Prevalence and predictors of weight change post discharge from hospital: a study of the Canadian Malnutrition Task Force

Keller, Heather; Laporte, Manon; Payette, Hélène; Allard, Johane P.; Bernier, Paule; Gramlich, Leah; Jeejeebhoy, Khursheed N.

doi:10.1038/ejcn.2016.277

Cited by 12 publications

(13 citation statements)

References 29 publications

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“…Predictors of dietetic care post discharge include being under the care of a dietitian in hospital, weight loss post discharge, severe malnutrition and comorbidity. This analysis suggests that malnutrition is being undertreated in the community because almost one quarter reported weight loss post discharge . Future work needs to more comprehensively and prospectively assess the transition care experience to understand how care for malnourished patients post discharge can be improved and whether this care results in improved outcomes.…”

Section: Discussionmentioning

confidence: 99%

Patient‐reported dietetic care post hospital for free‐living patients: a Canadian Malnutrition Task Force Study

Keller

Payette

Laporte³

et al. 2017

J Human Nutrition Diet

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Background: Transitions out of hospital can influence recovery. Ideally, malnourished patients should be followed by someone with nutrition expertise, specifically a dietitian, post discharge from hospital. Predictors of dietetic care post discharge are currently unknown. The present study aimed to determine the patient factors independently associated with 30-days post hospital discharge dietetic care for free-living patients who transitioned to the community. Methodology: Nine hundred and twenty-two medical or surgical adult patients were recruited in 16 acute care hospitals in eight Canadian provinces on admission. Eligible patients could speak English or French, provide their written consent, were anticipated to have a hospital stay of ≥2 days and were not considered palliative. Telephone interviews were completed with 747 (81%) participants using a standardised questionnaire to determine whether dietetic care occurred post discharge; 544 patients discharged to the community were included in the multivariate analyses, excluding those who were admitted to nursing homes or rehabilitation facilities. Covariates during and post hospitalisation were collected prospectively and used in logistic regression analyses to determine independent patientlevel predictors. Results: Dietetic care post discharge was reported by 61/544 (11%) of participants and was associated with severe malnutrition [Subjective Global Assessment category C: odd's ratio (OR) 2.43 (1.23-4.83)], weight loss post discharge )], comorbidity [(OR 1.09 (1.02-1.17)] and a dietitian consultation on admission . Conclusions: Dietetic care post discharge occurs in few patients, despite the known high prevalence of malnutrition on admission and discharge. Dietetic care in hospital was the most influential predictor of post-hospital care.

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Section: Discussionmentioning

confidence: 99%

Patient‐reported dietetic care post hospital for free‐living patients: a Canadian Malnutrition Task Force Study

Keller

Payette

Laporte³

et al. 2017

J Human Nutrition Diet

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“…Recent hospitalizations and changes in functional status (e.g. joint replacement leading to physical inactivity) that may lead to weight gain 105 . Other standard questioning on weight history, previous strategies and alcohol use parallel methods used in the general population.…”

Section: Medical Evaluation Specific To Older Adults With Obesitymentioning

confidence: 99%

Addressing Obesity in Aging Patients

Batsis

Zagaria

2018

Medical Clinics of North America

131

109

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Obesity in older adults affects not only morbidity and mortality but, importantly, quality of life and the risk of institutionalization. Weight loss interventions can effectively lead to improved physical function. Diet-alone interventions can detrimentally affect muscle and bone physiology and, without interventions to affect these elements, can lead to adverse outcomes. Understanding social and nutritional issues facing older adults is of utmost importance to primary care providers. This article will also discuss the insufficient evidence related to pharmacotherapy as well as providing an overview of using physiologic rather than chronologic age for identifying suitable candidates for bariatric surgery.

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“…Approximately a quarter of patients report weight loss 30-days after discharge, which was associated with being on a “special” diet (also called a therapeutic diet) and reporting a fair/poor appetite [ 13 ]. This same study found that only 11% of participants reported consulting a dietitian post-discharge and this was associated with severe malnutrition, weight loss after discharge, comorbidity, and having seen a dietitian in hospital [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Nutrition Care after Discharge from Hospital: An Exploratory Analysis from the More-2-Eat Study

et al. 2018

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Many patients leave hospital in poor nutritional states, yet little is known about the post-discharge nutrition care in which patients are engaged. This study describes the nutrition-care activities 30-days post-discharge reported by patients and what covariates are associated with these activities. Quasi-randomly selected patients recruited from 5 medical units across Canada (n = 513) consented to 30-days post-discharge data collection with 48.5% (n = 249) completing the telephone interview. Use of nutrition care post-discharge was reported and bivariate analysis completed with relevant covariates for the two most frequently reported activities, following recommendations post-discharge or use of oral nutritional supplements (ONS). A total of 42% (n = 110) received nutrition recommendations at hospital discharge, with 65% (n = 71/110) of these participants following those recommendations; 26.5% (n = 66) were taking ONS after hospitalization. Participants who followed recommendations were more likely to report following a special diet (p = 0.002), different from before their hospitalization (p = 0.008), compared to those who received recommendations, but reported not following them. Patients taking ONS were more likely to be at nutrition risk (p < 0.0001), malnourished (p = 0.0006), taking ONS in hospital (p = 0.01), had a lower HGS (p = 0.0013; males only), and less likely to believe they were eating enough to meet their body’s needs (p = 0.005). This analysis provides new insights on nutrition-care post-discharge.

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Prevalence and predictors of weight change post discharge from hospital: a study of the Canadian Malnutrition Task Force

Abstract: Weight change was relatively common with WL predominating. Several variables were identified to be predictors of WL or weight gain, with appetite being common to both. Future work to further define and confirm these associations is warranted.

Cited by 12 publications

References 29 publications

Patient‐reported dietetic care post hospital for free‐living patients: a Canadian Malnutrition Task Force Study

Patient‐reported dietetic care post hospital for free‐living patients: a Canadian Malnutrition Task Force Study

Addressing Obesity in Aging Patients

Nutrition Care after Discharge from Hospital: An Exploratory Analysis from the More-2-Eat Study

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