Y Sharma1, C H Thompson2, B Kaambwa3, R Shahi4, P Hakendorf5, M Miller6. 1. Department of General Medicine, Flinders Medical Centre, South Australia, School of Medicine, Flinders University, Adelaide, South Australia 5042. 2. Discipline of Medicine, University of Adelaide, Adelaide, South Australia 5005. 3. Department of Health Economics, Flinders University, Adelaide, South Australia 5042. 4. Faculty of Medicine, Health and Nursing, Monash University, Melbourne, Australia 3800. 5. Department of Clinical Epidemiology, Flinders Medical Centre, Adelaide, South Australia 5042. 6. Department of Nutrition & Dietetics, Flinders University, Adelaide, South Australia 5042.
Abstract
BACKGROUND: The benefit of providing early nutrition intervention and its continuation post-discharge in older hospitalized patients is unclear. This study examined efficacy of such an intervention in older patients discharged from acute care. METHODS: In this randomized controlled trial, 148 malnourished patients were randomized to receive either a nutrition intervention for 3 months or usual care. Intervention included an individualized nutrition care plan plus monthly post-discharge telehealth follow-up whereas control patients received intervention only upon referral by their treating clinicians. Nutrition status was determined by the Patient Generated Subjective Global Assessment (PG-SGA) tool. Clinical outcomes included changes in length of hospital stay, complications during hospitalization, Quality of life (QoL), mortality and re-admission rate. RESULTS: Fifty-four males and 94 females (mean age, 81.8 years) were included. Both groups significantly improved PG-SGA scores from baseline. There was no between-group differences in the change in PG-SGA scores and final PG-SGA scores were similar at 3 months 6.9 (95% CI 5.6-8.3) vs. 5.8 (95% CI 4.8-6.9) (P = 0.09), in control and intervention groups, respectively. Median total length of hospital stay was 6 days shorter in the intervention group (11.4 (IQR 16.6) vs. 5.4 (IQR 8.1) (P = 0.01). There was no significant difference in complication rate during hospitalization, QoL and mortality at 3-months or readmission rate at 1, 3 or 6 months following hospital discharge. CONCLUSION: In older malnourished inpatients, an early and extended nutrition intervention showed a trend towards improved nutrition status and significantly reduced length of hospital stay.
BACKGROUND: The benefit of providing early nutrition intervention and its continuation post-discharge in older hospitalized patients is unclear. This study examined efficacy of such an intervention in older patients discharged from acute care. METHODS: In this randomized controlled trial, 148 malnourished patients were randomized to receive either a nutrition intervention for 3 months or usual care. Intervention included an individualized nutrition care plan plus monthly post-discharge telehealth follow-up whereas control patients received intervention only upon referral by their treating clinicians. Nutrition status was determined by the Patient Generated Subjective Global Assessment (PG-SGA) tool. Clinical outcomes included changes in length of hospital stay, complications during hospitalization, Quality of life (QoL), mortality and re-admission rate. RESULTS: Fifty-four males and 94 females (mean age, 81.8 years) were included. Both groups significantly improved PG-SGA scores from baseline. There was no between-group differences in the change in PG-SGA scores and final PG-SGA scores were similar at 3 months 6.9 (95% CI 5.6-8.3) vs. 5.8 (95% CI 4.8-6.9) (P = 0.09), in control and intervention groups, respectively. Median total length of hospital stay was 6 days shorter in the intervention group (11.4 (IQR 16.6) vs. 5.4 (IQR 8.1) (P = 0.01). There was no significant difference in complication rate during hospitalization, QoL and mortality at 3-months or readmission rate at 1, 3 or 6 months following hospital discharge. CONCLUSION: In older malnourished inpatients, an early and extended nutrition intervention showed a trend towards improved nutrition status and significantly reduced length of hospital stay.
Authors: Christine Baldwin; Marian Ae de van der Schueren; Hinke M Kruizenga; Christine Elizabeth Weekes Journal: Cochrane Database Syst Rev Date: 2021-12-21
Authors: Olivia Bornæs; Aino L Andersen; Morten B Houlind; Thomas Kallemose; Juliette Tavenier; Anissa Aharaz; Rikke L Nielsen; Lillian M Jørgensen; Anne M Beck; Ove Andersen; Janne Petersen; Mette M Pedersen Journal: Geriatrics (Basel) Date: 2022-09-10