Malnutrition is a well-established syndrome in geriatric medicine, affecting, in particular,
fragile elderly individuals in the hospital and in long-term care facilities. Compensating
for nutritional deficiencies is a constant and prevailing feature of medical management
in geriatric care. Conversely, the potential dangers of refeeding are less well known
in fragile, elderly individuals as compared with the context of intensive care. Over
a 5-month observation period, 5 patients in our geriatric medicine ward (2% of all
cases) presented refeeding syndrome (Table 1). We present here an illustrative clinical case, and the typical characteristics
of refeeding syndrome, with a relevant review of the literature.
Table 1Characteristics of 5 Patients Presenting Refeeding Syndrome Over a 5-Month Period
in Our Geriatric Care Unit
| Patient | Age, y | Body Mass Index, kg/m² | Primary Diagnosis | Weight Loss >10% in Past 3 mo | Phosphate | Magnesium | Potassium |
|---|---|---|---|---|---|---|---|
| 1 | 75 | 22.0 | Gastroenteritis | Yes | 0.77 | 0.53 | 3.3 |
| 2 | 78 | 18.5 | Squamous cell carcinoma, throat cancer | Yes | 0.74 | 0.56 | 3.2 |
| 3 | 80 | 16.4 | Shingles on the chest | Yes | 0.73 | 0.59 | 3.5 |
| 4 | 78 | 24.0 | Cirrhosis, Child-Pugh class B | No | 0.62 | 0.54 | 4.5 |
| 5 | 81 | 18.6 | Melanoma | Yes | 0.4 | 1.4 | 3.3 |
∗ Normal 0.87–1.45 mmol/L.
† Normal 0.70–1.10 mmol/L.
‡ Norm 3.50–5.10 mmol/L.
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© 2014 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
