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The use of a simple nutritional assessment procedure in elderly orthopaedic patients
P.35
THE ROLE OF THE INTESTINE IN ACID-BASK REGULATIONAFTER A MIXED NEAL IB PIGS. C. L. H. van Berlo, P.B. Soeters. University Hospital Maastricht, Department of Surgery, Maastricht, The Netherlands. Introduction: Metabolism of protein produces bicarbonate and this is a strongly alkalinl zing process. It was the aim of this study to evaluate to what extent a protein meal influenced selective portal and systemic pH. lhterials and methods: Fasted, unrestrained conscious pigs (n=lO; 20+_,8 kg) were used. Blood was sampled from the aorta, portal of the large and small intestine for determinatior vein, and from the venous effluents of urea, ammonia, amino acids and blood gasses before and sequentially after a standard pigmeal (750 g, 90 g protein, 1505 Kcal). Flow was measured electromagnetically. Results: Flow did not differ significantly during a meal. The table shows part of the pH, pCOr arterial (A), portal (P), small bowel (S) and large bowel CL) venous effluent and p02 levels In time (x+sem; X p< 0.05 as compared to fasted state). Portal pH values were lower than arterial pH values. The venous effluent of the large bowel showed a pB more acid than that of the small bowel. pH values increased after a protein meal. value More Oz was consumed in the small than in the large bowel, while in the large bowel more COa was produced. 0 1 2 3 6 pti (A) 7.41to. 01 7.45to. 02* 7.47to. 01’ 7.45to. 02’ 7.46tO. Ol* 7.38tO. 01 7.45to. 02f pH (P) 7.47to. 01* 7.45to. 02’ 7.46tO. 01’ 7.38tO. 01 7.4oto. 02 pH (S) 7.42to. 01’ 7.39to. 02 7.42to. 02, pH (L) 7.29tO. 02 7.28tO. 02 7.34to. 02* 7.3oto.03 7.28+0.03 *(A, tmmfig) 82.Ot2.9 78.5t3.7 77.7+1.4* 78.6t2.8 78.9tl.a 39.6+2. 1’ p&W (ImllHg) 48.5+6.3 42.3+1.9* 39.5+2.1x 40.9t2.5’ poz(L)
p.36
THE USE OF A SIMPLE ORTHOPAEDIC PATIENTS.
NUTRITIONAL
ASSESSMENT
PROCEDURE
IN ELDERLY
mLumbers, L.T. Driver, M.W.J. Older and CM. Williams. Division of Nutrition, Department of Biochemistry, University of Surrey, Guildford, United Kingdom. A simple nutritional risk questionnaire was used to categorise elderly orthopaxlic patients into high risk @IR) (n=14) and low risk (LR) (n=16) groups on admission to hospital for emergency and elective hip surgery. The questionnaire comprised a tick list of questions relating to social factors, age, chronic disease, appetite and food habits. No attempt was made to weight different sections of the questionnaire. Anthropometric measurements were made on admission and at intervals in hospital and after discharge. Patients allocated to the HR group on admission were found to have significantly lower mean k SD) values for mental function (HR 20.2 2 2.2, LR 22.6 + 1.5; p < O.Ol), tricep skinfold thickness (mms) (HR 12.4 2 5.2, LR 17.6 + 4.6; p c 0.01) and mid-upper arm circumference (ems) (I-IR 27.6 + 5.3, LR 32.6 + 2.8; p c 0.01). Patients in the HR group were older (HR 82 + 5.6, LR 74.3 + 6.9; p < 0.01) and a greater percentage were admitted for emergency compared with elective surgery (HR 87%, LR 23%; p < 0.01). Comparing patients in mid-upper p < 0.05). mid-upper
anthropometric values at eight week post discharge with those obtained on admission, the HR group showed significant losses in tricep skinfold (mms) (-2.15 + 1.73; p < 0.05), arm circumference (ems) (-1.4 + 1.3; p < 0.05) and body weight (kg) (-3.74 + 1.9; Corresponding values in the LR group were: tricep skinfold (mms) (+O.ll + 3.4; NS), arm circumference (ems) (-0.6 + 1.6; NS), and bodyweight (kgs) (a.75 + 1.3; NS).
The nutritional assessment procedure allows identification of patients who show long-term weight loss and depletion of body fat and lean tissue after orthopaxlic surgery.
