Factors Related to Oral Intake of Food by Hospitalized Patients with Malnutrition under the Care of a Nutrition Support Team
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Outcomes
2.2.1. Mode of Nutritional Intake
2.2.2. Oral Outcomes
2.2.3. Other Variables
2.3. Statistical Analysis
3. Results
3.1. Divergence between the Nutritional Intake Mode at the Initial NST Consultation and the Recommended Mode of Intake
3.2. Factors Affecting Primary Nutritional Intake Modes
3.3. Factors Affecting Food Form Determination with Oral Ingestion as the Primary Nutritional Intake Mode
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
References
- Kubrak, C.; Jensen, L. Malnutrition in acute care patients: A narrative review. Int. J. Nurs. Stud. 2007, 44, 1036–1054. [Google Scholar] [CrossRef] [PubMed]
- Waitzberg, D.L.; Caiaffa, W.T.; Correia, M.I. Hospital malnutrition: The Brazilian national survey (IBRANUTRI): A study of 4000 patients. Nutrition 2001, 17, 573–580. [Google Scholar] [CrossRef]
- Hafsteinsdóttir, T.B.; Mosselman, M.; Schoneveld, C.; Riedstra, Y.D.; Kruitwagen, C.L. Malnutrition in hospitalised neurological patients approximately doubles in 10 days of hospitalisation. J. Clin. Nurs. 2010, 19, 639–648. [Google Scholar] [CrossRef] [PubMed]
- Mosselman, M.J.; Kruitwagen, C.L.; Schuurmans, M.J.; Hafsteinsdóttir, T.B. Malnutrition and risk of malnutrition in patients with stroke: Prevalence during hospital stay. J. Neurosci. Nurs. 2013, 45, 194–204. [Google Scholar] [CrossRef]
- Braunschweig, C.; Gomez, S.; Sheean, P.M. Impact of declines in nutritional status on outcomes in adult patients hospitalized for more than 7 days. J. Am. Diet. Assoc. 2000, 100, 1316–1322. [Google Scholar] [CrossRef]
- Sullivan, D.H.; Sun, S.; Walls, R.C. Protein-energy undernutrition among elderly hospitalized patients: A prospective study. JAMA 1999, 281, 2013–2019. [Google Scholar] [CrossRef] [Green Version]
- Marshall, S.; Bauer, J.; Isenring, E. The consequences of malnutrition following discharge from rehabilitation to the community: A systematic review of current evidence in older adults. J. Hum. Nutr. Diet. 2014, 27, 133–141. [Google Scholar] [CrossRef] [Green Version]
- Howard, P. Organizational aspects of starting and running an effective nutritional support service. Clin. Nutr. 2001, 20, 367–374. [Google Scholar] [CrossRef] [Green Version]
- Senkal, M.; Dormann, A.; Stehle, P.; Shang, E.; Suchner, U. Survey on structure and performance of nutrition-support teams in Germany. Clin. Nutr. 2002, 21, 329–335. [Google Scholar] [CrossRef]
- Rasmussen, N.M.L.; Belqaid, K.; Lugnet, K.; Nielsen, A.L.; Rasmussen, H.H.; Beck, A.M. Effectiveness of multidisciplinary nutritional support in older hospitalised patients: A systematic review and meta-analyses. Clin. Nutr. ESPEN 2018, 27, 44–52. [Google Scholar] [CrossRef]
- Mistiaen, P.; Van den Heede, K. Nutrition Support Teams: A Systematic Review. JPEN J. Parenter. Enteral. Nutr. 2020, 44, 1004–1020. [Google Scholar] [CrossRef]
