Enteral nutrition in nursing home residents: a 5-year (2001-2005) epidemiological analysis.
BACKGROUND
Despite controversy and increasing use of enteral nutrition (EN) among elderly people, descriptive population-based data are scarce. The aim of this study was to evaluate the epidemiological data of nursing home residents (NHRs) who received EN in a northeast area of Italy.


METHODS
All NHRs referred to our Nutrition Service for EN between 2001 and 2005 were enrolled. Data collected at EN initiation included age, gender, underlying disease, Karnofsky index, type of enteral access device, presence of pressure ulcers, weight, body mass index, and daily enteral intake. The outcomes considered were patient survival and duration of therapy.


RESULTS
The 482 NHRs (130 males; 352 females) received EN. The mean incidence (cases/million population/year) and prevalence (cases/million population) were 223.4 and 279.4, respectively. An average of 6.6% of all NHRs were tube fed. EN was prescribed for the following conditions: 27.7% cerebrovascular accident, 54.6% neurodegenerative disease, 2.7% head and neck cancer, 1.2% abdominal cancer, 1.3% head trauma, 4.8% congenital disease, 7.7% other. Almost all patients had a Karnofsky index <or=50; 42.3% of patients had pressure ulcers. The median duration of EN was 296 days and the median overall survival was 411 days.


CONCLUSIONS
NHRs receiving EN were mainly afflicted with neurodegenerative and cerebrovascular diseases, functional impairments, and a high incidence of pressure sores. The mortality rate was low compared with others reported in literature. The low EN use among NHRs in our study may suggest a limited use in advanced dementia and at end-stage of life.
Nutrition and Diabetic Unit, Treviso Healthcare Authority, Italy. apaccagnella@ulss.tv.it
Michela
M
Morello
Maria L
ML
Marcon
Alessandro
A
Laviano
Marta
M
Giometto
Carla
C
Baruffi
Elisa
E
Zulian
Paolo
P
Cenerelli
Pierpaolo
P
Faronato
Michele
M
Tessarin
Amos
A
Conte
Agostino
A
Paccagnella
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002561:Cerebrovascular Disorders / Q000453:epidemiology / Q000628:therapy; D004750:Enteral Nutrition / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008134:Long-Term Care / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D019636:Neurodegenerative Diseases / Q000453:epidemiology / Q000628:therapy; D009735:Nursing Homes / Q000706:statistics & numerical data*; D003668:Pressure Ulcer / Q000453:epidemiology; D015995:Prevalence; D016019:Survival Analysis