Effectiveness and safety of oral nutrition in older patients with moderate dysphagia: a real-world cohort study in geriatric inpatients
Abstract Background Dysphagia and malnutrition increase with age and are correlated with adverse clinical outcomes. Researchers have not fully studied the safety and effectiveness between oral nutrition pathway and tube feeding in dysphagic and malnourished elderly individuals. Methods Elderly indiv...
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2025-07-01
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| Online Access: | https://doi.org/10.1186/s12877-025-06175-2 |
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| author | Mohan Li Shan Jiang Jiaojiao Li Xiling Chen Lan Ma Qihao Guo Yuehui Wang Lan Luo Liping An Yonghua Wu Wei Huang Ludan Yuan Lin Wang Xiping Ding Xujing Zhao Zhongyuan Zhang Hongyu Zhang Yin Wu Rong Yang Yang Liu Jian Cao Xiaohong Liu |
| author_facet | Mohan Li Shan Jiang Jiaojiao Li Xiling Chen Lan Ma Qihao Guo Yuehui Wang Lan Luo Liping An Yonghua Wu Wei Huang Ludan Yuan Lin Wang Xiping Ding Xujing Zhao Zhongyuan Zhang Hongyu Zhang Yin Wu Rong Yang Yang Liu Jian Cao Xiaohong Liu |
| author_sort | Mohan Li |
| collection | DOAJ |
| description | Abstract Background Dysphagia and malnutrition increase with age and are correlated with adverse clinical outcomes. Researchers have not fully studied the safety and effectiveness between oral nutrition pathway and tube feeding in dysphagic and malnourished elderly individuals. Methods Elderly individuals > 65 years old with nutrition risk admitted to the department of geriatrics from 58 third-grade hospitals between September 2020 and December 2022 were recruited. The analysis was conducted in patients with moderate dysphagia. Baseline characteristics, including demography, nutrition, swallowing function and body function, were collected per inclusion. Nutritional suggestions were given by geriatricians and nutritionists. Nutritional therapy pathways were recorded, and the body and functional measurements were repeated at discharge and the 90-day follow-up. Adverse outcomes, including new-onset pneumonia, falls, unplanned readmission and all-cause death were recorded. Results A total of 1027 hospitalized elderly individuals were included, with 168 (16.4%) having moderate dysphagia. Among the participants receiving oral nutrition or tube feeding, 91 (81.3%) and 45 (80.4%) gained sufficient calories after nutritional intervention and were included in the analysis. The median age was 89 (IQR: 82–92) years, 43 (31.6%) were female, and 128 (94.1%) were malnourished. Ninety-one (66.9%) patients were treated with oral nutrition (oral diet or oral nutritional supplements), and 45 (33.1%) were treated with tube feeding. Among the oral nutrition patients, 11 (12.1%), 3 (3.3%), 14 (16.7%) and 2 (2.6%) had new-onset pneumonia, all-cause death, readmission and falls, respectively. The corresponding events in the tube-feeding group were 5 (11.1%), 1 (2.2%), 7 (16.7%) and 1 (2.5%). No statistically significant difference was observed between nutrition treatment pathways. BMI, grip strength and calf circumference increased similarly between the oral nutrition and tube-feeding groups, whereas the percentage of improved MNA-SF status was greater in the oral nutrition group than in the tube-feeding group (53% vs. 26%, p = 0.004). Conclusions Among moderately dysphagic geriatric inpatients with malnutrition or nutritional risk, oral nutritional may demonstrate comparable safety to tube feeding regarding new-onset pneumonia, all-cause death, readmissions, and falls during short term follow-up. Oral nutrition may also demonstrate comparable effectiveness in terms of energy supply and improving function, and oral nutrition may be more effective in improving nutritional status. Trial registration ClinicalTrials.gov: NCT04751032. |
| format | Article |
| id | doaj-art-4d350d5a2a654c13ba771fa00f1e076c |
| institution | DOAJ |
| issn | 1471-2318 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
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| series | BMC Geriatrics |
| spelling | doaj-art-4d350d5a2a654c13ba771fa00f1e076c2025-08-20T03:06:04ZengBMCBMC Geriatrics1471-23182025-07-0125111110.1186/s12877-025-06175-2Effectiveness and safety of oral nutrition in older patients with moderate dysphagia: a real-world cohort study in geriatric inpatientsMohan Li0Shan Jiang1Jiaojiao Li2Xiling Chen3Lan Ma4Qihao Guo5Yuehui Wang6Lan Luo7Liping An8Yonghua Wu9Wei Huang10Ludan Yuan11Lin Wang12Xiping Ding13Xujing Zhao14Zhongyuan Zhang15Hongyu Zhang16Yin Wu17Rong Yang18Yang Liu19Jian Cao20Xiaohong Liu21Department of Geriatrics at Peking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College HospitalDepartment of Geriatrics at Peking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College HospitalDepartment of Geriatrics at Peking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College HospitalDepartment of Geriatrics, The Second Affiliated Hospital of Zhengzhou UniversityDepartment of Geriatrics, The Second Affiliated Hospital of Harbin Medical UniversityDepartment of Geriatrics at Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Geriatrics, The First Hospital of Jilin UniversityDepartment of Geriatrics, Affiliated Hospital of Nantong UniversityDepartment of Geriatrics at Heilongjiang Provincial HospitalDepartment of