Clinical Significance of Malnutrition Risk in Severe Trauma Patients: A Single-Center Study

ABSTRACT

Purpose@#A suboptimal nutritional status is often observed among hospitalized patients across all medical/surgical specialties. The objective of the present study was to (1) analyze the prevalence of malnutrition in severe trauma patients and (2) evaluate the relationship between malnutrition and select clinical outcomes. @*Materials and Methods@#This retrospective study was conducted between October 2015 and March 2017 at the Pusan National University Hospital Trauma Center. Of a total of 3,560 patients, 945 were enrolled in this study. Patients were checked for malnutrition using a nutrition assessment tool by the hospital nutrition support team. The parameters assessed included serum albumin, the ratio of actual body weight to ideal body weight (%), total lymphocyte count, appetite, and gastrointestinal problems. Clinical outcomes under consideration included 1) mortality, 2) length of hospitalization, and 3) length of stay in the intensive care unit (ICU). @*Results@#The total prevalence of malnutrition in hospitalized trauma patients was 55.0% (n=520). Malnutrition risk was the independent prognostic factor of mortality in severe trauma patients (adjusted odds ratio [OR]=3.440;95% confidence interval [CI]=1.401~8.447, P=0.007). Risk factors of malnutrition were age over 65 years (adjusted OR=2.393; 95% CI=1.699~3.370, P<0.001), injury severity score (adjusted OR=1.034, 95% CI=1.012~1.056, P=0.002), length of hospitalization (adjusted OR=1.104; 95% CI=1.007~1.020, P<0.001), and length of stay in the ICU (adjusted OR=1.050; 95% CI=1.029~1.072, P<0.001). @*Conclusion@#Malnutrition is widespread in hospitalized patients with severe trauma and results in suboptimal clinical outcomes. Thus, patients at high risk of malnutrition should be monitored carefully during hospitalization.