https://doi.org/10.4081/gc.2026.15788
37 | Oral nutritional supplementation in geriatric patients hospitalized for sepsis: a prospective randomized study
G. Lacerenza, A. Franceschin, G. Annessi, G. Franceschini, G. Ravazzoni, R.L. Spiaggiari, M.C. Macaluso, G. Gandini, A. Zoboli, L. Franchi | Unità Internistica Multidisciplinare ad Indirizzo Geriatrico Riabilitativo, Ospedale San Sebastiano di Correggio (RE).
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Published: 11 June 2026
Introduction. Malnutrition frequently affects hospitalized older adults under metabolic stress, such as sepsis. Management focuses on ensuring adequate energy/protein intake, with oral nutritional supplements (ONS) recommended when dietary intake is insufficient.
Objectives. This study aims to characterize the nutritional profile of geriatric patients hospitalized with sepsis and evaluate early ONS impact on clinical outcomes.
Materials and Methods. We prospectively randomized 41 septic patients (≥ 65 years), enrolled per Sepsis-3 criteria, to standard care or early ONS. Assessments included Cumulative Illness Rating Scale (CIRS), Activities of Daily Living/Instrumental Activities of Daily Living (ADL/IADL), Short Portable Mental State Questionnaire (SPMSQ), 4A test, Clinical Frailty Scale (CFS), and Multidimensional Prognostic Index (MPI). Nutritional status was evaluated via Mini Nutritional Assessment Short-Form (MNA-SF), Malnutrition Universal Screening Tool (MUST), and laboratory markers. Outcomes included in-hospital/post-discharge mortality (up to 90 days) and length of stay.
Results. Patients showed significant frailty and functional dependence. Malnutrition (MNA-SF: 68.3%) and weight loss >10% (58.5%) were widespread. Cumulative 90-day mortality was 36.6%; risk factors included frailty, low handgrip strength, and high MUST scores. Early ONS showed superior outcomes: significantly higher 30-day (p=0.03) and overall survival (65.4% vs 27%, p=0.047). A trend toward reduced in-hospital mortality was observed (17% vs 83%, p=0.06). ONS did not significantly alter inflammation or length of stay.
Conclusions. Multidimensional assessment is essential for risk stratification. Since early ONS correlates with superior survival, integrating nutritional support into routine sepsis protocols is warranted to optimize recovery and autonomy.
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