| Objective: NRS 2002 and MNA-sf were used to analyze the nutritional status of the elderly fracture patients before operation,and to explore a suitable screening tool for evaluating the nutritional status of the elderly fracture patients in our country.Methods: Selected fracture patients aged 65 years or older admitted to the Xi’an Jiaotong University Trauma Unit of the Hong Kong Red Cross Hospital between January2022 and December 2022,according to the inclusion and exclusion criteria,a total of 825 patients were enrolled,including 243 male patients(29.45%)and 582 female patients(70.55%).Among the injured sides,there were 427 cases(51.76%)on the left side and398 cases(48.24%)on the right side.The data of age,sex,fracture site,injured side,injury mechanism,height,weight,blood test(blood routine and biochemistry)and so on were collected at admission,NRS2002 and MNA-sf were used to evaluate the nutritional status of the patients.The diagnostic criteria for malnutrition were BMI ≤18.5 kg/㎡,ALB<35.0 g/L and MNA-sf score 0-7 for those who could not obtain effective BMI.Nutritional Risk: NRS 2002 score ≥3.Risk of malnutrition: MNA-SF score ranged from 0 to 11.And statistical analysis of the data obtained,the elderly hospitalized patients with malnutrition and malnutrition(malnutrition)risk rates.Results: All enrolled patients were eligible for MNA-sf and NRS 2002 scoring tables,among which 98 people had a BMI ≤ of 18.5Kg/㎡,and the overall malnutrition rate was11.88%;There were 112 people with albumin ALB <30g/L,and the overall malnutrition rate was 13.58%.NRS 2002 scoring results: 0 points 45 cases,1 score 219 cases,2 points170 cases,3 points 145 cases,4 points 112 cases,5 points 97 cases,6 points 31 cases,7points 6 cases.Among them,a total of 391 people scored ≥3,and the incidence of nutritional risk was 47.39%.MNA-sf score: 12～14 points 404 people;8～11 points 314people;0～7 points 107 people.There were 107 malnutrition,the incidence of malnutrition was 12.97%,and the risk of malnutrition was 421,and the incidence of malnutrition risk was 51.03%.The average age of all elderly trauma fracture patients was(75.97±7.66)years old,229 patients above 65～,with an average length of stay of 6.64±3.45;304patients with 70～± or above with an average length of stay of 6.633.50;262 patients above80～,with an average length of stay of 6.44±3.08;30 patients with 90～± and above with an average length of stay of 6.473.19;and 825 patients with an average length of stay of6.56± 3.34。 Among elderly trauma fracture patients,414 cases(50.2%)of hip fracture and 142 cases(17.2%)of proximal humerus fracture were located.In 2002,there were 24 cases of malnutrition in NRS 2002,with 119 cases of malnutrition risk,and 28 cases of MNA-sf malnutrition and 129 cases of malnutrition risk.NRS 2002 had 74 cases of malnutrition and 272 cases of malnutrition risk,and 79 cases of MNA-sf malnutrition and292 cases of malnutrition risk in patients with lower limb fracture.There were 305 urban medical insurance patients,accounting for 37.00%,NRS 2002 malnutrition 44 cases,malnutrition risk 176 cases,MNA-sf malnutrition 48 cases,malnutrition risk 189 cases;There were 207 self-paid patients,accounting for 25.10%,13 cases of malnutrition and46 cases of malnutrition risk in NRS 2002,14 cases of malnutrition and 51 cases of malnutrition risk of MNA-sf.There were 313 cases of employee medical insurance patients,accounting for 37.90%,NRS 2002 malnutrition 41 cases,malnutrition risk 169 cases,MNA-sf malnutrition 45 cases,malnutrition risk 181 cases.There were 533 cases of flat ground fall injuries,accounting for 64.60%,80 cases of malnutrition and 270 cases of malnutrition risk in NRS 2002,85 cases of malnutrition and 282 cases of malnutrition risk of MNA-sf.There were 208 cases of traffic accident injuries,accounting for 25.20%,NRS 2002 malnutrition 12 cases,malnutrition risk 95 cases,MNA-sf malnutrition 14 cases,malnutrition risk 104 cases;There were 84 cases of violent injuries from falls,accounting for 10.20%,NRS 2002 malnutrition was 6 cases,malnutrition risk was 26 cases,MNA-sf malnutrition was 8 cases,malnutrition risk was 35 cases.Conclusion: Older patients with preoperative fractures have poorer nutritional status with age,and lower extremity fractures,fall fractures,and rural patients are at higher risk of malnutrition,NRS 2002 and MNA-sf are two kinds of nutritional screening tools,which are simple,non-invasive and easy to master. |
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