Abstract

A PROSPECTIVE STUDY ON DETERMINATION OF EARLY NUTRITION INTERVENTION FOR PATIENTS ADMITTED IN A LEVEL I TRAUMA CARE CENTRE

*Koyel Pal Chowdhury, Rajat Choudhuri, Sarbari Swaika, Avijit Hazra, Jotideb Mukhopadhyay, Animesh Dey, Sandip Mukherjee and Alak K. Syamal

Abstract

Nutritional support is a unique challenge because the therapy regimen is changeable according to patients’ conditions. Many patients in trauma care are severely malnourished, and further nutrient losses may occur due to starvation, infection, pneumonia, blood loss, and drug interactions. The main goals of the study are to find out how well trauma patients were eating when they were admitted to a level I trauma care centre (using the Subjective Global Assessment and Nutrition Risk Score 2002) and to figure out the best way to help these patients eat based on their disease-adjusted mortality rate, level of consciousness, and the bad effects of their first treatment (using the APACHE IV, GCS, SOFA, and NUTRIC scores). This ongoing study has recruited 102 patients to date, with an estimated sample size of 245. The average age of patients is 42.4 (± standard deviation 16.5) years, and BMI is 18.3 (range 15.1 to 25.8) kg/m2. Most underweight patients faced critical nutrition conditions (88.5%), with a mortality rate between 40 and 73% as per APACHE IV. Patients having high mortality rates derived from SOFA were also suffering from nutritional risk. The correlation between SGA and NUTRIC scores in judging nutritional risk status was moderate. Enteral nutrition has been started in 90% of cases, although the diet principle varies. As the patients are critically ill at admission and the severity of illness is highly unpredictable, assessment at admission becomes very challenging. Early nutritional intervention may improve the outlook and speed up recovery in people who have recently been through a traumatic event in a hospital setting, where secondary infections and persistent catabolism can make things more difficult. A single nutrition risk assessment tool cannot be the best interpreter.

Keywords: Trauma, Nutrition Care Process, Assessment, Intervention, Interrelationship.