Older rehabilitation patients are at high risk of malnutrition: Evidence from a large Australian database

Charlton, Karen E; Nichols, Claire; Bowden, Steven; Lambert, Kelly; Barone, L; Mason, Michelle; Milosavljevic, Marianna

doi:10.1007/s12603-010-0307-3

Cited by 96 publications

(99 citation statements)

References 37 publications

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“…However, it is 50 essential that the nutrition screening tools and nutrition assessment tools used to complete 51 these steps have undergone adequate evaluation for validity so that the most appropriate tool 52 can be selected for the patient group [2]. 53 The prevalence of malnutrition in rehabilitation and the nutrition screening and assessment 54 tools appropriate for use in rehabilitation have not been reviewed since 2009 [2].…”

Section: Introductionmentioning

confidence: 99%

Protein-energy malnutrition in the rehabilitation setting: Evidence to improve identification

Marshall

2016

Maturitas

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Section: Introductionmentioning

confidence: 99%

Protein-energy malnutrition in the rehabilitation setting: Evidence to improve identification

Marshall

2016

Maturitas

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“…In a large sample (N = 2076) of older patients admitted to Australian rehabilitation hospitals, most were classified as either malnourished (33 %) or at risk of malnutrition (52 %) (12). Of these, over half of malnourished patients and 76 % of those at risk of malnutrition were discharged home from hospital, and would thus be in need of nutritional support during their period of convalescence.…”

Section: Introductionmentioning

confidence: 99%

“It could probably help someone else but not me”: A feasibility study of a snack programme offered to meals on wheels clients

Charlton

Walton

Moon

et al. 2013

The Journal of nutrition, health and aging

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Objectives Community-based services, such as Meals on Wheels (MOW), allow older adults to remain in their homes for as long as possible. Many MOW recipients experience decreased appetite that limits intake at mealtimes. This pilot study aimed to determine the feasibility of providing high protein high energy snacks to improve nutrient intakes of MOW clients in a regional centre of New South Wales, Australia.Participants A convenience sample of 12 MOW clients.Intervention Participants received snacks five times a week, in addition to their usual MOW order, for four weeks.Measurements Nutritional status was assessed using the Mini Nutritional Assessment tool. Pre-post changes in dietary intake were assessed using a diet history and food frequency questionnaire. Qualitative interviews conducted in clients' homes were digitally recorded, transcribed verbatim, and themes identified.Results Post-intervention, there was a trend for an increased energy (mean = +415kJ (SD=1477)/day) and protein (+7.2 (±14.06) g/day) intake. MNA scores significantly increased (P= 0.036) and proportion of respondents categorised as 'malnourished' or 'at risk of malnutrition' decreased from 17% to 8%, and 67% to 25%, respectively (P Conclusion Provision of an additional daily mid-meal snack may be a useful addition to existing MOW services, for improved energy and protein intakes. However, not all MOW clients at risk of malnutrition perceived the snacks to be beneficial to them. Keywordsprobably, help, someone, wheels, else, but, not, me, programme, clients, offered, could, meals, feasibility, study, snack

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“…This finding is supported by previously published data from patients admitted to rehabilitation (sub-acute) hospitals in the same local hospital district. 21 A potential confounder in assessing the impact of malnutrition on hospital length of stay is that LOS may be shorter in those who die as a result of severity of their underlying illness. We attempted to account for this anomaly by including patients' disease classification as a covariate in the analysis.…”

Section: Discussionmentioning

confidence: 99%

A high prevalence of malnutrition in acute geriatric patients predicts adverse clinical outcomes and mortality within 12 months

et al. 2013

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Background & aims Older malnourished patients experience increased length of hospital stay and greater morbidity compared to their well nourished counterparts. This study aimed to assess whether nutritional status at hospital admission predicted clinical outcomes at 12 months follow-up. Methods Secondary data analysis of 2602 consecutive patient admissions to an acute tertiary hospital in New South Wales, Australia on or before 1st June 2009. Twelve-month data was analysed in a sub-sample of 774 patients. Nutritional status was determined within 72 h of admission using the Mini Nutritional Assessment (MNA). Outcomes, obtained from electronic patient records included hospital readmission rate, total length of stay (LOS), change in level of care at discharge, and in-hospital mortality. Results A third (34%) of patients were malnourished and 55% at risk of malnutrition. Using a Cox proportional hazards regression model, controlling for underlying illness and age, patients at risk of malnutrition were 2.46 (95% CI: 1.36, 4.45; p = 0.003) times more likely to have a poor clinical outcome (mortality/discharge to higher level of care), while malnourished patients had a 3.57 (95% CI: 1.94, 6.59; p = 0.000) times higher risk. Conclusions A poor nutritional status carries a substantially greater risk of death and/or loss of dependency in older adults. Interventions to improve the nutritional status of patients during their hospital stay, and following discharge back to the community, are needed to lower the risk of adverse outcomes.

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Older rehabilitation patients are at high risk of malnutrition: Evidence from a large Australian database

Abstract: The majority of older patients in the rehabilitation setting are nutritionally compromised which adversely influences LOS. In order to encourage more widespread screening, the MNA-SF may be able to replace the full MNA.

Cited by 96 publications

References 37 publications

Protein-energy malnutrition in the rehabilitation setting: Evidence to improve identification

Protein-energy malnutrition in the rehabilitation setting: Evidence to improve identification

“It could probably help someone else but not me”: A feasibility study of a snack programme offered to meals on wheels clients

A high prevalence of malnutrition in acute geriatric patients predicts adverse clinical outcomes and mortality within 12 months

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