A comparative study evaluating improvements in nutritional status and zinc deficiency by oral and enteral versus parenteral nutrition in elderly inpatients discharged from the internal medicine department of an emergency hospital

Abstract

The controlling nutrition status (CONUT) score assesses the nutritional status of subjects by considering the serum albumin level, total lymphocyte count, and total cholesterol level. We estimated the efficacy of total parenteral nutrition for improving the nutritional status and zinc deficiency. In total, 493 elderly inpatients who were admitted to the internal medicine department of an emergency hospital over 7 years were divided into 2 groups: patients who were discharged (320 patients) and those who died in the hospital (173 patients). The discharged patients were further divided to four groups according time of discharge from the hospital; oral nutrition, enteral nutrition, peripheral parenteral nutrition, and total parenteral nutrition. Using analysis of variance (ANOVA), we compared the albumin and zinc levels and the CONUT score within 10 days post-admission and before discharge from the hospital. Japanese society is rapidly aging. In patients who were leaving the hospital, the CONUT score improved with oral and enteral nutrition. The zinc level improved with oral, enteral, peripheral parenteral, and total parenteral nutrition. While the nutritional status of patients at the time of discharge improved with oral and enteral nutrition, total parenteral nutrition without oral or enteral nutrition did not improve the status. To discharge patients alive, efforts must be made to continue oral and enteral nutrition for as long as possible.