96 hours of parenteral nutrition as a crisis intervention was insufficient, additional supplementation could be considered. Laboratory and functional outcome parameters for measuring successive supplementation certainly need further evaluations involving randomized controlled trials. Keywords: malnutrition, perioperative nutrition management, elderly, cognitive impaired geriatric trauma patientsEschbach DKirchbichler TWiesmann TOberkircher LBliemel CRuchholtz SBuecking BDove Medical Pressarticlemalnutritionperioperative nutrition managementelderlycognitive impaired geriatric trauma patientsGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 11, Pp 1239-1246 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	malnutrition perioperative nutrition management elderly cognitive impaired geriatric trauma patients Geriatrics RC952-954.6
spellingShingle	malnutrition perioperative nutrition management elderly cognitive impaired geriatric trauma patients Geriatrics RC952-954.6 Eschbach D Kirchbichler T Wiesmann T Oberkircher L Bliemel C Ruchholtz S Buecking B Nutritional intervention in cognitively impaired geriatric trauma patients: a feasibility study
description	D Eschbach,1 T Kirchbichler,1 T Wiesmann,2 L Oberkircher,1 C Bliemel,1 S Ruchholtz,1 B Buecking1 1Center for Orthopedics and Trauma Surgery, 2Department of Anaesthesiology and Critical Care, University of Marburg, Marburg, Germany Background: Most studies focusing on improving the nutritional status of geriatric trauma patients exclude patients with cognitive impairment. These patients are especially at risk of malnutrition at admission and of worsening during the perioperative fasting period. This study was planned as a feasibility study to identify the difficulties involved in including this high-risk collective of cognitively impaired geriatric trauma patients. Patients and methods: This prospective intervention study included cognitively impaired geriatric patients (Mini–Mental State Examination <25, age >65 years) with hip-related fractures. We assessed Mini Nutritional Assessment (MNA), Nutritional Risk Screening (NRS 2002), body mass index, calf circumference, American Society of Anesthesiologists’ classification, and Braden Scale. All patients received parenteral nutritional supplementation of 800 kcal/d for the 96-hour perioperative period. Serum albumin and pseudocholinesterase were monitored. Information related to the study design and any complications in the clinical course were documented. Results: A total of 96 patients were screened, among whom eleven women (median age: 87 years; age range: 74–91 years) and nine men (median age: 82 years; age range: 73–89 years) were included. The Mini–Mental State Examination score was 9.5 (0–24). All patients were manifestly undernourished or at risk according to MNA and NRS 2002. The body mass index was 23 kg/m2 (13–30 kg/m2), the calf circumference was 29.5 cm (18–34 cm), and the mean American Society of Anesthesiologists’ classification status was 3 (2–4). Braden Scale showed 18 patients at high risk of developing pressure ulcers. In all, 12 patients had nonsurgical complications with 10% mortality. Albumin as well as pseudocholinesterase dropped significantly from admission to discharge. The study design proved to be feasible. Conclusion: The testing of MNA and NRS 2002 was feasible. Cognitively impaired trauma patients proved to be especially at risk of malnutrition. Since 96 hours of parenteral nutrition as a crisis intervention was insufficient, additional supplementation could be considered. Laboratory and functional outcome parameters for measuring successive supplementation certainly need further evaluations involving randomized controlled trials. Keywords: malnutrition, perioperative nutrition management, elderly, cognitive impaired geriatric trauma patients
format	article
author	Eschbach D Kirchbichler T Wiesmann T Oberkircher L Bliemel C Ruchholtz S Buecking B
author_facet	Eschbach D Kirchbichler T Wiesmann T Oberkircher L Bliemel C Ruchholtz S Buecking B
author_sort	Eschbach D
title	Nutritional intervention in cognitively impaired geriatric trauma patients: a feasibility study
title_short	Nutritional intervention in cognitively impaired geriatric trauma patients: a feasibility study
title_full	Nutritional intervention in cognitively impaired geriatric trauma patients: a feasibility study
title_fullStr	Nutritional intervention in cognitively impaired geriatric trauma patients: a feasibility study
title_full_unstemmed	Nutritional intervention in cognitively impaired geriatric trauma patients: a feasibility study
title_sort	nutritional intervention in cognitively impaired geriatric trauma patients: a feasibility study
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/f7bf8bd245e941e697ccec0e8a1edc10
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Nutritional intervention in cognitively impaired geriatric trauma patients: a feasibility study

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