Geriatrics at Suzhou Municipal HospitalDepartment of Geriatrics at Tangshan Gongren HospitalDepartment of Geriatrics, The First Affiliated Hospital of Jiamusi UniversityDepartment of Geriatrics at Jiangyin People′s HospitalDepartment of Geriatrics, The First Affiliated Hospital of University of Science and Technology of China, Anhui Provincial HospitalDepartment of Geriatrics, Peking University Shougang HospitalDepartment of Geriatrics, Nanjing Tongren Hospital Affiliated to the School of Medicine of Southeast UniversityDepartment of Geriatrics, Qilu Hospital of Shandong UniversityDepartment of Geriatrics at Yingyuan HospitalDepartment of Geriatrics at People’s Hospital of Shanghai Putuo District, Tongji UniversityDepartment of Geriatrics, Tongji Hospital of Tongji UniversityDepartment of Geriatrics, The Second Medical Center, The National Clinical Research Center for Geriatric Diseases, Chinese People’s Liberation Army General HospitalDepartment of Geriatrics at Peking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College HospitalAbstract Background Dysphagia and malnutrition increase with age and are correlated with adverse clinical outcomes. Researchers have not fully studied the safety and effectiveness between oral nutrition pathway and tube feeding in dysphagic and malnourished elderly individuals. Methods Elderly individuals > 65 years old with nutrition risk admitted to the department of geriatrics from 58 third-grade hospitals between September 2020 and December 2022 were recruited. The analysis was conducted in patients with moderate dysphagia. Baseline characteristics, including demography, nutrition, swallowing function and body function, were collected per inclusion. Nutritional suggestions were given by geriatricians and nutritionists. Nutritional therapy pathways were recorded, and the body and functional measurements were repeated at discharge and the 90-day follow-up. Adverse outcomes, including new-onset pneumonia, falls, unplanned readmission and all-cause death were recorded. Results A total of 1027 hospitalized elderly individuals were included, with 168 (16.4%) having moderate dysphagia. Among the participants receiving oral nutrition or tube feeding, 91 (81.3%) and 45 (80.4%) gained sufficient calories after nutritional intervention and were included in the analysis. The median age was 89 (IQR: 82–92) years, 43 (31.6%) were female, and 128 (94.1%) were malnourished. Ninety-one (66.9%) patients were treated with oral nutrition (oral diet or oral nutritional supplements), and 45 (33.1%) were treated with tube feeding. Among the oral nutrition patients, 11 (12.1%), 3 (3.3%), 14 (16.7%) and 2 (2.6%) had new-onset pneumonia, all-cause death, readmission and falls, respectively. The corresponding events in the tube-feeding group were 5 (11.1%), 1 (2.2%), 7 (16.7%) and 1 (2.5%). No statistically significant difference was observed between nutrition treatment pathways. BMI, grip strength and calf circumference increased similarly between the oral nutrition and tube-feeding groups, whereas the percentage of improved MNA-SF status was greater in the oral nutrition group than in the tube-feeding group (53% vs. 26%, p = 0.004). Conclusions Among moderately dysphagic geriatric inpatients with malnutrition or nutritional risk, oral nutritional may demonstrate comparable safety to tube feeding regarding new-onset pneumonia, all-cause death, readmissions, and falls during short term follow-up. Oral nutrition may also demonstrate comparable effectiveness in terms of energy supply and improving function, and oral nutrition may be more effective in improving nutritional status. Trial registration ClinicalTrials.gov: NCT04751032.https://doi.org/10.1186/s12877-025-06175-2DysphagiaMalnutritionNutritional therapyTube feedingOlder inpatients |
| spellingShingle | Mohan Li Shan Jiang Jiaojiao Li Xiling Chen Lan Ma Qihao Guo Yuehui Wang Lan Luo Liping An Yonghua Wu Wei Huang Ludan Yuan Lin Wang Xiping Ding Xujing Zhao Zhongyuan Zhang Hongyu Zhang Yin Wu Rong Yang Yang Liu Jian Cao Xiaohong Liu Effectiveness and safety of oral nutrition in older patients with moderate dysphagia: a real-world cohort study in geriatric inpatients BMC Geriatrics Dysphagia Malnutrition Nutritional therapy Tube feeding Older inpatients |
| title | Effectiveness and safety of oral nutrition in older patients with moderate dysphagia: a real-world cohort study in geriatric inpatients |
| title_full | Effectiveness and safety of oral nutrition in older patients with moderate dysphagia: a real-world cohort study in geriatric inpatients |
| title_fullStr | Effectiveness and safety of oral nutrition in older patients with moderate dysphagia: a real-world cohort study in geriatric inpatients |
| title_full_unstemmed | Effectiveness and safety of oral nutrition in older patients with moderate dysphagia: a real-world cohort study in geriatric inpatients |
| title_short | Effectiveness and safety of oral nutrition in older patients with moderate dysphagia: a real-world cohort study in geriatric inpatients |
| title_sort | effectiveness and safety of oral nutrition in older patients with moderate dysphagia a real world cohort study in geriatric inpatients |
| topic | Dysphagia Malnutrition Nutritional therapy Tube feeding Older inpatients |
| url | https://doi.org/10.1186/s12877-025-06175-2 |
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