Nutritional Risk in Frostbite

Introduction: People with frostbite are often unhoused with a history of substance use which can increase the risk of malnutrition. We sought to evaluate malnutrition risk and incidence in those with frostbite admitted to our facility. Methods: Medical records of adults admitted with frostbite in 2019-2021 and with stays >4 days were reviewed. Data included housing status, substance use and nutritional status. Results: A total of 42 patients met inclusion criteria. Most had stable housing (69% housed; 31% unhoused). Alcohol (33%) and drug use (29%) were common in both groups. Three patients were at high risk for malnutrition (self reported weight loss); 31 denied weight loss and 8 did not know. Five patients (12%) received a more focused nutritional assessment but only three (all with reported weight loss) met criteria for malnutrition. Conclusions: We did not identify malnutrition often in this population. The paucity of reported pre-admit weight loss suggest that this risk factor may have limited use to screen for malnutrition. Contrary to published reports, few patients had malnutrition risk factors reported on admission. Reliance on self-reported weight and intake may obscure risk and presents an opportunity for more focused screening in our patients.