Impact of Socioeconomic Status on Malnutrition among Orthopedic Patients

Abstract

Background: Malnutrition is a critical but often underdiagnosed problem among hospitalized patients, particularly those with orthopedic conditions where nutritional adequacy is vital for fracture healing, rehabilitation, and complication prevention. In low- and middle-income countries, socioeconomic determinants such as income, education, and family size substantially influence dietary intake and clinical outcomes (1–4). Objective: To determine the impact of socioeconomic status on malnutrition among orthopedic inpatients at King Abdullah Teaching Hospital, Mansehra. Methods: A descriptive cross-sectional study was conducted from March to May 2025 including 90 orthopedic inpatients aged ≥18 years. Data were collected through structured questionnaires, anthropometric measurements, three-day 24-hour dietary recall, and hemoglobin reports. Nutritional status was assessed using BMI, caloric intake, and hemoglobin levels. Descriptive statistics, chi-square tests, Pearson correlation, and logistic regression models were applied, with significance set at p < 0.05 (12–16). Results: Of 90 participants, 52.2% were female and the mean age was 41.6 ± 15.2 years. Caloric deficiency was nearly universal (97.8%), while anemia affected 53.3% of patients. Underweight was found in 21.1% and overweight/obesity in 33.3%. Low income (<15,000 PKR) and large family size (>10 members) were strongly associated with malnutrition, with odds ratios up to 9.33 (95% CI 2.13–40.9, p < 0.01). Illiteracy significantly increased anemia risk (OR 2.78, 95% CI 1.23–6.31). Conclusion: Malnutrition is highly prevalent among orthopedic inpatients, with socioeconomic disadvantage as a major determinant of inadequate caloric intake, anemia, and abnormal BMI. Integrating early nutritional screening with socioeconomic support strategies is essential to optimize recovery and reduce complications.