P588 - EFFECTIVE INDIVIDUALIZED NUTRITIONAL SUPPORT FOR HOSPITALIZED ADULTS: A SYSTEMATIC REVIEW AND META-ANALYSIS

P588

EFFECTIVE INDIVIDUALIZED NUTRITIONAL SUPPORT FOR HOSPITALIZED ADULTS: A SYSTEMATIC REVIEW AND META-ANALYSIS

J. Ueshima^1,2,3,*, S. Nishioka⁴, K. Maeda^2,5, N. Mori³

¹Department of Nutritional service, NTT Medical Center Tokyo, Tokyo, ²Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, ³Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Aichi, ⁴Department of Nutrition Science, University of Nagasaki, Nagasaki, ⁵Nutrition Therapy Support Center, Aichi Medical University Hospital, Aichi, Japan

Rationale: Malnutrition in hospitalized adults is linked to higher mortality, longer hospital stays, and poor recovery. Identifying effective strategies for individualized nutritional support is essential. This study synthesized evidence on structured interventions to inform best practices.

Methods: We systematically searched Medline, EMBASE, Cochrane Library, and Web of Science for English-language articles (Jan 2001–Oct 2023) including adults (≥18 years) receiving individualized nutritional support during hospitalization. Data on study design, interventions, and outcomes were extracted and verified by multiple authors. Meta-analyses using RevMan 5.4 applied a random-effects model to calculate mean differences (MDs) and risk ratios (RRs). Heterogeneity was assessed with the I² statistic and explored through sensitivity and subgroup analyses. The protocol was registered in PROSPERO (CRD42023489174).

Results: Of 2,060 screened articles, 26 studies (n = 5,889; age 40.9–83.7 years) met inclusion criteria. Key components included time-defined interventions (16), screening (17), assessment (16), and delivery by dietitians or multidisciplinary teams (8 and 9). Most used individualized goal-setting (20) and counseling/education (15). Meta-analysis showed reduced hospital stay (MD −3.77 days; p = 0.002; I² = 96%) and mortality (RR 0.75; p = 0.03; I² = 37%). In non-ICU settings, support improved energy intake (MD +360.1 kcal/day; p < 0.001), protein intake (MD +10.3 g/day; p < 0.001), and body weight during hospitalization (MD +1.20 kg; p = 0.02) and post-discharge (MD +4.45 kg; p < 0.001).

Conclusion: Individualized, structured nutritional interventions—especially those involving early screening, assessment, and personalized goal-setting—improve outcomes. These findings support integrating evidence-based nutrition pathways into routine inpatient care to enhance recovery and optimize resources.

Disclosure of Interest: None declared