Short-term individual nutritional care as part of routine clinical setting improves outcome and quality of life in malnourished medical patients

Abstract

Background & aims: Strategies to treat malnutrition lack practicability in the hospital setting. The present study aimed at developing and evaluating a routinely manageable concept for an improved nutritional care of malnourished in-hospital patients.

Methods: A randomized controlled intervention study was conducted. 132 risk patients defined by Nutritional Risk Screening 2002, were randomized to individualised nutrition support (intervention group [n = 66]) or standard hospital care (control group [n = 66]). Body weight, plasma vitamin levels, quality of life, complications, antibiotic therapies, readmissions and mortality were assessed.

Results: Nutrition interventions led to higher intakes (mean [standard deviation]) in energy (1553 [341] kcal vs. 1115 [381] kcal, p < 0.001) and protein (65.4 [16.4] g vs. 43.9 [17.2] g, p < 0.001). Intervention patients (n = 66) kept their body weight in comparison to control patients (n = 66; 0.0 [2.9] kg vs. -1.4 [3.2] kg, p = 0.008). Positive effects on plasma ascorbic acid level (46.7 [26.7] μmol/l vs. 34.1 [24.2] μmol/l, p = 0.010), SF-36 function summary scale (37 [11] % vs. 32 [9] %, p = 0.030), number of complications (4/66 vs. 13/66, p = 0.035), antibiotic therapies (1/66 vs. 8/66, p = 0.033) and readmissions (17/64 vs. 28/61, p = 0.027) were recorded.

Conclusions: Malnourished patients profit from nutrition support regarding nutrition status and quality of life. They have fewer complications, need fewer antibiotics and are less often re-hospitalised.