Oral Nutritional Support of Older (65 Years+) Medical and Surgical Patients After Discharge From Hospital: Systematic Review and Meta-Analysis of Randomized Controlled Trials

Clinical Rehabilitation. 2013 Jan; 27(1):19-27. doi: 10.1177/0269215512445396.
Beck, A. M., Holst, M., & Rasmussen, H. H.


Objective: To estimate the effectiveness of oral nutritional support compared to placebo or usual care in improving clinical outcome in older (65 years+) medical and surgical patients after discharge from hospital. Outcome goals were: re-admissions, survival, nutritional and functional status, quality of life and morbidity.

Data sources: Three recent Cochrane reviews and an update of their literature search using MEDLINE, EMBASE, Web of Science. Search terms included randomized controlled trials; humans; age 65+ years; subset: dietary supplements.

Review methods: One reviewer assessed trials for inclusion, extracted data and assessed trial quality.

Results: Six trials were included (N = 716 randomly assigned participants). All trials used oral nutritional supplements. A positive effect on nutritional intake (energy) and/or nutritional status (weight) (in compliant participants) were observed in all trials. Two pooled analysis was based on a fixed-effects model. No significant effect were found on mortality (four randomized controlled trials with 532 participants, odds ratio 0.80 (95% confidence (CI) interval 0.46 to 1.39)) or re-admissions (four randomized controlled trials with 478 participants, odds ratio 1.07 (95% CI 0.71 to 1.61)).

Conclusion: 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.

Information NutriBib

Reference work for leading, current and selected literature in the field of clinical nutrition

Publications on clinical nutrition have grown steadily in recent years and the scientific evidence has been improved by numerous observational as well as intervention studies. Various umbrella organisations, such as the Swiss Society for Clinical Nutrition (GESKES), the German Society for Nutritional Medicine (DGEM) or the European Society for Clinical Nutrition and Metabolism (ESPEN) publish guidelines on nutrition in various clinical situations at regular intervals. Thus, a large amount of literature is available for evidence-based nutritional medicine.

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List of abbreviations

DGEM German Society for Nutritional Medicine (German Deutsche Gesellschaft für Ernährungsmedizin)
GESKES  Swiss Society for Clinical Nutrition (German Gesellschaft für klinische Ernährung der Schweiz) 
ESPEN European Society of Clinicl Nutrition and Metabolism