First Experience with a Concept of Nutrition Therapy in Trauma Surgery

Abstract

Introduction: Malnutrition is endemic in western industrialised countries. In hospitalised patients malnutrition leads to an increase of morbidity, mortality, complications, time of hospitalisation and costs. In 1999 a commission for nutritional matters was inaugurated at our hospital. Its first results in the department of Trauma Surgery are presented.
Methods: From August 2000 to July 2001 all in-patients older than 70 years, patients with decubital ulcers and polytraumatised patients were included and treated during a weekly round. To evaluate their nutritional state we assayed total serum protein, albumin and cholinesterases once a week. The nutritional therapy provided included special diets, additional enteral solutions or partial or full parenteral nutrition.
Results: 279 in-patients were treated. We were able to prevent a deterioration of the nutritional state during the hospital stay. The average of the biochemical parameters in the worst percentile could be increased significantly. In two similar groups before and after the introduction of the nutritional rounds the duration of hospital stay could be decreased.
Conclusions: Trauma patients in a reduced nutritional state in particular benefit from nutritional therapy. The success is hard to verify in the short time of hospitalisation. Nutritional measures should be continued in rehabilitation centres, nursing homes and family care.

Key words

Malnutrition - trauma surgery - geriatric surgery - nutrition therapy

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