Older patients ‘need more vitamins’

Alarmingly low Vitamin C levels in older hospital patients has been described as a serious hurdle in recovery by Flinders University researchers.

The study found large numbers of older patients arrive at hospital with a severe Vitamin C deficiency, adding to recent media reports of scurvy being treated in South Australian hospitals.

Flinders University and the General Medicine researchers at Flinders Medical Centre have been conducting extensive and ongoing research into the nutritional wellbeing of older hospital patients and found that more than 50% are malnourished.

Now, as well as macro-nutritional examination of general medical patients admitted to FMC, a team of researchers led by Dr Yogesh Sharma has focused on specific vitamins, reading the Vitamin C levels of general patients admitted between September 2017 and November 2017.

More than three-quarters of patients examined in the study had lower than normal Vitamin C levels – with 40% classified as having a severe Vitamin C deficiency.

Dr Sharma, a consultant physician and senior lecturer at Flinders University’s College of Medicine and Public Health, who has a research focus on frailty and nutritional rehabilitation of older hospitalised patients, says the high proportion of patients admitted to hospital with a deficiency in Vitamin C – valued for its anti-oxidant properties and serving as a co-factor for several enzymes – presents a serious obstacle to the swift recovery and release of patients from hospital.

Moreover, the researchers found that most physicians are unaware that a large proportion of hospitalised patients may be Vitamin C deficient.

“Socially isolated older people are the high risk group most prone to suffer from Vitamin C deficiency – the infirm, those living alone, people struggling with alcoholism and mental health issues – but our research found that this deficiency was found across all types of patients in hospitals aged 60 or over,” says Dr Sharma.

“It is a more significant issue than we first thought.”

The Flinders University team’s nutritional analysis research on older hospitalised patients has provided an alarming picture of poor nutritional health of patients when they are admitted to hospital, which ultimately leads to longer stays in hospital, and is proving very costly.

This research has already been widely published in national and international journals.

“If proper screening was done of older patients’ nutrition when they entered hospital and an effective dietary plan was implemented, it would result in significant cost savings – an estimated $900 per patient,” explains Dr Sharma.

“If this was applied across all older patients admitted to Flinders Medical Centre, that would equate to a saving of $1.8 million a year. If applied to all hospitals in South Australia, a saving of $9 million a year.”

The paper – “Vitamin C deficiency in Australian hospitalised patients: an observational study,” by Yogesh Sharma, Michelle Miller, Rashmi Shahi, Adrienne Doyle, Chris Horwood, Paul Hakendorf and Campbell Thompson – has been published in Internal Medicine Journal (doi:10.1111/imj.14030).

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College of Medicine and Public Health