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Effect of Active Nutrition Care on Underweight Elderly Patients Receiving Long-term Enteral Tube Feeding


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Effect of Active Nutrition Care on Underweight Elderly Patients Receiving Long-term Enteral Tube Feeding

Article information

Korean J Community Nutr. 2018;23(1):48-59
Publication date (electronic) : 2018 February 28
doi : https://doi.org/10.5720/kjcn.2018.23.1.48
Hwa-Young Yoon, Hye-Kyeong Kimorcid_icon
Department of Food Science & Nutrition, The Catholic University of Korea, Bucheon, Korea.
Corresponding author: Hye-Kyeong Kim. Department of Food Science & Nutrition, The Catholic University of Korea, 43 Jibongro, Wonmi-gu, Bucheon, Gyeonggi-do 14662, Korea. Tel: (02) 2164-4314, Fax: (02) 2164-4314, hkyeong@catholic.ac.kr
Received 2018 February 07; Revised 2018 February 21; Accepted 2018 February 21.

Abstract

Objectives

This study was performed to investigate the effect of active nutrition care on feeding and nutritional status of elderly patients receiving long-term enteral tube feeding.

Methods

Subjects included 77 elderly patients who had received enteral nutrition more than one week before admission. Nutrition care was provided to patients supplied less calories than required. Feeding intolerance was examined and managed every day and formula was adjusted to meet nutritional requirement during the first 3 months after admission. Patients were classified into under or over 80% of percent ideal body weight (PIBW) and medical records were used to compare changes in weight,, biochemical indices, and nutritional status during the study.

Results

Weight, BMI, triglyceride and total cholesterol in blood, hemoglobin, and hematocrit levels were significantly lower in patients under 80% of the PIBW than in those over 80% of the PIBW at admission. The percentage of supply to required calories was also lower in patients under 80% of the PIBW. After 1 month of nutritional care, supplied volume of formula was significantly increased in patients under 80% of the PIBW. Weight, BMI, and PIBW were increased and there were no differences between groups after 6 months. In addition, the concentrations of triglyceride and total cholesterol in blood, hemoglobin, and hematocrit tended to increase in patients under 80% of the PIBW, leading to no difference between groups after 3 months.

Conclusions

Personalized active nutrition care is effective to increase weight and improve feeding and nutritional status in underweight elderly patients receiving longterm enteral nutrition.

Keywords: enteral feeding; elderly patients; feeding status; malnutrition

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Copyright © 2018 The Korean Society of Community Nutrition
The Korean Society of Community Nutrition

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Fig. 1

Fig. 1

The protocol of the study

Table 1

Nutritional risk screening

Table 1

PIBW; percentage of ideal body weight, MI; myocardiac infarction, COPD; chronic obstructive pulmonary disease, CRF; chronic renal failure, AIDS; acquired immune deficiency syndrome

Table 2

General characteristics of the patients

Table 2

PIBW; percent of ideal body weight, COPD; chronic obstructive pulmonary disease, T-tube; tracheostomy tube, NG: nasogastric tube, PEG: percutaneous endoscopic gastrostomy tube

1) Means ± SD, 2) N (%), 3) Patient's status to each item were checked and the result is the rate of ‘yes’ to each item

Table 3

Change of enteral feeding status during 6 months of nutrition support

Table 3

RC; required calorie, SC; supplied calorie, SRC; supply to required calorie, RP; required protein, SP; supplied protein, SRP; supply to required protein, PIBW; percent ideal body weight

1) Means ± SD, Mean values with different superscripts are significantly different among the time points in each group at p<0.05 as determined by ANOVA and Duncan's multiple range test, 2) N (%), *: p<0.05, **: p<0.01, ***: p<0.0001 between groups

Table 4

Incidence of feeding intolerance during 6 months of nutrition support

Table 4

PIBW; percent ideal body weight

1) Percent (%) of patients with each intolerance. Feeding intolerance was checked daily for the first 3 months after admission and when referral from doctor was given thereafter.

Table 5

Change of anthropometric data during 6 months of nutrition support

Table 5

PIBW; percent of ideal body weight, BMI; body mass index

1) Means ± SD, Mean values with different superscripts are significantly different among the time points in each group at p<0.05 as determined by ANOVA and Duncan's multiple range test

*: p<0.05 between groups

Table 6

Change of laboratory data during 6 months of nutrition support

Table 6

GOT : glutamate oxalacetate transaminase, GPT: glutamate pyruvate transaminase, TP: total protein, ALB: albumin, TC: total cholesterol, HDL-c: high density lipoprotein cholesterol, TG: triglyceride, LDL-c: low density lipoprotein cholesterol, Hb: hemoglobin, Hct: hematocrit, TLC: total lymphocyte count, PIBW; percent ideal body weight, N/A; not available

1) Means ± SD, Mean values with different superscripts are significantly different among the time points in each group at p<0.05 as determined by ANOVA and Duncan's multiple range test

*: p<0.05 between groups

Table 7

Change of nutritional status during 6 months of nutrition support

Table 7

1) P value from chi-square test between groups at baseline

2) P value from chi-square test between groups after 6 months of nutrition support

3) P value from chi-square test between baseline and 6 months in each group