Folven Kristin I, Tangvik Randi J, Nilsen Roy M, Beck Anne Marie, Sygnestveit Kari, Skeie Eli, Hetlevik Øystein, Biringer Eva
Department of Research and Innovation, Fonna Hospital Trust, P.O. Box 2170, NO-5504 Haugesund, Norway; Centre for Nutrition, Department of Clinical Medicine, University of Bergen, P.O. Box 7804, NO-5020 Bergen, Norway.
Centre for Nutrition, Department of Clinical Medicine, University of Bergen, P.O. Box 7804, NO-5020 Bergen, Norway.
Clin Nutr. 2025 Aug;51:334-341. doi: 10.1016/j.clnu.2025.07.007. Epub 2025 Jul 7.
There is a need for knowledge about the factors affecting nutritional support to hospitalised older patients at risk of malnutrition. We aimed to investigate whether patient characteristics are associated with the likelihood of hospitalised older patients at risk of malnutrition receiving nutritional support.
The study included 3188 hospital stays among 2739 individual somatic patients aged ≥65 years who were at risk of malnutrition according to the Nutritional Risk Screening 2002 (NRS 2002). Information on the risk of malnutrition, nutritional support (menu modification, oral nutritional supplements and enteral or parenteral nutrition) and dietitian involvement was collected from in-hospital point prevalence surveys between 2008 and 2018. Information on age, sex, diagnoses and type of hospitalisation was retrieved from the electronic patient administration systems. We applied logistic and multinomial regression models to investigate associations of patient characteristics (age, sex, number of diagnoses, BMI, type of hospitalisation and nutritional risk screening score) with the likelihoods of receiving any nutritional support and specific types of nutritional support.
Nutritional support was provided in 56 % and planned in 9 % of hospital stays. Dietitians were involved in 7 % of hospital stays, and 21 % of patients at risk of malnutrition had diagnoses related to malnutrition. Older patients were less likely to have received any nutritional support as compared to the patients 65-69 years old (adjusted OR range: 0.69-0.84). Patients classified as underweight were more likely (adjusted OR (95%CI): 1.77 (1.44, 2.17)) and patients in the overweight and obese categories were less likely (adjusted OR (95%CI): 0.70 (0.57, 0.87) and 0.70 (0.52, 0.94), respectively) to receive nutritional support. The OR for receiving nutritional support substantially increased with increasing NRS 2002 score (adjusted OR range: 1.79-4.20).
This study showed that over one-third of older patients at risk of malnutrition did not receive nutritional support in hospital and that older patients with more diagnoses, those classified as underweight, and those with higher NRS 2002 scores were more frequently provided nutritional support. The findings suggest that healthcare professionals' decisions regarding whether to provide nutritional support to older patients at risk of malnutrition to a large extent are affected by patient characteristics.
了解影响对有营养不良风险的住院老年患者进行营养支持的因素很有必要。我们旨在调查患者特征是否与有营养不良风险的住院老年患者接受营养支持的可能性相关。
该研究纳入了2739名年龄≥65岁的个体躯体疾病患者的3188次住院情况，这些患者根据2002年营养风险筛查（NRS 2002）存在营养不良风险。从2008年至2018年的住院时点患病率调查中收集了关于营养不良风险、营养支持（饮食调整、口服营养补充剂以及肠内或肠外营养）和营养师参与情况的信息。从电子患者管理系统中获取了关于年龄、性别、诊断和住院类型的信息。我们应用逻辑回归和多项回归模型来研究患者特征（年龄、性别、诊断数量、BMI、住院类型和营养风险筛查评分）与接受任何营养支持以及特定类型营养支持的可能性之间的关联。
56%的住院患者接受了营养支持，9%的住院患者计划接受营养支持。7%的住院患者有营养师参与，21%有营养不良风险的患者有与营养不良相关的诊断。与65 - 69岁的患者相比，年龄较大的患者接受任何营养支持的可能性较小（调整后的OR范围：0.69 - 0.84）。体重过轻的患者更有可能接受营养支持（调整后的OR（95%CI）：1.77（1.44, 2.17）），超重和肥胖类别的患者接受营养支持的可能性较小（调整后的OR（95%CI）分别为：0.70（0.57, 0.87）和0.70（0.52, 0.94））。随着NRS 2002评分的增加，接受营养支持的OR大幅增加（调整后的OR范围：1.79 - 4.20）。
本研究表明，超过三分之一有营养不良风险的老年患者在医院未接受营养支持，且诊断较多、体重过轻以及NRS 2002评分较高的老年患者更常获得营养支持。研究结果表明，医护人员关于是否为有营养不良风险的老年患者提供营养支持的决策在很大程度上受患者特征影响。