- McClave, S.A.; Taylor, B.E.; Martindale, R.G.; Warren, M.M.; Johnson, D.R.; Braunschweig, C.; McCarthy, M.S.; Davanos, E.; Rice, T.W.; Cresci, G.A.; et al. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J. Parenter. Enteral. Nutr. 2016, 40, 159–211. [Google Scholar] [CrossRef]
- Suzuki, H.; Matsuo, K.; Okamoto, M.; Nakata, H.; Sakamoto, H.; Fujita, M. Preoperative periodontal treatment and its effects on postoperative infection in cardiac valve surgery. Clin. Exp. Dent. Res. 2019, 5, 485–490. [Google Scholar] [CrossRef]
- Yoshimi, K.; Nakagawa, K.; Momosaki, R.; Yamaguchi, K.; Nakane, A.; Tohara, H. Effects of Oral Management on Elderly Patients with Pneumonia. J. Nutr. Health Aging 2021, 25, 979–984. [Google Scholar] [CrossRef]
- Jaroń, A.; Preuss, O.; Konkol, B.; Trybek, G. Quality of life of patients after kinesio tape applications following impacted mandibular third molar surgeries. J. Clin. Med. 2021, 10, 2197. [Google Scholar] [CrossRef]
- Crary, M.A.; Mann, G.D.; Groher, M.E. Initial psychometric assessment of a functional oral intake scale for dysphagia in stroke patients. Arch. Phys. Med. Rehabil. 2005, 86, 1516–1520. [Google Scholar] [CrossRef]
- Furuya, J.; Suzuki, H.; Tamada, Y.; Onodera, S.; Nomura, T.; Hidaka, R.; Minakuchi, S.; Kondo, H. Food intake and oral health status of inpatients with dysphagia in acute care settings. J. Oral Rehabil. 2020, 47, 736–742. [Google Scholar] [CrossRef]
- Nishimura, K.; Kagaya, H.; Shibata, S.; Onogi, K.; Inamoto, Y.; Ota, K.; Miki, T.; Tamura, S.; Saitoh, E. Accuracy of Dysphagia Severity Scale rating without using videoendoscopic evaluation of swallowing. Jpn. J. Compr. Rehabil. Sci. 2015, 6, 124–128. [Google Scholar]
- Chalmers, J.M.; King, P.L.; Spencer, A.J.; Wright, F.A.; Carter, K.D. The oral health assessment tool--validity and reliability. Aust. Dent. J. 2005, 50, 191–199. [Google Scholar] [CrossRef] [Green Version]
- Charlson, M.E.; Pompei, P.; Ales, K.L.; MacKenzie, C.R. A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. J. Chronic Dis. 1987, 40, 373–383. [Google Scholar] [CrossRef]
- Ohta, T.; Kikuchi, H.; Hashi, K.; Kudo, Y. Nizofenone administration in the acute stage following subarachnoid hemorrhage. Results of a multi-center controlled double-blind clinical study. J. Neurosurg. 1986, 64, 420–426. [Google Scholar] [CrossRef]
- Maeda, K.; Takaki, M.; Akagi, J. Decreased Skeletal Muscle Mass and Risk Factors of Sarcopenic Dysphagia: A Prospective Observational Cohort Study. J. Gerontol. A. Biol. Sci. Med. Sci. 2017, 72, 1290–1294. [Google Scholar] [CrossRef]
- Maeda, K.; Koga, T.; Akagi, J. Tentative nil per os leads to poor outcomes in older adults with aspiration pneumonia. Clin. Nutr. 2016, 35, 1147–1152. [Google Scholar] [CrossRef]
- Volkert, D.; Berner, Y.N.; Berry, E.; Cederholm, T.; Coti Bertrand, P.; Milne, A.; Palmblad, J.; Schneider, S.; Sobotka, L.; Stanga, Z.; et al. ESPEN Guidelines on Enteral Nutrition: Geriatrics. Clin. Nutr. 2006, 25, 330–360. [Google Scholar] [CrossRef]
