Assessing pre-operative nutritional status in geriatric inpatients, and associating it with post-operative clinical outcomes’; in a tertiary care hospital of central India

Abstract

Introduction: Malnutrition though prevalent during hospitalization is often unrecognized in geriatric population. The study aimed to determine the prevalence of malnutrition among hospitalized geriatric patients undergoing elective surgery using a standardized nutritional tool and to find association between the pre-operative nutritional status and post-operative clinical outcomes. Materials and Methods: This observational follow up study was conducted at a tertiary care hospital of Central India. Total 90 patients were included. Each patient's nutritional status was determined by MNA (Mini Nutritional Assessment) scale within 24 hours of admission and required anthropometric and biochemical parameters were also collected preoperatively. Patients were followed with respect to surgical wound healing and length of hospital stay. Results: MNA tool detected the prevalence of malnutrition (under-nutrition) at 60%, and at risk of Malnourishment at 24%. These patients experienced significantly prolonged hospital stay after surgery (p<0.01). The MNA based nutritional grading showed high level of sensitivity (91% -94%) specificity (92%-95%), predictive value (91% -94%) and concordance coefficient (70%-90%). Conclusion: Large number of geriatric surgical patients are malnourished or at risk for malnutrition. MNA, a simple low skilled tool that can be conducted by paramedics can identify this with good accuracy and help in nutritional planning and lowering postoperative complications.