Clin Nutr ESPEN .

ISSN:

国家:

Denmark.

影响因子:

SCIE收录情况:

JCR分区:

Rasmussen NML; Belqaid K; Lugnet K; Nielsen AL; Rasmussen HH; Beck AM.; Rasmussen NML; Belqaid K; Lugnet K; Nielsen AL; Rasmussen HH; Beck AM.
2018-10 相关链接

摘要

Malnutrition  is  common  in  older  hospitalised  patients.  As  the  aetiology  is  multifactorial,  nutritional  care  should  involve  a  multidisciplinary  team.  However,  the  knowledge  of  the  effectiveness  of  this  strategy  is  limited.  This  systematic  review  aims  at  investigating  the  effectiveness  of  multidisciplinary  nutritional  support  on  mortality,  readmissions  and  quality  of  life  (QoL)  in  patients  aged  65  years  and  above  during  hospitalisation  and  after  discharge  compared  to  usual  practise.  We  conducted  a  series  of  systematic  literature  search  from  2013  to  2017,  with  additional  studies  hand-searched  from  reference  lists  of  retrieved  publications.  Eligible  studies  were  controlled  trials  with  a  multidisciplinary  nutritional  intervention  during  hospitalisation  and  after  discharge  in  older  (65+)  patients.  A  intervention  by  more  than  one  profession  incorporating  a  nutritional  component  was  defined  as  "Multidisciplinary".  The  nutritional  intervention  included  use  of  oral  nutritional  supplements  (ONS),  improved  nutritional  care,  and/or  dietary  counselling.  For  quality  assessment  of  studies,  "Cochrane  Collaboration's  tool  for  assessing  risk  of  bias"  was  used.  Conduction  of  meta-analyses  were  by  combining  data  from  homogenous  trials.  The  search  resulted  in  five  studies  fulfilling  the  inclusion  criteria,  but  varied  in  quality  and  type  of  interventions  used.  598  patients  were  included.  Meta-analyses  found  improved  QoL  (MD  0.13  (0.02,  0.23),  P  =  0.01)  and  indicated  tendencies  towards  lower  mortality  (OR  0.50  (0.22,  1.14),  P  =  0.10),  in  the  intervention  group  vs.  control  group.  Meta-analysis  showed  no  difference  between  intervention  and  control  group  regarding  readmissions  during  intervention  (OR  1.04  (0.40,  2.70))  or  at  a  26  weeks  follow-up  (OR  0.84  (0.18,  3.82))  Although  a  small  number  of  studies  and  a  relatively  small  sample  size,  a  suggestion  is  that  provision  of  multidisciplinary  nutritional  support  may  have  a  positive  effect  on  mortality  and  improves  quality  of  life  in  older  patients.  There  is  a  need  for  more  high-quality  studies  including  multidisciplinary  nutritional  support  to  verify  these  findings.  Study  registration  in  PROSPERO  is  no.  CRD42016047997.

Elderly; Mortality; Nutrition; Quality of life; Readmissions.

食品/营养卫生 ; 弱势人群卫生 ; 技术资源

老年人

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