- Zheng, T.; Zhu, X.; Liang, H.; Huang, H.; Yang, J.; Wang, S. Impact of early enteral nutrition on short term prognosis after acute stroke. J. Clin. Neurosci. 2015, 22, 1473–1476. [Google Scholar] [CrossRef]
- Jabbar, A.; Chang, W.K.; Dryden, G.W.; McClave, S.A. Gut immunology and the differential response to feeding and starvation. Nutr. Clin. Pract. 2003, 18, 461–482. [Google Scholar] [CrossRef]
- Heyland, D.K.; Dhaliwal, R.; Drover, J.W.; Gramlich, L.; Dodek, P.; Canadian Critical Care Clinical Practice Guidelines Committee. Canadian clinical practice guidelines for nutrition support in mechanically ventilated, critically ill adult patients. JPEN J. Parenter. Enteral. Nutr. 2003, 27, 355–373. [Google Scholar] [CrossRef] [Green Version]
- Inui, A.; Takahashi, I.; Kurauchi, S.; Soma, Y.; Oyama, T.; Tamura, Y.; Noguchi, T.; Murashita, K.; Nakaji, S.; Kobayashi, W. Oral conditions and dysphagia in Japanese, community-dwelling middle- and older- aged adults, independent in daily living. Clin. Interv. Aging 2017, 12, 515–521. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Mandell, L.A.; Niederman, M.S. Aspiration Pneumonia. N. Engl. J. Med. 2019, 380, 651–663. [Google Scholar] [CrossRef] [PubMed]
- Komiya, K.; Rubin, B.K.; Kadota, J.I.; Mukae, H.; Akaba, T.; Moro, H.; Aoki, N.; Tsukada, H.; Noguchi, S.; Shime, N.; et al. Prognostic implications of aspiration pneumonia in patients with community acquired pneumonia: A systematic review with meta-analysis. Sci. Rep. 2016, 6, 38097. [Google Scholar] [CrossRef] [PubMed]
- Kenzaka, T.; Kumabe, A.; Kosami, K.; Matsuoka, Y.; Minami, K.; Ninomiya, D.; Noda, A.; Okayama, M. Physicians’ opinions regarding the criteria for resuming oral intake after aspiration pneumonia: A questionnaire survey and cluster analysis of hospitals across Japan. Geriatr. Gerontol. Int. 2017, 17, 810–818. [Google Scholar] [CrossRef] [Green Version]
- Parnaby, C.N.; MacDonald, A.J.; Jenkins, J.T. Sham feed or sham? A meta-analysis of randomized clinical trials assessing the effect of gum chewing on gut function after elective colorectal surgery. Int. J. Colorectal Dis. 2009, 24, 585–592. [Google Scholar] [CrossRef]
- Pedersen, A.; Sørensen, C.E.; Proctor, G.B.; Carpenter, G.H. Salivary functions in mastication, taste and textural perception, swallowing and initial digestion. Oral Dis. 2018, 24, 1399–1416. [Google Scholar] [CrossRef]
- Genkai, S.; Kikutani, T.; Suzuki, R.; Tamura, F.; Yamashita, Y.; Yoshida, M. Loss of occlusal support affects the decline in activities of daily living in elderly people receiving home care. J. Prosthodont. Res. 2015, 59, 243–248. [Google Scholar] [CrossRef]
- Yamamoto, S.; Shiga, H. Masticatory performance and oral health-related quality of life before and after complete denture treatment. J. Prosthodont. Res. 2018, 62, 370–374. [Google Scholar] [CrossRef]
