A prospective study of outcome from protein-energy malnutrition in nursing home residents

To study recovery from protein-energy malnutrition in patients newly admitted to a chronic care facility, biochemical and anthropomorphic malnutrition indicators were measured prospectively over a 2-month period. Subjects were observed for a mean of 76 +/- 18 days after admission. Factors which might affect nutritional status including method of feeding, energy prescribed, use of supplemental feedings, assistance in eating, and amount of diet consumed were recorded. Confounding variables including illness, mental status, functional status, or prescription drugs were evaluated for their impact. On the basis of an empiric nutrition score, 54% of newly admitted residents were malnourished. Improvement in nutritional score occurred in 63% of malnourished patients remaining in the facility whereas 37% remained malnourished. Two related factors, percentage of diet consumed and degree of assistance required in eating, were important differences in the outcome of patients remaining malnourished. Interventional studies to determine whether outcome can be improved by more aggressive feeding methods or by feeding teams need to be undertaken.