Improving the efficacy of nutritional supplementation in the hospitalised elderly

被引:27
作者
Jukkola, Katja [1 ]
MacLennan, Penny [1 ]
机构
[1] Concord Repatriat Gen Hosp, Dept Nutr & Dietet, Concord, NSW, Australia
关键词
elderly; malnutrition; nutrition as medication;
D O I
10.1111/j.1741-6612.2005.00082.x
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Background: Protein-energy malnutrition delays wound healing, extends length of stay, and increases complication rates. Identification of patients at risk of malnutrition, together with early intervention, may prevent further deterioration of nutritional status. Objectives: Through the use of nutrition screening and assessment, prioritise nutrition intervention to those at greatest nutritional risk. To improve the consumption rate of nutritional supplements, using a 'nutrition as medication' program. Methods: We assessed 200 acute aged care patients for malnutrition risk using the Mini Nutritional Assessment (MNA) tool (Nestle SA, Vevey, Switzerland) within 72 h of hospital admission. Patients 'at risk' or malnourished, received either mid meal supplements (control group) or 60 mL of a 2 kcal per ml supplement, given four times daily (trial group). Outcome measures included comparison of supplement consumption changes in MNA scores on fortnightly reassessment or discharge. Results: Thirty per cent of patients were malnourished on admission, with a further 42% 'at risk'. Patient compliance with the 'nutrition as medication' program was excellent (95%) compared with current practice (48%). On reassessment patients in the trial group showed a trend towards a greater improvement in score for appetite (P = 0.065), number of meals consumed (P = 0.01) and protein intake (P = 0.007). Improvement in score for weight was significant in the trial group (P = 0.027). Length of stay was shorter in the trial group (P = 0.044). Conclusion: Routine use of a validated assessment tool is essential for early identification of malnutrition risk. A 'nutrition as medication' program is effective in attenuating deterioration in nutritional status.
引用
收藏
页码:119 / 124
页数:6
相关论文
共 26 条
[1]   Institutional feeding of the elderly [J].
Allison, S .
CURRENT OPINION IN CLINICAL NUTRITION AND METABOLIC CARE, 2002, 5 (01) :31-34
[2]   Cost-effectiveness of nutritional support in the elderly [J].
Allison, SP .
PROCEEDINGS OF THE NUTRITION SOCIETY, 1995, 54 (03) :693-699
[3]  
Allison SP, 1995, HOSP UPDATE FEB, P55
[4]  
Azad N, 1999, CAN MED ASSOC J, V161, P511
[5]  
Bales CW, 2001, AM J CLIN NUTR, V74, P155
[6]  
Butterworth CE, 1974, NUTR TODAY, V2, P4
[7]  
Charette Susan L, 2003, J Am Med Dir Assoc, V4, P90, DOI 10.1097/01.JAM.0000052518.12318.4D
[8]   The relationship between clinical assessments of nutritional status and adverse outcomes in older hospitalized medical patients [J].
Covinsky, KE ;
Martin, GE ;
Beyth, RJ ;
Justice, AC ;
Sehgal, AR ;
Landefeld, CS .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 1999, 47 (05) :532-538
[9]  
Dudek S G, 2000, Am J Nurs, V100, P36, DOI 10.2307/3522023
[10]  
Fanello S, 2000, Sante Publique, V12, P83