Description
Malnutrition in hospital is common, particularly in frail older people. Becoming malnourished adversely affects outcome; it is therefore logical to assume that nutritional intervention might improve outcomes in those patients at risk. This paper summarises the available evidence and addresses common ethical difficulties. Summary: Oral nutritional supplements reduce mortality in older patients who are unwell or malnourished. There is no data from the frail elderly population to guide the use of enteral feeding, but its use in critical care and acute stroke suggest that it would be beneficial in acute geriatric illness. Total parenteral nutrition appears to be harmful when used early in acute illness, but may be beneficial in the malnourished when nutritional requirements cannot be met orally or enterally.
