Nutritional support after hospital discharge improves long-term mortality in malnourished adult medical patients: Systematic review and meta-analysis
Abstract
Background & aims In patients with malnutrition there is an increased long-term risk for mortality beyond the preciding hospital stay. We investigated the effects of postdischarge nutritional support in the outpatient setting on all-cause mortality in the populaton of malnourished medical patients in a systematic review of randomized controlled trials. Methods We searched MEDLINE and EMBASE, from inception to December 21, 2022. Randomized-controlled trials investigating nutritional support in medical patients following hospital discharge vs. control group (usual care, placebo and no nutritional support) were included. Data were independently extracted by two authors and were pooled using random effects model. Our primary outcome was all cause-mortality up to 12-months (end of intervention) of hospital discharge. Results We included 14 randomized-controlled trials with a total of 2438 participants and mostly moderate trial quality. Compared to the control group, patients receiving outpatient nutritional support had lower mortality (13 trials, odds ratio [OR] 0.63, 95% confidence interval [CI] 0.48 to 0.84, p = 0.001, I 2 = 1%). Nutritional support was also associated with a significant increase in the mean daily intake of energy (568 kcal, 95% CI 24 to 1,113, p = 0.04), proteins (24 g, 95% CI 7 to 41), p = 0.005) and body weight (1.1 kg, 95% CI 0.6 to 1.7), p Conclusions This meta-analysis of randomized-controlled trials with mostly moderate trial quality suggests that nutriti…
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Trial quality in the meta-analysis was deemed moderate, highlighting the need for further large-scale studies.
“However, trial quality was deemed moderate, highlighting the need for further large-scale studies”
From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [115]
A systematic review and meta-analysis including 2438 patients concluded that mortality was significantly lowered in patients with nutritional support continued after hospital discharge (OR 0.63, 95% CI 0.48 to 0.84, p=0.001, I2=1%; 13 trials).
“a recently published systematic review and meta-analysis [115] including a total of 2438 patients concluded that mortality was significantly lowered in patients with nutritional support which was continued after hospital discharge (OR 0.63, 95% CI 0.48 to 0.84, p ¼ 0.001, I 2 ¼ 1%; 13 trials).”
From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [115]
A recent meta-analysis demonstrated that caloric intake and protein intake were significantly higher in patients receiving nutritional support after hospital discharge.
“A recent metaanalysis also demonstrated that caloric intake but also protein intake was significantly higher in patients receiving nutritional support after hospital discharge”
From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [115]
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ESPEN guideline on nutritional support for polymorbid medical inpatients
Wunderle, C., Gomes, F., Schuetz, P., Stumpf, F., Austin, P., Ballesteros-Pomar, M. D., Cederholm, T., Fletcher, J., Laviano, A., Norman, K., et al. (2023) · Clinical Nutrition · doi:10.1016/j.clnu.2023.06.023 · Cited by 105 · see citing works
“A recent meta-analysis also demonstrated that caloric intake but also protein intake was signi fi cantly higher in patients receiving nutritional support after hospital discharge ( Level of evidence: 1 þþ ) [115].”
InfluentialSelf-citation
- Authors
- Kaegi-Braun, N., Kilchoer, F., Dragusha, S., Gressies, C., Faessli, M., Gomes, F., Deutz, N. E., Stanga, Z., Mueller, B., & Schuetz, P.
- Affiliations
- University of Basel (CH)
- Università della Svizzera italiana (CH)
- New York Academy of Sciences (US)
- Texas A&M University (US)
- University of Bern (CH)
- ORCID
- Venue
- Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2022-11
- Volume
- 41
- Issue
- 11
- Pages
- 2431-2441
- ISSN
- 0261-5614 (ISSN-L)
- OpenAlex
- W4297497361
- Cited by
- 50
- References
- 8
- Citations by year
- 2026: 9 · 2025: 13 · 2024: 14 · 2023: 14
- FWCI
- 1.39
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Bern Open Repository and Information System (University of Bern) (submittedVersion)
- Funders
- Forschungsrat des Kantonsspitals Aarau (1410.000.044)
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (PP00P3_150531 / 1)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Keywords
- nutritional support, malnutrition, post-discharge care, all-cause mortality, long-term survival, energy intake, protein intake, weight gain, medical patients, hospital readmission, grip strength
- MeSH terms
- Adult, Aftercare, Body Weight, Hospitals, Humans, Patient Discharge, Randomized Controlled Trials as Topic, Hand Strength, Malnutrition
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