Evaluation of the benefits of enteral nutrition in long-term care elderly patients.
BACKGROUND
Demented patients may refuse to eat as they come closer to the end of their lives. We evaluated the effectiveness of enteral nutrition in the improvement of survival and nutritional and functional status in very dependent and demented long-term care (LTC) elderly patients and its correlation with the nutritional parameters.


METHODS
Fifty-seven elderly patients, aged 60 years and older, who received nutrition by the enteral route (enteral nutrition group, ENG), were compared with 110 age-, sex-, comorbibity-, cognitive-, and dependent-matched subjects (control group, CG). Indications for enteral nutrition, type of tube; weight status subsequent to enteral nutrition; cognitive, functional, and pressure sore status; and complete clinical, complete blood count, and biochemical profile were recorded for each subject on initiation and conclusion of the study.


RESULTS
Enteral nutrition was associated with improvement in blood count (hemoglobin and lymphocyte count), in renal function tests and electrolytes (BUN, creatinine, BUN/creatinine ratio, sodium and potassium), hydration status, serum osmolarity, and in serum proteins (total protein, albumin, and transferrin), but not in serum cholesterol and CRP levels. Decline in functional and in cognitive status was higher in CG than in ENG (Delta changes; respectively P = .24 and P < .001). ENG had a higher Norton scale than CG (Delta changes; P < .001). Mortality rate was higher in ENG (42%) than in CG (27%, P > .05). Complication rate related to nutrition was higher in ENG than in CG (61% and 34%, respectively; P < .001).


CONCLUSIONS
Enteral nutrition does not have an advantage over oral nutrition in prolonging life or preventing pressure sore development in an LTC setting.
Arinzon
Zeev
Z
The Department of Geriatric Medicine, Sapir Medical Center, Kfar Saba, Israel; Frieda Schiff Warburg, Geriatric Medical Center, Dora, Netanya, Israel.
Peisakh
Alexander
A
Berner
Yitshal N
YN
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia; D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D005851:Geriatric Nursing; D006801:Humans; D008020:Life Support Care; D008134:Long-Term Care; D008297:Male; D009752:Nutritional Status; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies