Poster Presentation ANZTS Trauma 2024 Conference

One trauma service, two cohorts: how nutritional status of older persons with trauma compares to general trauma in a Major Trauma Centre (21618)

Caitlin MacCana 1 , Barbra Charge 1 , Sarah Phillips 2 , Nicholas Van Veenendaal 1 , Hannah Broadhurst 1 , Kym Wittholz 1 , David Read 3 4 , Hilda Griffin 1 , Kate Gregorevic 4 5 6
  1. Clinical Nutrition , Royal Melbourne Hospital , Melbourne, Victoria, Australia
  2. Clinical Nutrition, Sunshine Coast University Hospital, Birtinya, Queensland, Australia
  3. University of Melbourne , Melbourne, Victoria, Australia
  4. Royal Melbourne Hospital, Melbourne, VICTORIA, Australia
  5. Department of Aged Care, University of Melbourne , Melbourne, Victoria, Australia
  6. Department of Medicine, University of Melbourne , Melbourne, Victoria, Australia

Background:  

In 2022 the Royal Melbourne Hospital introduced a Trauma Older Persons Service (TOPS) which provides geriatric and allied health assessments to co-morbid patients ≥65 years admitted to the trauma unit after injury.  This study aimed to compare the nutritional status, nutrition interventions and length of stay (LOS) of TOPS patients compared with the general Trauma cohort

Methods:

Prospective observational data from all patients admitted under the TOPS bed card (November 2023 to March 2024) was compared with a historical data set, collected over a 3-month period (September to November 2022) of all patients admitted under Trauma. Demographic, LOS and nutritional data were collected from the electronic medical record.

Results:

One hundred TOPS patients (mean (SD) age 80.75 (7.6) years, 55% males) and 651 general Trauma patients (mean (SD) age 50 (21.7) years, 69% males) were included. One quarter (25%) of TOPS patients were malnourished compared with 4% of Trauma patients. Median [IQR] LOS was 12 [8.0-21.0] days for TOPS and 4 [1.0-8.5] days for Trauma. TOPS patients were more likely to receive dietary modifications (28% vs 2%) and oral nutrition supplements (57% vs 50%), and less likely to receive artificial nutrition support (8% vs 38%) than Trauma patients.  

Conclusion:  

TOPS patients had an increased prevalence of malnutrition on admission and were prescribed less intensive nutrition interventions when compared with general Trauma patients. Nutrition models of care, including early risk screening and diet modifications, targeted toward the specific needs of TOPS patients may be warranted in this unique cohort