Individualized Nutritional Intervention During and After Hospitalization: The Nutrition Intervention Study Clinical Trial
- 18 November 2010
- journal article
- research article
- Published by Wiley in Journal of the American Geriatrics Society
- Vol. 59 (1), 10-17
- https://doi.org/10.1111/j.1532-5415.2010.03174.x
Abstract
To test the hypothesis that individualized nutritional treatment during and after discharge from acute hospitalization will reduce mortality and improve nutritional outcomes. Randomized, controlled trial. Internal medicine departments. Two hundred fifty-nine hospitalized adults aged 65 and older at nutritional risk were recruited and randomized according to hospitalization ward into one intervention and two control groups during hospitalization. Group 1 (intervention group) received individualized nutritional treatment from a dietitian in the hospital and three home visits after discharge. Group 2 received one meeting with a dietitian in the hospital. Group 3 received standard care. Groups 2 and 3 were combined into a single group that served as the control group in the analysis. Mortality, health status, nutritional outcomes, blood tests, cognition, emotional, and functional parameters were assessed at baseline and after 6 months. All participants were contacted monthly. The overall dropout rate was 25.8%. After 6 months, rise in Mini Nutritional Assessment score, adjusted for education and hospitalization ward, was significantly higher in the intervention group than in the control groups (3.01 ± 2.65 vs 1.81 ± 2.97, P =.004) mainly on the subjective assessment part (0.34 ± 0.86 vs. -0.04 ± 0.87, P=.004). The only laboratory parameter for which a difference was observed between the groups was albumin; 9.7% of the intervention group had serum albumin levels of less than 3.5 g/dL, versus 22.9% of the control group (P =.03). Mortality was significantly lower in the intervention group (3.8%) than in the control group (11.6%, P =.046). Lower mortality and moderate improvement in nutritional status were found in patients receiving individualized nutritional treatment during and after acute hospitalization.Keywords
This publication has 31 references indexed in Scilit:
- Inflammation Markers and Malnutrition as Risk Factors for Infections and Impaired Health-Related Quality of Life Among Older Nursing Home ResidentsJournal of the American Medical Directors Association, 2009
- Increased Energy Density of the Home-Delivered Lunch Meal Improves 24-Hour Nutrient Intakes in Older AdultsJournal of the American Dietetic Association, 2008
- Nutritional status of adult patients admitted to internal medicine departments in public hospitals in Castilla y Leon, Spain — A multi-center studyEuropean Journal of Internal Medicine, 2006
- Nutritional Supplementation of Very Old People at Hospital Discharge Increases Muscle Strength: A Randomised Controlled TrialGerontology, 2005
- Nutritional status of patients hospitalised in PolandEuropean Journal of Clinical Nutrition, 2005
- Nutritional status among adult patients admitted to an university-affiliated hospital in Spain at the time of genomaClinical Nutrition, 2004
- Protein Energy Supplements in Unwell Elderly Patients—A Randomized Controlled TrialJournal of Parenteral and Enteral Nutrition, 2001
- A Randomized, Controlled, Single‐Blind Trial of Nutritional Supplementation After Acute StrokeJournal of Parenteral and Enteral Nutrition, 1998
- Nutritional Status of Elderly Patients during Recovery from Chest Infection and the Role of Nutritional Supplementation Assessed by a Prospective Randomized Single-blind TrialAge and Ageing, 1994
- Nutrition interventions for intensive therapy in the diabetes control and complications trialJournal of the American Dietetic Association, 1993