Nutritional Status of Older Persons following Burn Injury requiring hospitalisation

Caroline Nicholls^1,2, Cheryl Brownlow^1,2, Nicola Clayton^2,3,4,5, Justine O’Hara², Andrea Issler-Fisher², Oliver Fisher⁶, Peter Maitz^2,5,
¹Nutrition and Dietetics, Concord Hospital, Concord, NSW, Australia
²Burns Unit, Concord Hospital, Concord, NSW, Australia
³Speech Pathology Department, Concord Hospital, Concord, NSW, Australia
⁴School of Health & Rehabilitation Sciences, University of Queensland , St Lucia, QLD, Australia
⁵Faculty of Medical and Health Sciences, University of Sydney , Camperdown, NSW, Australia
⁶UNSW Department of Surgery, St George Hospital, Kogarah, NSW, Australia

Abstract

Background: Malnutrition is recognised as an issue in the general ageing population. Approximately 10-30% of community dwelling older people are malnourished, with higher rates observed in residential aged care. Burn injury is considered to have significant impacts on nutritional status due to the body’s hypermetabolic response and subsequent elevated nutritional needs, therefore increasing risk for malnutrition. However, rates of community acquired malnutrition prior to hospitalisation for burn injury in the older population are not well understood.

Aims: To describe the nutritional status of patients aged ≥75 years requiring hospitalisation for burn injury.

Methods: As part of a larger prospective cohort study, all patients ≥75years admitted to Concord Repatriation General Hospital (CRGH) with burn injury over a 4-year period (2019-2023) underwent dietetic nutritional assessment. Malnutrition was defined by validated tools: Subjective Global Assessment (SGA) and Mini Nutrition Assessment (MNA).

Results: Nutritional status data was collected for 61 of the 62 patients admitted (51% male, median age=83 years, range=75-95 years). Most injuries (82%) were <10% TBSA (range 1-35%), and all patients resided at home pre-admission. The SGA identified 21% as malnourished on admission, and the MNA identified 8% as malnourished and 33% ‘at risk’ of malnutrition. Nutrition supplements were prescribed to 58% of the cohort. Conclusions: Rates of malnutrition in older persons admitted to the CRGH burns unit are comparable to those reported in the community. Nutrition status should be assessed for all older patients, irrespective of burn size, to ensure their nutritional needs are optimised to facilitate recovery.

Biography

Caroline Nicholls is a Senior Dietitian at Concord Repatriation General Hospital, working in Burns and Aged Care. She has over 15 years experience working with burn injured patients and is well recognised in the field of nutrition support and clinical research in severe burn injury. She has an interest in the role indirect calorimetry can play in optimising energy provision for this patient group and is undertaking research in this area.