294

Part II Nutrition Assessment, Consequences, and Implications TABLE 20.1 Nutrition Intervention Studies and Hospital Readmission Reference

Holyday et al, 2012 (39)

Population

Elderly hospital inpatients

Location Randomized Controlled Trials Australia 143

Malnutrition care plan (modification of hospital meals prescription of ONS, meal assistance,

education, HCP referrals) (n = 71); at least 72 hours

No statistically significant difference in readmissions between intervention and control groups (1-month readmission frequency: control 0.11 ± 0.04 vs intervention 0.09 ± 0.04, P = .66) (6-month readmission frequency: control: 0.53 ± 0.08 vs intervention 0.45 ± 0.05, P = .51)

Trend toward reduction in readmission rates for malnourished patients at 1 and 6 months postdischarge (1-month readmission frequency: control 0.16 ± 0.09 vs intervention 0.00 ± 0.00, P = .083) (6-month readmission frequency: control: 0.63 ± 0.31 vs intervention 0.50 ± 0.31, P = .31)

Starke et al, 2011 (51)

Malnourished hospital adult inpatients

Switzerland 132

Individualized nutrition support (including ONS) vs standard hospital care during hospital; 5–28 days

McMurdo et al, 2009 (52)

Chapman et al, 2009 (53)

Hospitalized undernourished older adults (age 70+) (mean age 82)

Community- dwelling,

undernourished older adults (ages > 65 y)

UK 253

ONS (600 kcal/d) vs control

supplement (200 kcal/d);16 weeks

Australia 49

Oral testosterone vs ONS (475 kcal/d) vs both vs no treatment; 1 year

No hospital admissions in ONS + testosterone group, 9 admissions (2 elective) in the no treatment group, 4 in the testosterone group, and 5 in the ONS group (P = .06 with no treatment compared with combined treatment) For nonelective hospitalizations, the differences among groups was nearly significant (P = .08)

When compared with no treatment, the combined treatment group had signif- icantly fewer subjects admitted to the hospital (0 compared with 5; P = .03).

Norman et al, 2008 (41)

Malnourished patients with benign digestive disease

Germany 80

High-protein ONS (150 kcal, 10 g pro 3 × day) plus dietary counseling (ONS patients) vs only dietary counseling (DC patients); 3 months

DC patients experienced significantly more readmissions

(n = 20) than ONS patients (n = 10) during the study period (P = .041).

Individualized nutrition support showed fewer hospital readmissions vs standard hospital care (17 vs 28, P = .027)

Sample Size

Intervention/ Duration

Readmission Rates

The number of unplanned readmissions were similar in both groups (77 vs 65).