75
THE ROLE OF THE INTESTINE IN ACID-BASK REGULATIONAFTER A MIXED NEAL IB PIGS. C. L. H. van Berlo, P.B. Soeters. University Hospital Maastricht, Department of Surgery, Maastricht, The Netherlands. Introduction: Metabolism of protein produces bicarbonate and this is a strongly alkalinl zing process. It was the aim of this study to evaluate to what extent a protein meal influenced selective portal and systemic pH. lhterials and methods: Fasted, unrestrained conscious pigs (n=lO; 20+_,8 kg) were used. Blood was sampled from the aorta, portal of the large and small intestine for determinatior vein, and from the venous effluents of urea, ammonia, amino acids and blood gasses before and sequentially after a standard pigmeal (750 g, 90 g protein, 1505 Kcal). Flow was measured electromagnetically. Results: Flow did not differ significantly during a meal. The table shows part of the pH, pCOr arterial (A), portal (P), small bowel (S) and large bowel CL) venous effluent and p02 levels In time (x+sem; X p< 0.05 as compared to fasted state). Portal pH values were lower than arterial pH values. The venous effluent of the large bowel showed a pB more acid than that of the small bowel. pH values increased after a protein meal. value More Oz was consumed in the small than in the large bowel, while in the large bowel more COa was produced. 0 1 2 3 6 pti (A) 7.41to. 01 7.45to. 02* 7.47to. 01’ 7.45to. 02’ 7.46tO. Ol* 7.38tO. 01 7.45to. 02f pH (P) 7.47to. 01* 7.45to. 02’ 7.46tO. 01’ 7.38tO. 01 7.4oto. 02 pH (S) 7.42to. 01’ 7.39to. 02 7.42to. 02, pH (L) 7.29tO. 02 7.28tO. 02 7.34to. 02* 7.3oto.03 7.28+0.03 *(A, tmmfig) 82.Ot2.9 78.5t3.7 77.7+1.4* 78.6t2.8 78.9tl.a 39.6+2. 1’ p&W (ImllHg) 48.5+6.3 42.3+1.9* 39.5+2.1x 40.9t2.5’ poz(L)
p.36
THE USE OF A SIMPLE ORTHOPAEDIC PATIENTS.
NUTRITIONAL
ASSESSMENT
PROCEDURE
IN ELDERLY
mLumbers, L.T. Driver, M.W.J. Older and CM. Williams. Division of Nutrition, Department of Biochemistry, University of Surrey, Guildford, United Kingdom. A simple nutritional risk questionnaire was used to categorise elderly orthopaxlic patients into high risk @IR) (n=14) and low risk (LR) (n=16) groups on admission to hospital for emergency and elective hip surgery. The questionnaire comprised a tick list of questions relating to social factors, age, chronic disease, appetite and food habits. No attempt was made to weight different sections of the questionnaire. Anthropometric measurements were made on admission and at intervals in hospital and after discharge. Patients allocated to the HR group on admission were found to have significantly lower mean k SD) values for mental function (HR 20.2 2 2.2, LR 22.6 + 1.5; p < O.Ol), tricep skinfold thickness (mms) (HR 12.4 2 5.2, LR 17.6 + 4.6; p c 0.01) and mid-upper arm circumference (ems) (I-IR 27.6 + 5.3, LR 32.6 + 2.8; p c 0.01). Patients in the HR group were older (HR 82 + 5.6, LR 74.3 + 6.9; p < 0.01) and a greater percentage were admitted for emergency compared with elective surgery (HR 87%, LR 23%; p < 0.01). Comparing patients in mid-upper p < 0.05). mid-upper
anthropometric values at eight week post discharge with those obtained on admission, the HR group showed significant losses in tricep skinfold (mms) (-2.15 + 1.73; p < 0.05), arm circumference (ems) (-1.4 + 1.3; p < 0.05) and body weight (kg) (-3.74 + 1.9; Corresponding values in the LR group were: tricep skinfold (mms) (+O.ll + 3.4; NS), arm circumference (ems) (-0.6 + 1.6; NS), and bodyweight (kgs) (a.75 + 1.3; NS).
The nutritional assessment procedure allows identification of patients who show long-term weight loss and depletion of body fat and lean tissue after orthopaxlic surgery.
75