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

Snider J et al, 2014 (46)

Population Health Economic Studies

Medicare patients aged 65+ with a primary

diagnosis of COPD during hospitalization

Lakdawalla et al, 2013 (45)

Medicare patients aged 65+ and carrying a diagnosis of AMI, CHF, or PNA during hospitalization

Philipson et al, 2013 (44)

Medicare patients aged 65+ with a hospital episode

Beck et al, 2012 (61)

Medical and surgical

US

AMI: 20,870 CHF: 38,418 PNA: 47,477 Medicare 65+: 667,684

US 14,326

ONS use vs non-ONS use during hospital stay for matched samples

ONS use vs non-ONS use during hospital stay for matched samples

13.1% decrease in 30-day readmission probability (P < .05)

Location

Sample Size

Intervention/ Duration

Readmission Rates

297

Decrease in 30-day readmission probability:

AMI: 12.0% (P<0.01) CHF: 10.1% (P<0.01) PNA: 5.2%

Medicare 65+: 8.4% (P<0.01) US 1,160,888

ONS use vs non-ONS use during hospital stay for matched samples

Meta-Analysis and Systematic Reviews —

patients, age 65+

479

Four studies compared ONS, homemade milk- based

supplements, fortification of normal food sources, and dietary advice vs standard of care; range from 2 weeks to 1 year

Cawood et al, 2012 (42)

Mostly elderly, mean age 74 y, including those with fractures, pressure ulcers, COPD, cancer, GI disease, and range of

critical/acute illnesses

Stratton et al, 2013 (43)

Hospitalized adult patients

— —

36 RCTs (n = 3,790) 2 RCT (n = 546) reported data on hospital

readmissions at 3–6 months

6 RCTs (n = 852)

ONS vs routine care; range from 60 days to 1 year

Significant reductions with ONS vs routine care (OR 0.59, 95% CI 0.43– 0.80, P = .001)

High-protein ONS vs standard of care/control; range from 3–6 months

High-protein ONS had a significant effect on hospital readmissions compared to control (OR 0.59 CI 0.41–0.84), P + .004. ONS reduced the overall readmissions by 30%.

6.9% decrease in readmissions

No significant effect on readmissions (OR 1.07

(95% CI 0.71 to 1.61)