- Cho, M.J.; Kim, E.K. Subjective chewing ability and health-related quality of life among the elderly. Gerodontology 2019, 36, 99–106. [Google Scholar] [CrossRef]
- Weimann, A.; Braga, M.; Harsanyi, L.; Laviano, A.; Ljungqvist, O.; Soeters, P.; DGEM (German Society for Nutritional Medicine); Jauch, K.W.; Kemen, M.; Hiesmayr, J.M.; et al. ESPEN Guidelines on Enteral Nutrition: Surgery including organ transplantation. Clin. Nutr. 2006, 25, 224–244. [Google Scholar] [CrossRef]
- Braga, M.; Ljungqvist, O.; Soeters, P.; Fearon, K.; Weimann, A.; Bozzetti, F. ESPEN Guidelines on Parenteral Nutrition: Surgery. Clin. Nutr. 2009, 28, 378–386. [Google Scholar] [CrossRef]
- Dent, E.; Hoogendijk, E.O.; Visvanathan, R.; Wright, O.R.L. Malnutrition screening and assessment in hospitalised older people: A review. J. Nutr. Health Aging 2019, 23, 431–441. [Google Scholar] [CrossRef]
- Wright, L.; Cotter, D.; Hickson, M.; Frost, G. Comparison of energy and protein intakes of older people consuming a texture modified diet with a normal hospital diet. J. Hum. Nutr. Diet. 2005, 18, 213–219. [Google Scholar] [CrossRef]
- Sieske, L.; Janssen, G.; Babel, N.; Westhoff, T.H.; Wirth, R.; Pourhassan, M. Inflammation, appetite and food intake in older hospitalized patients. Nutrients 2019, 11, 1986. [Google Scholar] [CrossRef] [Green Version]
FOIS | FOIS-I | FOIS-R * | ||
---|---|---|---|---|
n | % | n | % | |
1 | 123 | 48.3 | 95 | 37.3 |
2 | 25 | 9.8 | 34 | 13.3 |
3 | 9 | 3.5 | 9 | 3.5 |
4 | 10 | 3.9 | 13 | 5.1 |
5 | 21 | 8.2 | 29 | 11.4 |
6 | 36 | 14.1 | 40 | 15.7 |
7 | 31 | 12.2 | 35 | 13.7 |
FOIS-R 1–2 Group | FOIS-R 3–7 Group | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
Mean ± SD | Median | n | % | Mean ± SD | Median | n | % | p-Value | ||
Age | 71.4 ± 13.6 | 74 | 129 | 68.0 ± 15.0 | 71 | 126 | 0.048 * | |||
Sex | Male | 80 | 62.0 | 74 | 58.7 | 0.592 | ||||
Female | 49 | 38.0 | 52 | 41.3 | ||||||
BMI (kg/m2) | 20.5 ± 4.4 | 20.2 | 129 | 20.3 ± 4.8 | 20.1 | 126 | 0.63 | |||
Alb | 2.4 ± 0.6 | 2.4 | 129 | 2.5 ± 0.6 | 2.4 | 126 | 0.567 | |||
CRP | 6.0 ± 6.9 | 3.1 | 129 | 5.6 ± 6.0 | 4.1 | 126 | 0.808 | |||
CCI score | 2.4 ± 2.2 | 2 | 129 | 2.6 ± 2.4 | 2 | 126 | 0.752 | |||
Days from hospital admission until NST consultation | 33.0 ± 38.2 | 21 | 129 | 24.7 ± 42.2 | 14 | 126 | 0.005 * | |||
JCS level | 0 | 20 | 15.5 | 61 | 48.4 | <0.001 ** | ||||
I | 70 | 54.3 | 63 | 50.0 | ||||||
II | 20 | 15.5 | 0 | 0.0 | ||||||
III | 19 | 14.7 | 2 | 1.6 | ||||||
DSS score | 2.2 ± 1.5 | 2 | 129 | 5.3 ± 1.2 | 5 | 126 | <0.001 * | |||
1 | 56 | 43.4 | 0 | 0.0 | ||||||
2 | 37 | 28.7 | 1 | 0.8 | ||||||
3 | 15 | 11.6 | 8 | 6.3 | ||||||
4 | 10 | 7.8 | 29 | 23.0 | ||||||
5 | 4 | 3.1 | 29 | 23.0 | ||||||
6 | 4 | 3.1 | 38 | 30.2 | ||||||
7 | 3 | 2.3 | 21 | 16.7 | ||||||
OHAT total score | 5.1 ± 3.2 | 4 | 129 | 4.3 ± 2.9 | 4 | 126 | 0.027 * | |||
OHAT score | Lips | 0.5 ± 0.6 | 0 | 0.4 ± 0.6 | 0 | 0.012 * | ||||
Tongue | 0.8 ± 0.7 | 1 | 0.5 ± 0.6 | 0 | 0.001 * | |||||
