Ji Tong, Zhang Li, Han Rui, Peng Linlin, Shen Shanshan, Liu Xiaolei, Shi Yanqing, Chen Xujiao, Chen Qiong, Li Yun, Ma Lina
Department of Geriatrics, Xuanwu Hospital Capital Medical University, Beijing, China.
Department of Geriatrics, Xiangya Hospital Central South University, Changsha, China.
Front Nutr. 2022 May 9;9:851590. doi: 10.3389/fnut.2022.851590. eCollection 2022.
In hospital settings, malnutrition affects 30-50% of aged inpatients and is related to a higher risk of hospital complications and death. This study aims to demonstrate the effectiveness of a tailored optimum nutritional therapy in malnourished, elderly inpatients based on multidisciplinary team recommendations in hopes of decreasing the incidence of deleterious clinical outcomes.
This trial will be a multicenter, open-label, randomized control trial conducted in the geriatric wards of at least five hospitals in five different regions. We aim to include 500 inpatients over the age of 60 with or at risk of malnutrition based on a Mini Nutritional Assessment Short-Form (MNA-SF) score of ≤ 11 points and the Global Leadership Initiative on Malnutrition with an expected length of stay of ≥ 7 days. Eligible inpatients will be randomized into a 1:1 ratio, with one receiving a multidisciplinary team intervention and the other receiving standard medical treatment or care alone. A structured comprehensive assessment of anthropometry, nutritional status, cognition, mood, functional performance, and quality of life will be conducted twice. These assessments will take place on the day of group allocation and 1 year after discharge, and a structured screening assessment for elderly malnutrition will be conducted at 3 and 6 months after discharge using the MNA-SF. The primary outcome will be nutritional status based on changes in MNA-SF scores at 3, 6 months, and 1 year. The secondary outcome will be changes in cognition, mood, functional status, length of hospital stay, and all-cause mortality 1 year after discharge.
Guided by the concept of interdisciplinary cooperation, this study will establish a multidisciplinary nutrition support team that will develop an innovative intervention strategy that integrates nutritional screenings, evaluations, education, consultation, support, and monitoring. Moreover, nutritional intervention and dietary fortification will be provided to hospitalized elderly patients with or at risk of malnutrition. The nutrition support team will formulate a clinical map for malnutrition in elderly patients with standardized diagnosis and treatment for malnutrition in this population.
[www.ClinicalTrials.gov], identifier [ChiCTR2200055331].
在医院环境中，营养不良影响30%-50%的老年住院患者，并与更高的医院并发症和死亡风险相关。本研究旨在证明基于多学科团队建议的量身定制的最佳营养治疗对营养不良的老年住院患者的有效性，以期降低不良临床结局的发生率。
本试验将是一项多中心、开放标签、随机对照试验，在五个不同地区至少五家医院的老年病房进行。我们的目标是纳入500名60岁及以上、根据简易营养评估简表（MNA-SF）评分≤11分且符合全球营养不良领导倡议标准、预计住院时间≥7天的营养不良或有营养不良风险的住院患者。符合条件的住院患者将按1:1的比例随机分组，一组接受多学科团队干预，另一组仅接受标准医疗治疗或护理。将对人体测量学、营养状况、认知、情绪、功能表现和生活质量进行两次结构化综合评估。这些评估将在分组当天和出院后1年进行，出院后3个月和6个月使用MNA-SF对老年营养不良进行结构化筛查评估。主要结局将是基于出院后3个月、6个月和1年时MNA-SF评分变化的营养状况。次要结局将是出院后1年时认知、情绪、功能状态、住院时间和全因死亡率的变化。
在跨学科合作理念的指导下，本研究将建立一个多学科营养支持团队，该团队将制定一种创新的干预策略，整合营养筛查、评估、教育、咨询、支持和监测。此外，将为患有营养不良或有营养不良风险的住院老年患者提供营养干预和膳食强化。营养支持团队将为老年患者的营养不良制定临床图谱，对该人群的营养不良进行标准化诊断和治疗。
