Thiamine and the elderly orthopaedic patient.

An assessment of thiamine status was made in two groups of elderly orthopaedic patients. None of the 30 men and women presenting for elective total hip replacement was malnourished before operation but there was a significant fall in the thiamine status 48 hours later, which had returned to normal by 14 days. In contrast, the majority of the 34 patients in the second group were thiamine deficient after surgery for a femoral neck fracture and remained so throughout the initial post-operative period of 14 days. In both groups those patients who were noticeably confused after operation were found to have a considerable fall in their thiamine status suggesting this may be a contributory factor to postoperative confusion.