Department of Nutrition and Dietetics, Prince of Wales Hospital, Randwick, New South Wales, 2031, Australia.
J Nutr Health Aging. 2012;16(6):562-8. doi: 10.1007/s12603-012-0022-3.
High rates of malnutrition have been reported in the older hospitalized patient population. This is recognised to impact on patient outcomes and health costs. This study aimed to assess the impact of nutrition screening and intervention on these parameters.
Randomised controlled prospective study.
The study was performed in the acute geriatric medicine wards of the Prince of Wales Hospital, Sydney Australia.
All patients admitted to these wards under a geriatrician with an expected length of stay of at least 72 hours were considered for the study.
Patients were screened on admission for malnutrition using the Mini Nutritional Assessment (MNA) tool and randomly assigned to control or intervention groups. Intervention patients were immediately commenced on a malnutrition care plan (MCP). Control patients were only commenced on a MCP if referred by clinical staff.
Length of stay (LOS), weight change and frequency of readmission to hospital were compared between the groups.
143 patients were screened. 119 were identified as malnourished (MN) or at risk of malnutrition (AR). Overall LOS was not different between the two groups (control v. intervention: 13.4 ± 1.3 days v. 12.5 ± 1.2 days, p=0.64). However there was a significant decrease in LOS in the MN (control v. intervention: 19.5 ± 3 days v. 10.6 ± 1.6 days, p=0.013) and a trend to reduced readmissions. There was no difference in weight change over admission between the groups. Without screening, clinical staff identified only a small proportion of malnourished patients (35% of MN and 20% of AR).
Malnutrition in the older hospital population is common. Malnutrition screening on hospital admission facilitated targeted nutrition intervention, however length of stay and re-presentations were only reduced in older malnourished patients with an MNA score less than 17.
在老年住院患者群体中，营养不良的发生率很高。这会影响患者的预后和医疗费用。本研究旨在评估营养筛查和干预对这些参数的影响。
随机对照前瞻性研究。
该研究在澳大利亚悉尼王子威尔士医院的急性老年医学病房进行。
所有被老年病医生收治、预计住院时间至少为 72 小时的患者都被纳入本研究。
患者入院时使用微型营养评估（MNA）工具进行营养筛查，并随机分为对照组和干预组。干预组患者立即开始进行营养不良护理计划（MCP）。如果临床工作人员转介，对照组患者才开始进行 MCP。
比较两组患者的住院时间（LOS）、体重变化和再次入院频率。
共筛查了 143 名患者。119 名患者被诊断为营养不良（MN）或有营养不良风险（AR）。两组患者的 LOS 总体无差异（对照组与干预组：13.4±1.3 天比 12.5±1.2 天，p=0.64）。然而，MN 患者的 LOS 显著缩短（对照组与干预组：19.5±3 天比 10.6±1.6 天，p=0.013），且再入院率有降低趋势。两组患者入院时的体重变化无差异。未经筛查，临床工作人员仅识别出一小部分营养不良患者（35%的 MN 和 20%的 AR）。
老年住院患者中营养不良很常见。入院时进行营养筛查有助于实施针对性的营养干预，但只有 MNA 评分<17 的老年营养不良患者的 LOS 和再入院率降低。
