Nutrition Care in the Emergency Department: A Neglected Window for Screening the Frail Older Patient
DOI:
https://doi.org/10.5281/zenodo.22303780Keywords:
Emergency department, Malnutrition screening, Older adults, Frailty, Care pathwaysAbstract
The emergency department sees more older adults than any other point of contact, and nutritional risk is common among them. In
353 older adults screened at one Irish emergency department with the Mini Nutritional Assessment short form, mean age 79.6
years, 7.6 per cent were malnourished and a further 28 per cent were at risk. Those malnourished at the visit had poorer quality of
life and functional ability, were more frail, and at 30 days were more likely to report another hospital admission, a nursing home
admission, reduced quality of life and functional decline. The complication is what the phrase neglected window identifies. A
scoping review of 19 studies found that nutrition care reported in emergency departments is largely limited to screening, with full
assessment, recorded diagnosis and intervention often absent, and screening formed part of a comprehensive geriatric assessment
in only 9 of the 19. How many patients are found also depends on the instrument, with nutritional risk reported at 41.5 per cent
using a tool that incorporates illness severity. The neglected part of the window is not the screening.
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