Effect of nutritional and physical exercise intervention on hospital readmission for patients aged 65 or older: a systematic review and meta-analysis of randomized controlled trials

International Journal of Behavioral Nutrition and Physical Activity

Jonas Debesay¹  Marianne Molin²  Asta Bye³  Cecilie Fromholt Olsen⁴  Maria Bjerk⁵  Christine Hillestad Hestevik⁵  Are Hugo Pripp⁶  Ellisiv Lærum-Onsager⁷ 

[1] Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway;Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway;Department of Health, Bjorknes University College, Oslo, Norway;Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway;Regional Advisory Unit for Palliative Care, Department of Oncology, Oslo University Hospital, Oslo, Norway;Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway;Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway;Norwegian Institute of Public Health, Oslo, Norway;Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway;Oslo Centre of Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway;Lovisenberg Diaconal University College, Oslo, Norway;

关键词: Nutrition;    Physical exercise;    Older people;    Readmission;    Meta-analysis;    Transitional care;   

DOI  :  10.1186/s12966-021-01123-w

来源: Springer

【 摘 要 】

BackgroundUnplanned 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.MethodsA 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.ResultsA 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).ConclusionsThis 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.

【 授权许可】

CC BY