Key result
Nutritional interventions cut hospital readmissions ~16% in older adults, while exercise shows no benefit.
Why the study?
In older patients, physical decline and malnutrition are considered risk factors for readmission, but the effects of nutritional and physical exercise interventions after hospital admission remained to be determined.
Do nutritional and/or physical exercise interventions reduce hospital readmission in older adults aged 65 or older?
Meta-Analysis (n=2,681)
Yes
Do nutritional and/or physical exercise interventions reduce hospital readmission in older adults aged 65 or older?
Nutritional support optimizing energy intake may reduce the risk of hospital readmission in patients aged 65 years or older, whereas physical exercise interventions alone did not show a significant effect.
Answers are grounded in this paper and cite their sources.
Nutritional interventions merit consideration to lower readmissions in adults ≥65; confirms nutrition benefit while challenging exercise alone.
BACKGROUND: Unplanned readmission may result in consequences for both the individual and society. The transition of patients from hospital to postdischarge settings often represents a discontinuity of care and is considered crucial in the prevention of avoidable readmissions. In older patients, physical decline and malnutrition are considered risk factors for readmission. The purpose of the study was to determine the effects of nutritional and physical exercise interventions alone or in combination after hospital admission on the risk of hospital readmission among older people. METHODS: A systematic review and meta-analysis of randomized controlled studies was conducted. The search involved seven databases (Medline, AMED, the Cochrane Library, CINAHL, Embase (Ovid), Food Science Source and Web of Science) and was conducted in November 2018. An update of this search was performed in March 2020. Studies involving older adults (65 years and above) investigating the effect of nutritional and/or physical exercise interventions on hospital readmission were included. RESULTS: A total of 11 randomized controlled studies (five nutritional, five physical exercise and one combined intervention) were included and assessed for quality using the updated Cochrane Risk of Bias Tool. Nutritional interventions resulted in a significant reduction in readmissions (RR 0.84; 95% CI 0.70-1.00, p = 0.049), while physical exercise interventions did not reduce readmissions (RR 1.05; 95% CI 0.84-1.31, p-value = 0.662). CONCLUSIONS: This meta-analysis suggests that nutrition support aiming to optimize energy intake according to patients' needs may reduce the risk of being readmitted to the hospital for people aged 65 years or older.
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Lærum‐Onsager et al. (2021) conducted a meta-analysis in Hospitalized older adults (n=2,681). Nutritional interventions vs. Usual care or placebo was evaluated on Hospital readmission at ≤90 days (RR 0.84, 95% CI 0.70-1.00, p=0.049). Nutritional interventions reduced hospital readmissions by 16% (RR 0.84) in patients aged 65 years or older, while physical exercise interventions showed no significant effect.
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