Nutritional support and functional status in under

Authors: D Volkert S Hübsch P Oster G Schlierf

Publish Date: 2013/12/28

Volume: 8, Issue: 6, Pages: 386-395

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Abstract

The objective of this study designed as a randomized controlled prospective intervention study was to evaluate the effect of nutritional supplementation on functional status and need of care in undernourished geriatric patients during hospitalization and up to 6 months after discharge Participants consisted of 46 undernourished geriatric patients from a geriatric acute care hospital aged 75 years or older without malignant disease or need for tube feeding or parenteral nutrition Patients in the supplement group SG N=20 were offered 400 mL 2100 kJ daily of a liquid supplement during hospital stay and 200 mL 1050 kJ per day for the following 6 months at home Patients in the control group CG N=26 had usual care without supplements The main outcome measure was functional status based on the Barthel Activities of Daily Living score ADL at hospital admission discharge and after 6 months with higher scores indicating greater independence and a maximum score of 100 points In supplemented patients with good acceptance SG+ N=11 a median improvement of 20 points was observed between admission and discharge and a further improvement of 5 points at home Median changes were 0 and −10 points in supplemented patients with poor acceptance SG N=9 and 5 and 25 points in CG respectively In SG+ the proportion of independent patients 65 points increased continuously from 36 at admission to 63 at discharge to 72 after 6 months and was significantly higher compared to CG at discharge 63 vs 19 pš 005 and after 6 months 72 vs 39 p005 64 of the patients in SG+ improved during hospitalization compared to 23 in CG p005 In the six months at home 18 of SG+ improved none of SG+ deteriorated in hospital or at home In contrast deterioration of the ADL score occurred in considerable proportions of SG− 22 in hospital 22 at home and CG 4 at hospital 12 at home patients The proportion of patients who improved was smaller in SG− 44 at hospital 22 at home as well as in CG 23 at hospital 35 at home compared to SG+ In conclusion a positive functional course was evident in supplemented patients with good acceptance during hospitalization and further improvement was observed during the following 6 months at home Nutritional support may contribute to reconvalescence and recovery of undernourished geriatric patients

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