title: Age-dependent risk factors for malnutrition in traumatology and orthopedic patients.
abstract: OBJECTIVE
  The aim of this study was to investigate the prevalence of risk of malnutrition (RoM) in an orthopedic and traumatology patient cohort with a broad range of ages. In addition to the classical indicators for risk assessment (low body mass index, weight loss, and comorbidity), this study aimed to analyze the effects of lifestyle factors (eating pattern, smoking, physical activity) on RoM.
  
  
  METHODS
  The prospective cohort study included 1053 patients in a level 1 trauma center in Germany. RoM was assessed by Nutritional Risk Screening (NRS) 2002 and for the elderly additionally by Mini Nutritional Assessment (MNA). Age-dependent risk factors identified in univariate statistical analysis were used for multivariate logistic regression models.
  
  
  RESULTS
  The prevalence of patients at RoM (NRS ≥3) was 22%. In the three age categories (<50 y, 50-69 y, and ≥70 y), loss of appetite, weight loss, number of comorbidities, drugs and gastrointestinal symptoms significantly increased RoM in univariate statistical analysis. In patients ages ≥70 y, several disease- and lifestyle-related factors (not living at home, less frequent consumption of vegetables and whole meal bread, low physical activity, and smoking) were associated with RoM. Multivariate logistic regression model for the total study population identified weight loss (odds ratio [OR], 6.09; 95% confidence interval [CI], 4.14-8.83), loss of appetite (OR, 3.81; 95% CI, 2.52-5.78), age-specific low BMI (OR, 1.87; 95% CI, 1.18-2.97), number of drugs taken (OR, 1.19; 95% CI, 1.12-1.26), age (OR, 1.03; 95% CI, 1.02-1.04), and days per week with vegetable consumption (OR, 0.938; 95% CI, 0.89-0.99) as risk factors.
  
  
  CONCLUSIONS
  Malnutrition in trauma and orthopedic patients is not only a problem related to age. Lifestyle-related factors also contribute significantly to malnutrition in geriatric patients.
authors.affiliation: Institute of Biological Chemistry and Nutrition, University of Hohenheim, Stuttgart, Germany. Electronic address: Christine.lambert@uni-hohenheim.de.
authors.forename: Christine
authors.initials: C
authors.lastname: Lambert
authors.affiliation: Siegfried Weller Institute for Trauma Research, BG Trauma Center Tuebingen, Eberhard Karls University Tuebingen, Tuebingen, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Nüssler
authors.affiliation: Institute of Biological Chemistry and Nutrition, University of Hohenheim, Stuttgart, Germany.
authors.forename: Hans Konrad
authors.initials: HK
authors.lastname: Biesalski
authors.affiliation: Siegfried Weller Institute for Trauma Research, BG Trauma Center Tuebingen, Eberhard Karls University Tuebingen, Tuebingen, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Freude
authors.affiliation: Siegfried Weller Institute for Trauma Research, BG Trauma Center Tuebingen, Eberhard Karls University Tuebingen, Tuebingen, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Bahrs
authors.affiliation: Siegfried Weller Institute for Trauma Research, BG Trauma Center Tuebingen, Eberhard Karls University Tuebingen, Tuebingen, Germany.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Ochs
authors.affiliation: Siegfried Weller Institute for Trauma Research, BG Trauma Center Tuebingen, Eberhard Karls University Tuebingen, Tuebingen, Germany.
authors.forename: Ingo
authors.initials: I
authors.lastname: Flesch
authors.affiliation: Siegfried Weller Institute for Trauma Research, BG Trauma Center Tuebingen, Eberhard Karls University Tuebingen, Tuebingen, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Stöckle
authors.affiliation: Siegfried Weller Institute for Trauma Research, BG Trauma Center Tuebingen, Eberhard Karls University Tuebingen, Tuebingen, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Ihle
mesh_terms: D000367:Age Factors; D000368:Aged; D001066:Appetite; D015992:Body Mass Index; D015897:Comorbidity; D004032:Diet; D015444:Exercise; D005260:Female; D050723:Fractures, Bone / Q000150:complications / Q000628:therapy; D015577:Geriatric Assessment; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008019:Life Style; D008297:Male; D044342:Malnutrition / Q000453:epidemiology* / Q000209:etiology; D008875:Middle Aged; D015596:Nutrition Assessment; D009985:Orthopedics; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014194:Traumatology; D015431:Weight Loss
keywords: Food pattern; MNA; Malnutrition; NRS; Nutritional risk