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Malnutrition and its effects in severely injured trauma patients

PURPOSE: In hospitalized patients, malnutrition is associated with adverse outcomes. However, the consequences of malnutrition in trauma patients are still poorly understood. This study aims to review the current knowledge about the pathophysiology, prevalence, and effects of malnutrition in severel...

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Autores principales: Dijkink, Suzan, Meier, Karien, Krijnen, Pieta, Yeh, D. Dante, Velmahos, George C., Schipper, Inger B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7593306/
https://www.ncbi.nlm.nih.gov/pubmed/31974669
http://dx.doi.org/10.1007/s00068-020-01304-5
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author Dijkink, Suzan
Meier, Karien
Krijnen, Pieta
Yeh, D. Dante
Velmahos, George C.
Schipper, Inger B.
author_facet Dijkink, Suzan
Meier, Karien
Krijnen, Pieta
Yeh, D. Dante
Velmahos, George C.
Schipper, Inger B.
author_sort Dijkink, Suzan
collection PubMed
description PURPOSE: In hospitalized patients, malnutrition is associated with adverse outcomes. However, the consequences of malnutrition in trauma patients are still poorly understood. This study aims to review the current knowledge about the pathophysiology, prevalence, and effects of malnutrition in severely injured patients. METHODS: A systematic literature review in PubMed and Embase was conducted according to PRISMA-guidelines. RESULTS: Nine review articles discussed the hypermetabolic state in severely injured patients in relation to malnutrition. In these patients, malnutrition negatively influenced the metabolic response, and vice versa, thereby rendering them susceptible to adverse outcomes and further deterioration of nutritional status. Thirteen cohort studies reported on prevalences of malnutrition in severely injured patients; ten reported clinical outcomes. In severely injured patients, the prevalence of malnutrition ranged from 7 to 76%, depending upon setting, population, and nutritional assessment tool used. In the geriatric trauma population, 7–62.5% were malnourished at admission and 35.6–60% were at risk for malnutrition. Malnutrition was an independent risk factor for complications, mortality, prolonged hospital length of stay, and declined quality of life. CONCLUSIONS: Despite widespread belief about the importance of nutrition in severely injured patients, the quantity and quality of available evidence is surprisingly sparse, frequently of low-quality, and outdated. Based on the malnutrition-associated adverse outcomes, the nutritional status of trauma patients should be routinely and carefully monitored. Trials are required to better define the optimal nutritional treatment of trauma patients, but a standardized data dictionary and reasonable outcome measures are required for meaningful interpretation and application of results. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00068-020-01304-5) contains supplementary material, which is available to authorized users.
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spelling pubmed-75933062020-11-10 Malnutrition and its effects in severely injured trauma patients Dijkink, Suzan Meier, Karien Krijnen, Pieta Yeh, D. Dante Velmahos, George C. Schipper, Inger B. Eur J Trauma Emerg Surg Review Article PURPOSE: In hospitalized patients, malnutrition is associated with adverse outcomes. However, the consequences of malnutrition in trauma patients are still poorly understood. This study aims to review the current knowledge about the pathophysiology, prevalence, and effects of malnutrition in severely injured patients. METHODS: A systematic literature review in PubMed and Embase was conducted according to PRISMA-guidelines. RESULTS: Nine review articles discussed the hypermetabolic state in severely injured patients in relation to malnutrition. In these patients, malnutrition negatively influenced the metabolic response, and vice versa, thereby rendering them susceptible to adverse outcomes and further deterioration of nutritional status. Thirteen cohort studies reported on prevalences of malnutrition in severely injured patients; ten reported clinical outcomes. In severely injured patients, the prevalence of malnutrition ranged from 7 to 76%, depending upon setting, population, and nutritional assessment tool used. In the geriatric trauma population, 7–62.5% were malnourished at admission and 35.6–60% were at risk for malnutrition. Malnutrition was an independent risk factor for complications, mortality, prolonged hospital length of stay, and declined quality of life. CONCLUSIONS: Despite widespread belief about the importance of nutrition in severely injured patients, the quantity and quality of available evidence is surprisingly sparse, frequently of low-quality, and outdated. Based on the malnutrition-associated adverse outcomes, the nutritional status of trauma patients should be routinely and carefully monitored. Trials are required to better define the optimal nutritional treatment of trauma patients, but a standardized data dictionary and reasonable outcome measures are required for meaningful interpretation and application of results. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00068-020-01304-5) contains supplementary material, which is available to authorized users. Springer Berlin Heidelberg 2020-01-23 2020 /pmc/articles/PMC7593306/ /pubmed/31974669 http://dx.doi.org/10.1007/s00068-020-01304-5 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Review Article
Dijkink, Suzan
Meier, Karien
Krijnen, Pieta
Yeh, D. Dante
Velmahos, George C.
Schipper, Inger B.
Malnutrition and its effects in severely injured trauma patients
title Malnutrition and its effects in severely injured trauma patients
title_full Malnutrition and its effects in severely injured trauma patients
title_fullStr Malnutrition and its effects in severely injured trauma patients
title_full_unstemmed Malnutrition and its effects in severely injured trauma patients
title_short Malnutrition and its effects in severely injured trauma patients
title_sort malnutrition and its effects in severely injured trauma patients
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7593306/
https://www.ncbi.nlm.nih.gov/pubmed/31974669
http://dx.doi.org/10.1007/s00068-020-01304-5
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