Chapter 20 Preventing Rehospitalization TABLE 20.1 cont. Nutrition Intervention Studies and Hospital Readmission Reference

Gariballa et al, 2006 (40)

Population

Hospitalized patients aged 65+

Location UK

Sample Size

445

Intervention/ Duration

Normal diet + placebo vs normal diet + ONS (995 kcal); 6-week intervention + 6-month follow-up

Miller MD et al, 2006 (54)

Nutritionally at- risk older adults (age 70+) hospitalized following a fall- related lower limb fracture

Australia 100

Intervention for 6–12 weeks of one of the following:

1. ONS for 6 weeks

2. Resistance training for 12 weeks

3. Combined ONS and resistance training

4. Usual care

Price et al, 2005 (55)

Hospitalized undernourished very old adults (age 75+) with an acute illness

Edington et al, 2004 (55)

Elderly

malnourished patients (age 65+)

Neumann et al, 2004 (57)

Hassell et al, 1994 (50)

Older adults (age 60+) undergoing surgical repair of a hip fracture

Tube-fed hospital patients US 46 UK 76

ONS (2 × /day) vs control (usual care); 12 weeks

UK 100

ONS vs control; 8 weeks

intervention, 24 weeks follow-up

Standard ONS vs high-protein ONS (2 × /day); 28 days

US 136

Nutrition support team vs no

nutrition support team involvement; 7 months

Scott et al, 2005 (58)

Adult patients referred for a gastrostomy

UK 101

Intervention: Regular follow-up by nutrition team (weekly in

hospital, monthly after discharge) (n = 49); 12 months

Fewer unplanned readmissions in the ONS group compared to the control group (10 vs 17)

In both groups, mean numbers of hospital admissions decreased significantly during the study period when compared with the 24 weeks before the study (ONS, P = .0345; control P = .0015)

No significant difference between the groups in hospital readmissions (1 vs 0)

Readmission Rates

At 6 months, 65 patients (29%) in the ONS group were readmitted to the hospital compared with 89 patients (40%) in the placebo group (P = .02).

295

There were no significant differences in hospital readmission across treatment groups.

43% reduction in adjusted readmission rates in the patients seen by a nutrition support team

No statistically significant difference in readmissions