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Individualized Nutritional Intervention During and After Hospitalization: The Nutrition Intervention Study Clinical Trial
Author(s) -
Feldblum Ilana,
German Larisa,
Castel Hana,
HarmanBoehm Ilana,
Shahar Danit R.
Publication year - 2011
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2010.03174.x
Subject(s) - medicine , randomized controlled trial , intervention (counseling) , physical therapy , clinical trial , nursing
OBJECTIVES: To test the hypothesis that individualized nutritional treatment during and after discharge from acute hospitalization will reduce mortality and improve nutritional outcomes. DESIGN: Randomized, controlled trial. SETTING: Internal medicine departments. PARTICIPANTS: Two hundred fifty‐nine hospitalized adults aged 65 and older at nutritional risk were recruited and randomized according to hospitalization ward into one intervention and two control groups during hospitalization. INTERVENTION: Group 1 (intervention group) received individualized nutritional treatment from a dietitian in the hospital and three home visits after discharge. Group 2 received one meeting with a dietitian in the hospital. Group 3 received standard care. Groups 2 and 3 were combined into a single group that served as the control group in the analysis. MEASUREMENTS: Mortality, health status, nutritional outcomes, blood tests, cognition, emotional, and functional parameters were assessed at baseline and after 6 months. All participants were contacted monthly. RESULTS: The overall dropout rate was 25.8%. After 6 months, rise in Mini Nutritional Assessment score, adjusted for education and hospitalization ward, was significantly higher in the intervention group than in the control groups (3.01 ± 2.65 vs 1.81 ± 2.97, P =.004) mainly on the subjective assessment part (0.34 ± 0.86 vs. −0.04 ± 0.87, P =.004). The only laboratory parameter for which a difference was observed between the groups was albumin; 9.7% of the intervention group had serum albumin levels of less than 3.5 g/dL, versus 22.9% of the control group ( P =.03). Mortality was significantly lower in the intervention group (3.8%) than in the control group (11.6%, P =.046). CONCLUSION: Lower mortality and moderate improvement in nutritional status were found in patients receiving individualized nutritional treatment during and after acute hospitalization.