Gum/mucosa | 0.5 ± 0.7 | 0 | 0.5 ± 0.6 | 0 | 0.783 | |||||
Saliva | 1.0 ± 0.7 | 1 | 0.6 ± 0.6 | 1 | <0.001 * | |||||
Teeth | 0.5 ± 0.7 | 0 | 0.5 ± 0.8 | 0 | 0.89 | |||||
Dentures | 1.0 ± 1.0 | 1 | 0.9 ± 1.0 | 0 | 0.244 | |||||
Oral cleanness | 0.8 ± 0.8 | 1 | 0.7 ± 0.7 | 0.5 | 0.186 | |||||
Dental pain | 0.2 ± 0.5 | 0 | 0.3 ± 0.6 | 0 | 0.033 * |
Independent Variables | Odds Ratio | 95% Confidence Interval | p-Value |
---|---|---|---|
Age | 1.029 | 0.996 to 1.062 | 0.082 |
Sex a | 0.840 | 0.360 to 1.959 | 0.687 |
BMI | 0.995 | 0.909 to 1.089 | 0.908 |
Alb | 0.731 | 0.359 to 1.488 | 0.387 |
CRP | 1.011 | 0.950 to 1.076 | 0.723 |
CCI | 1.003 | 0.843 to 1.193 | 0.972 |
Days from hospital admission until NST intervention | 0.996 | 0.983 to 1.010 | 0.577 |
JCS | 0.448 | 0.214 to 0.935 | 0.032 * |
OHAT | 1.007 | 0.876 to 1.157 | 0.923 |
DSS | 3.521 | 2.574 to 4.815 | <0.001 * |
Independent Variables | B a | SE b | 95% Confidence Interval | β c | p-Value | Variance Inflation Factor |
---|---|---|---|---|---|---|
Age | 0.004 | 0.006 | −0.009 to 0.016 | 0.044 | 0.563 | 1.337 |
Sex d | −0.005 | 0.171 | −0.344 to 0.333 | −0.002 | 0.975 | 1.138 |
BMI | 0.025 | 0.017 | −0.010 to −0.059 | 0.098 | 0.156 | 1.088 |
Alb | −0.023 | 0.144 | −0.308 to −0.262 | −0.012 | 0.873 | 1.233 |
CRP | 0.027 | 0.015 | −0.001 to −0.056 | 0.137 | 0.063 | 1.221 |
CCI | −0.009 | 0.036 | −0.079 to 0.062 | −0.017 | 0.810 | 1.179 |
Days from hospital admission until NST intervention | −0.001 | 0.002 | −0.005 to 0.003 | −0.038 | 0.580 | 1.078 |
JCS | −0.033 | 0.143 | −0.316 to 0.250 | −0.016 | 0.817 | 1.126 |
OHAT | −0.073 | 0.029 | −0.132 to −0.015 | −0.181 | 0.014 * | 1.200 |
DSS | 0.623 | 0.074 | 0.477 to 0.768 | 0.630 | <0.001 * | 1.270 |
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Furuya, J.; Suzuki, H.; Hidaka, R.; Nakagawa, K.; Yoshimi, K.; Nakane, A.; Yamaguchi, K.; Shimizu, Y.; Itsui, Y.; Saito, K.; et al. Factors Related to Oral Intake of Food by Hospitalized Patients with Malnutrition under the Care of a Nutrition Support Team. Int. J. Environ. Res. Public Health 2021, 18, 11725. https://doi.org/10.3390/ijerph182111725
Furuya J, Suzuki H, Hidaka R, Nakagawa K, Yoshimi K, Nakane A, Yamaguchi K, Shimizu Y, Itsui Y, Saito K, et al. Factors Related to Oral Intake of Food by Hospitalized Patients with Malnutrition under the Care of a Nutrition Support Team. International Journal of Environmental Research and Public Health. 2021; 18(21):11725. https://doi.org/10.3390/ijerph182111725
Chicago/Turabian StyleFuruya, Junichi, Hiroyuki Suzuki, Rena Hidaka, Kazuharu Nakagawa, Kanako Yoshimi, Ayako Nakane, Kohei Yamaguchi, Yukue Shimizu, Yasuhiro Itsui, Keiko Saito, and et al. 2021. "Factors Related to Oral Intake of Food by Hospitalized Patients with Malnutrition under the Care of a Nutrition Support Team" International Journal of Environmental Research and Public Health 18, no. 21: 11725. https://doi.org/10.3390/ijerph182111725