Clinical question: Is there a mortality benefit to optimizing nutritional status for malnourished patients with age-related frailty?
Background: Age-related frailty syndrome has been associated with increased morbidity and mortality in critically ill patients. It has not been well studied whether optimizing nutrition in elderly hospitalized patients with frailty syndrome improves outcomes.
Study design: Randomized controlled trial
Setting: Secondary and tertiary hospitals in Switzerland
Synopsis: A subgroup analysis of data from the EFFORT Trial included 881 patients identified as having age-related vulnerability with overlapping characteristics of frailty syndrome, age ≥80, and cognitive impairment. Patients randomized to additional nutritional support had >50% reduction in risk of 30-day mortality (95% CI, 0.31-0.76; P=0.002). Secondary outcomes included a reduction in 30-day functional decline and improvement of reported quality of life at both 30 and 180 days.
Bottom line: Individualized nutritional support improves 30-day mortality in elderly hospitalized patients with age-related frailty syndrome. Hospitalists should consider dietary supplementation for elderly patients who screen positive for frailty and malnutrition on admission.
Citation: Baumgartner A, et al. The impact of nutritional support on malnourished inpatients with aging-related vulnerability. Nutrition. 2021;89:111279. doi: 10.1016/j.nut.2021.111279.
Dr. O’Neill is a hospitalist and assistant professor of medicine at the University of New Mexico Hospital, Albuquerque, N.M.