T. Pepersack, M. Corretge, I. Beyer, B. Namias, S. André, F. Benoît, A. Mergam, C. Simonetti

Correspondance: Thierry Pepersack, Service de Gériatrie, Centre Hospitalier Universitaire Brugmann, Place Van Gehuchten 4, 1020 Bruxelles, Phone: 00.32.2.4772386. Fax: 00.32.2.4772178. E-mail : thierry.pepersack@chu-brugmann.be

BACKGROUND: Up to 65% of elderly patients are protein-energy undernourished at admission or acquire nutritional deficits while hospitalised. OBJECTIVES: The aims of this project were: 1) to assess the quality of care concerning nutrition among geriatric units; 2) to assess the impact of implementive nutritional interventions on nutritional status and on the length of hospitalisation. DESIGN: Two hundred and six patients consecutively admitted in a geriatric unit of a general hospital were studied prospectively for 6 months (from January to June 2001). All patients underwent a comprehensive geriatric assessment. For the first 3 months the nutritional status of the patients on admission and at discharge were assessed without particular recommendations for nutritional intervention. A standardised nutritional intervention was proposed for the last 3 months. RESULTS: Median value of Mini-Nutritional Assessment was 19 points (ranged from 9 to 29), mean admission's prealbumin concentration (PAB) was 0.179 g/l, and C-reactive protein 5.9±2.8 mg/100ml. Hospitalisation stay was significantly lower during the interventional period than during the observational period. A higher mean PAB variation was observed during the interventional period as compared to the observational period. CONCLUSIONS: Nutritional assessment should be part of routine clinical practice in elderly hospitalized patients. A comprehensive screening tool for assessment of nutritional status is needed that is clinically relevant and cost-effective to perform. If malnutrition is suggested by such screening tests, implementations of nutritional intervention allow to ameliorate discharge nutritional status and to reduce hospitalization stay.

Keywords: Nutritional assessment, geriatric assessment, hospitalisation, aged, quality, elderly, older adults.