S. Daniel Abraham International Center for Health and Nutrition, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
J Am Geriatr Soc. 2011 Jan;59(1):10-7. doi: 10.1111/j.1532-5415.2010.03174.x. Epub 2010 Nov 18.
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.
检验以下假设，即急性住院期间和出院后的个体化营养治疗可降低死亡率并改善营养结局。
随机对照试验。
内科病房。
招募了 259 名年龄在 65 岁及以上且有营养风险的住院成年人，根据住院病房分为营养干预组、1 个对照干预组和 1 个标准治疗组。
干预组（营养干预组）在住院期间接受营养师的个体化营养治疗和出院后 3 次家庭访视；对照干预组 2 接受住院期间与营养师的 1 次会面；标准治疗组接受常规治疗。将对照干预组 2 和 3 合并为 1 个对照组，用于分析。
在基线和 6 个月时评估死亡率、健康状况、营养结局、血液检查、认知、情绪和功能参数。所有参与者每月联系。
整体失访率为 25.8%。调整教育和住院病房后，6 个月时，营养干预组的 Mini 营养评估评分升高，显著高于对照组（3.01 ± 2.65 比 1.81 ± 2.97，P =.004），主要体现在主观评估部分（0.34 ± 0.86 比 -0.04 ± 0.87，P =.004）。两组之间唯一观察到的实验室参数差异是白蛋白；干预组中 9.7%的患者血清白蛋白水平<3.5 g/dL，而对照组中为 22.9%（P =.03）。干预组的死亡率显著低于对照组（3.8%比 11.6%，P =.046）。
接受急性住院期间和出院后个体化营养治疗的患者死亡率较低，营养状况有适度改善。
