Malnourished Hospital Patients Who Get Nutritional Supplements May Be Less Likely to Be Readmitted

By Lorraine L. Janeczko

April 26, 2019

NEW YORK (Reuters Health) - Very few patients who are malnourished when admitted to the hospital receive oral nutritional supplements (ONS), but those who do may be less apt to be readmitted, new research suggests.

"Malnourished patients who received ONS orders had a decrease in 30-day hospital readmission reflecting a likely benefit from received nutrition intervention," Dr. Gerard E. Mullin of the Johns Hopkins University School of Medicine in Baltimore, Maryland, told Reuters Health by email. "The timing of ONS orders appeared to forecast hospital length of stay."

Dr. Mullin and his colleagues reviewed the records of more than 8,700 malnourished adults admitted to one large U.S. academic medical center over 12 months in 2016 and 2017.

Only 3.1% of the malnourished patients were treated with ONS, the researchers report in the Journal of the Academy of Nutrition and Dietetics, online April 4. These patients were older and sicker, more likely to be black and female, and they had longer hospital stays.

After adjusting for demographic and clinical differences, ONS use was associated with 38.8% fewer 30-day readmissions (P=0.017) overall, as well as 46.1% fewer oncology readmissions (P<0.001). Cutting the time to ONS by half was tied to a 10.2% reduction in length of stay (P<0.01).

Prioritizing hospital nutritional care can lead to healthier patients with shorter stays and fewer readmissions, and it can save money, Dr. Mullin noted.

"Hospitalized patients who are older and sicker tend to be malnourished," he explained. "Sarcopenia, which occurs progressively with aging and accelerates with illness and in the hospital setting, has adverse prognostic implication. Mobility and nutritional intervention are keystones to treatment."

The authors acknowledged limitations of the study, including that it was done at a single center and that readmissions to hospitals outside the system may not be detected, leading to undercounts. They recommend further related research, including studies to validate malnutrition diagnosis criteria.

"The next logical step is a controlled intervention (randomized placebo-controlled trial) to determine whether patients would benefit from receiving an ONS drink upon identification of malnutrition," Dr. Mullin said.

Abbott Laboratories, which sells medical foods, funded the study; two of the authors are Abbott employees.


J Acad Nutr Diet 2019.