Oral nutritional support of older (65 years+) medical and surgical patients after discharge from hospital: systematic review and meta-analysis of randomized controlled trials

Beck, Anne Marie; Holst, Mette; Rasmussen, Henrik Højgaard

doi:10.1177/0269215512445396

Cited by 78 publications

(69 citation statements)

References 31 publications

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“…This is especially important in elderly patients 132 . Maintenance of enteral nutrition in home care (with home-based nutritional therapy) may contribute to increase nutritional intake after major operations 133 and prevent post-operative nutritional deterioration 134,135 .…”

Section: Howmentioning

confidence: 99%

ACERTO guidelines of perioperative nutritional interventions in elective general surgery

De-Aguilar-Nascimento

Salomão

Waitzberg

et al. 2017

Rev. Col. Bras. Cir.

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Objective: to present recommendations based on the ACERTO Project (Acceleration of Total Post-Operative Recovery) and supported by evidence related to perioperative nutritional care in General Surgery elective procedures. Methods: review of relevant literature from 2006 to 2016, based on a search conducted in the main databases, with the purpose of answering guiding questions previously formulated by specialists, within each theme of this guideline. We preferably used randomized controlled trials, systematic reviews and meta-analyzes but also selected some cohort studies. We contextualized each recommendation-guiding question to determine the quality of the evidence and the strength of this recommendation (GRADE). This material was sent to authors using an open online questionnaire. After receiving the answers, we formalized the consensus for each recommendation of this guideline. Results: the level of evidence and the degree of recommendation for each item is presented in text form, followed by a summary of the evidence found. Conclusion: this guideline reflects the recommendations of the group of specialists of the Brazilian College of Surgeons, the Brazilian Society of Parenteral and Enteral Nutrition and the ACERTO Project for nutritional interventions in the perioperative period of Elective General Surgery. The prescription of these recommendations can accelerate the postoperative recovery of patients submitted to elective general surgery, with decrease in morbidity, length of stay and rehospitalization, and consequently, of costs.

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Section: Howmentioning

confidence: 99%

ACERTO guidelines of perioperative nutritional interventions in elective general surgery

De-Aguilar-Nascimento

Salomão

Waitzberg

et al. 2017

Rev. Col. Bras. Cir.

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show abstract

“…12,122 Some modifications may improve taste or texture tolerability but not affect swallow parameters. [134][135][136] Environmental modifications have proved successful in improving nutrition in residential care settings 137 and are adaptable to other settings. [134][135][136] Environmental modifications have proved successful in improving nutrition in residential care settings 137 and are adaptable to other settings.…”

Section: Interventionsmentioning

confidence: 99%

Dysphagia: implications for older people

Miller

Patterson

2013

Rev. Clin. Gerontol.

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Dysphagia represents a salient concern in many conditions prevalent in older people. There are direct implications for morbidity and mortality. The importance of recognizing and managing dysphagia in hospital and the community also extends to psychosocial impact and quality of life, as well as health, economic and ethical-legal issues. This review outlines reasons for the importance of recognizing and treating dysphagia. It then proceeds to look at recent developments in our understanding of the nature, assessment and management of dysphagia in older people. Whilst there are wellestablished practices in assessment and management, ongoing work continues to challenge the validity and reliability of many methods. These concerns are covered and directions for future developments highlighted.

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“…Studies have demonstrated that efforts on optimizing energy and protein intake at discharge and in the rehabilitation period after discharge are beneficial [11, pages 3299–3307], [3, pages 321–325], [14, pages 2239–2245], [13, pages 61–67], [15, pages 295–301], [4, pages 386–395], and [16]. A recent review found a positive effect on nutritional intake and/or nutritional status by nutritional intervention after discharge from hospital [17, pages 19–27]. These positive results were however only found in compliant patients [14, pages 2239–2245], and [3, pages 321–325].…”

Section: Introductionmentioning

confidence: 99%

Nutrition Therapy in the Transition between Hospital and Home: An Investigation of Barriers

Holst

Rasmussen

2013

Journal of Nutrition and Metabolism

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Aims and Objectives. This study aimed to investigate barriers for nutrition therapy in the transition between hospital and home and hereby to identify areas for potential improvements. Background. Though the focus on nutritional risk is improving in hospital, there seems to be less effort to maintain or even improve nutritional status after discharge and during the rehabilitation period. Design. Qualitative focus group interviews. Methods. Semistructured focus group interviews with experienced multiprofessional staff from hospital, home care, nursing homes, and general practise. The study was done in the county of Aalborg with about 280.000 inhabitants regarding homecare and general practise as well as Aalborg University Hospital, Denmark. Results. Interviews were generated with 41 professionals from hospital, general practise, and home care. Barriers identified between settings included the following aspects: economic, organisation, and education. The impression of professionals was that few patients are discharged with nutrition therapy, compared to who could benefit from nutrition therapy after discharge. Most often, reasons were a short in-hospital stay and lack of knowledge and interest. Moreover, lack of clinical guidelines throughout all settings, time consumption, lack of transparency regarding economy and workflows, and lack of assistance from experts regarding complicated nutritional problems were identified. Conclusions. Many barriers were found in hospital as well as in the community and general practise. These were most often practical as well as organizational. Improvements of clinical guidelines and instructions and improvement of knowledge and communication at all levels are needed. Relevance to Clinical Practise. This study emphasizes that responsibility needs to be taken for patients whom are still at nutritional risk at discharge, and even before hospitalization. Nurses and doctors in and outside hospital are in need of improved knowledge, standard care plans, and instructions.

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Oral nutritional support of older (65 years+) medical and surgical patients after discharge from hospital: systematic review and meta-analysis of randomized controlled trials

Abstract: Although the evidence is limited, we suggest that oral nutritional support may be considered for older malnourished medical and surgical patients after discharge from hospital.

Cited by 78 publications

References 31 publications

ACERTO guidelines of perioperative nutritional interventions in elective general surgery

ACERTO guidelines of perioperative nutritional interventions in elective general surgery

Dysphagia: implications for older people

Nutrition Therapy in the Transition between Hospital and Home: An Investigation of Barriers

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