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A systematic review and meta-analysis of the impact of oral nutritional supplements on hospital readmissions
Abstract
The adverse effects of disease-related malnutrition (DRM) on health care use and costs are well substantiated. However, the impact of managing DRM with nutritional support on health care use, including hospital (re)admissions requires exploration. This systematic review (9 RCT, N=1190) examined the effects of oral nutritional supplements (ONS) on hospital (re)admissions. Meta-analysis of 6 RCT (N=852) with data on the proportion of patients (re)admitted to hospital showed significant reductions with ONS vs. routine care (OR 0.59, 95% CI 0.43-0.80, P=0.001), including 5 RCT (N=826) that recorded readmissions (OR 0.59, 95% CI 0.43-0.80, P=0.001). The significant reduction in (re)admissions was found in meta-analyses of ONS trials in various settings and in patients with DRM or of varied nutritional status. A larger meta-analysis (8 RCT, N=999) that combined other (re)admissions data using standardised differences also showed a significant reduction with ONS (effect size -0.23, 95% CI -0.36 to -0.10, P=0.001). Most of these trials (75%) were in older people aged ≥65 years (6 RCT, N=834, effect size -0.18, 95% CI -0.31 to -0.04, P=0.011). This systematic review shows that ONS significantly reduce hospital (re)admissions, particularly in older patient groups, with economic implications for health care.
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“Altogether, positive effects of ONS on dietary intake (115, 116, 119, 121) and BW (115, 116, 119, 121), and reduced risk of complications (121) and readmissions (115, 120, 121) were reported, whereas the length of hospital stay (114, 115, 121) and mortality risk (114-116, 119, 121) were not significantly reduced.”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [120]
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“A systematic literature search found six high-quality SLRs that have assessed the efficacy of ONS versus usual care in older persons (114-121).”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [120]
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Metadata
- Authors
- Stratton, R. J., Hébuterne, X., & Elia, M.
- Affiliations
- University of Southampton (GB)
- Université Nice Sophia Antipolis (FR)
- Corresponding author
- Stratton, Rebecca J.
- Venue
- Ageing Research Reviews
- Publisher
- Elsevier BV
- Published
- 2013-09
- Volume
- 12
- Issue
- 4
- Pages
- 884-897
- ISSN
- 1568-1637 (ISSN-L)
- OpenAlex
- W1993654396
- Cited by
- 183
- References
- 38
- Citations by year
- 2026: 8 · 2025: 10 · 2024: 7 · 2023: 7 · 2022: 18 · 2021: 24 · 2020: 19 · 2019: 16 · 2018: 21 · 2017: 17 · 2016: 8 · 2015: 16 · 2014: 12
- FWCI
- 1.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Ageing Research Reviews (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Javna Agencija za Raziskovalno Dejavnost RS
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Physiology (medical) › Nutrition and Health in Aging
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Keywords
- oral nutritional supplements, disease-related malnutrition, hospital readmission, nutritional support, older adults, health care utilization, health care costs
- MeSH terms
- Administration, Oral, Aged, Humans, Nutritional Status, Patient Readmission, Randomized Controlled Trials as Topic, Treatment Outcome, Dietary Supplements, Malnutrition
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