Nutritional status of patients admitted to a metropolitan tertiary care vascular surgery unit

BACKGROUND AND OBJECTIVES: Undernutrition in vascular surgery patients has a significant impact on clinical outcomes. This observational study aimed to investigate the nutritional status of a heterogeneous sample of vascular surgery inpatients and to determine the prevalence of nutritional risk, malnutrition (including nutrient deficiencies) and sarcopenia.

METHODS AND STUDY DESIGN: All participants were screened for risk of malnutrition using the Malnutrition Universal Screening Tool (MUST) and assessed using the Patient-Generated Subjective Global Assessment (PG-SGA). Micronutrient status was examined via plasma/serum samples. The presence of sarcopenia was explored using an accepted algorithm incorporating gait speed, muscle mass (DEXA) and grip strength. RESULTS: 322 participants (69% male, mean age 67.6±14.1y) consented to the study. 12.5% were identified as at risk of malnutrition by the MUST while 15.8% were deemed malnourished by the PG-SGA. Only 5% were diagnosed as sarcopenic. Prevalence of malnutrition was much higher when micronutrients were examined with 79% showing low vitamin C, 56% low vitamin D and over 40% having low zinc, vitamin B-12 and folate. A smaller proportion were also low in selenium (19%).

CONCLUSIONS: Patients with vascular disease are a nutritionally vulnerable group. The MUST and PG-SGA did not identify the full extent of nutritional deficiencies. Further investigation is warranted to assess tool validity in this group. A number of micronutrients are crucial in these patients and hence a more comprehensive assessment that encompasses a wider range of parameters, including micronutrient status appears warranted.