title: Scurvy in hospitalized elderly patients.
abstract: OBJECTIVE
  The aim of this study was to systematically screen hospitalized elderly patients for clinical symptoms of scurvy and to confirm the diagnosis with biological measures.
  
  
  METHODS
  Geriatric acute care ward.
  
  
  METHODS
  Scurvy symptoms (one or more among perifollicular hyperkeratosis, petechiae or bruises, haemorrhagic features caused by venous puncture, severe gingivitis). We compared associated diseases, nutritional status, need for assistance for feeding, serum albumin, transthyretin, B9 and B12 vitamins, iron status and Serum Ascorbic Acid Level (SAAL) and outcome (in-hospital mortality) between scurvy and scurvy free patients.
  
  
  RESULTS
  18 patients with clinical symptoms of scurvy (scurvy group) were identified out of 145 consecutive patients (12%). They were compared to 23 consecutive control patients with no clinical symptoms of scurvy (scurvy-free group). SAAL was significantly lower (1.09 +/- 1.06 vs 4.87 +/- 4.2 mg x L-1, p < .001) and vitamin C deficiency more frequent (94 vs 30 %, p < .001) in the scurvy group. Moreover, in scurvy group, coronary heart disease (39 vs 9 %, p=.028), need for assistance for feeding (56 vs 13 %, p=.006) and in-hospital deaths (44 vs 9 %, p=.012) were more frequent.
  
  
  CONCLUSIONS
  Ninety-four percent of patients with clinical symptoms of scurvy had vitamin C deficiency. Our results suggest that in hospitalized elderly patients, clinical symptoms allow scurvy diagnosis. Scurvy could be a frequent disease in elderly patients admitted to acute geriatric ward.
authors.affiliation: Service de gériatrie, Hôpital Bichat-Claude Bernard, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Raynaud-Simon
authors.forename: J
authors.initials: J
authors.lastname: Cohen-Bittan
authors.forename: A
authors.initials: A
authors.lastname: Gouronnec
authors.forename: E
authors.initials: E
authors.lastname: Pautas
authors.forename: P
authors.initials: P
authors.lastname: Senet
authors.forename: M
authors.initials: M
authors.lastname: Verny
authors.forename: J
authors.initials: J
authors.lastname: Boddaert
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001205:Ascorbic Acid / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D015577:Geriatric Assessment; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D008297:Male; D008403:Mass Screening; D015596:Nutrition Assessment; D009752:Nutritional Status; D012614:Scurvy / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology* / Q000401:mortality
chemical_list: D015415:Biomarkers; D001205:Ascorbic Acid