Ellisiv Lærum-Onsager1, Marianne Molin2,3, Cecilie Fromholt Olsen4, Asta Bye2,5, Jonas Debesay2, Christine Hillestad Hestevik4,6, Maria Bjerk4,6, Are Hugo Pripp7,8. 1. Lovisenberg Diaconal University College, Oslo, Norway. ellisiv.onsager@ldh.no. 2. Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway. 3. Department of Health, Bjorknes University College, Oslo, Norway. 4. Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway. 5. Regional Advisory Unit for Palliative Care, Department of Oncology, Oslo University Hospital, Oslo, Norway. 6. Norwegian Institute of Public Health, Oslo, Norway. 7. Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway. 8. Oslo Centre of Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway.
Abstract
BACKGROUND: Unplanned readmission may result in consequences for both the individual and society. The transition of patients from hospital to postdischarge settings often represents a discontinuity of care and is considered crucial in the prevention of avoidable readmissions. In older patients, physical decline and malnutrition are considered risk factors for readmission. The purpose of the study was to determine the effects of nutritional and physical exercise interventions alone or in combination after hospital admission on the risk of hospital readmission among older people. METHODS: A systematic review and meta-analysis of randomized controlled studies was conducted. The search involved seven databases (Medline, AMED, the Cochrane Library, CINAHL, Embase (Ovid), Food Science Source and Web of Science) and was conducted in November 2018. An update of this search was performed in March 2020. Studies involving older adults (65 years and above) investigating the effect of nutritional and/or physical exercise interventions on hospital readmission were included. RESULTS: A total of 11 randomized controlled studies (five nutritional, five physical exercise and one combined intervention) were included and assessed for quality using the updated Cochrane Risk of Bias Tool. Nutritional interventions resulted in a significant reduction in readmissions (RR 0.84; 95% CI 0.70-1.00, p = 0.049), while physical exercise interventions did not reduce readmissions (RR 1.05; 95% CI 0.84-1.31, p-value = 0.662). CONCLUSIONS: This meta-analysis suggests that nutrition support aiming to optimize energy intake according to patients' needs may reduce the risk of being readmitted to the hospital for people aged 65 years or older.
BACKGROUND: Unplanned readmission may result in consequences for both the individual and society. The transition of patients from hospital to postdischarge settings often represents a discontinuity of care and is considered crucial in the prevention of avoidable readmissions. In older patients, physical decline and malnutrition are considered risk factors for readmission. The purpose of the study was to determine the effects of nutritional and physical exercise interventions alone or in combination after hospital admission on the risk of hospital readmission among older people. METHODS: A systematic review and meta-analysis of randomized controlled studies was conducted. The search involved seven databases (Medline, AMED, the Cochrane Library, CINAHL, Embase (Ovid), Food Science Source and Web of Science) and was conducted in November 2018. An update of this search was performed in March 2020. Studies involving older adults (65 years and above) investigating the effect of nutritional and/or physical exercise interventions on hospital readmission were included. RESULTS: A total of 11 randomized controlled studies (five nutritional, five physical exercise and one combined intervention) were included and assessed for quality using the updated Cochrane Risk of Bias Tool. Nutritional interventions resulted in a significant reduction in readmissions (RR 0.84; 95% CI 0.70-1.00, p = 0.049), while physical exercise interventions did not reduce readmissions (RR 1.05; 95% CI 0.84-1.31, p-value = 0.662). CONCLUSIONS: This meta-analysis suggests that nutrition support aiming to optimize energy intake according to patients' needs may reduce the risk of being readmitted to the hospital for people aged 65 years or older.
Entities:
Keywords:
Meta-analysis; Nutrition; Older people; Physical exercise; Readmission; Transitional care
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