Anne Marie Beck, klinisk diætist, bromatolog, master i gerontologi, ph.d. seniorforsker, Martine Kjærsgaard Nielsen klinisk diætist, cand.scient. klinisk ernæring, ph.d.-studerende, Emma Dalbæk Mejlvang Pedersen, klinisk diætist, Anne Wilkens Knudsen, klinisk diætist, sygeplejerske, cand. scient. i klinisk ernæring, ph.d., forskningsmedarbejder, Tina Munk, klinisk diætist, cand. scient. i klinisk ernæring, ph.d., diætist- og forskningschef. Enheden af Diætister og Ernæringsforskning, EATEN, Herlev og Gentofte Hospital
Resumé
Baggrund
Dehydrering og underernæring er hyppige årsager til akut indlæggelse af ældre og har alvorlige konsekvenser. På nuværende tidspunkt opspores der ikke systematisk for dehydrering og risiko for underernæring i akutmodtagelsen. Derfor blev der udviklet et nyt forløb for opsporing, behandling og opfølgning af risiko for underernæring og dehydrering hos sårbare ældre patienter i akutmodtagelsen (AMA).
Design
Feasibility studie med deltagelse af ældre > 65 år, i risiko for underernæring og/eller dehydreret, inkluderet fra AMA samt fire kommuner.
Metode
Der blev indsamlet kvantitative og kvalitative data ved baseline samt ved opfølgende besøg på ca. dag 4 og ca. dag 30 efter interventionen.
Resultater
60 informanter deltog. Blodprøver viste dehydratio hos 47% og risiko for underernæring hos 97%. Vanlige screening opsporede kun 2 informanter. Opfølgning i kommunalt regi var 100%. 10% faldt fra undervejs, 19% blev genindlagt og 7% døde. Af dem der gennemførte, angav 87%, at være tilfredse med indsatsen i høj eller i meget høj grad.
Konklusion
Forekomsten af dehydrering og risiko for underernæring var høj, men meget få patienter var identificeret i AMA. Projektet var gennemførbart både på sygehuset og i kommunerne og patienterne var tilfredse med deltagelsen.
English abstract
Screening, treatment, and follow‑up of risk of malnutrition and dehydration in frail older patients in the emergency department
Background
Dehydration and malnutrition are frequent causes of acute hospitalisation in older people and have serious consequences. At present, there is no systematic screening for dehydration and risk of malnutrition in the emergency department, which led to the development of a new pathway for screening, treatment, and follow‑up of risk of malnutrition and dehydration in frail older patients in the emergency department (AMA).
Design
Feasibility study including older adults > 65 years at risk of malnutrition and/or dehydrated, recruited from the emergency department and four municipalities.
Method
Quantitative and qualitative data were collected at baseline and at follow‑up visits approximately day 4 and day 30 after the intervention.
Results
Sixty participants were included. Blood samples showed dehydration in 47% and risk of malnutrition in 97%, whereas routine screening identified only two participants. Follow‑up in the municipal setting was 100%; 10% dropped out during the study, 19% were readmitted, and 7% died. Among those who completed the programme, 87% reported being satisfied with the intervention to a high or very high degree.
Conclusion
The prevalence of dehydration and risk of malnutrition was high, yet very few patients were identified in the emergency department. The project was feasible in both the hospital and the municipalities, and patients were satisfied with participating.
Keywords: Older patients, dehydration, malnutrition, emergency department, screening, feasibility study, follow‑up.
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