Addressing Disease-Related Malnutrition in Hospitalized Patients: A Call for a National Goal

Guenter, Peggi; Jensen, Gordon L.; Patel, Vihas; Miller, Sarah J.; Mogensen, Kris M.; Malone, Ainsley; Corkins, Mark R.; Hamilton, Cindy W.; DiMaria‐Ghalili, Rose Ann

doi:10.1016/s1553-7250(15)41061-x

Cited by 49 publications

(58 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Due to the recognition of poor outcomes and increased healthcare costs, ASPEN has recommended that addressing malnutrition be considered a national goal 28 . To further this goal, ASPEN has developed a suggested algorithm for the nutrition care of hospitalized patients.…”

Section: Discussionmentioning

confidence: 99%

Difference in Composite End Point of Readmission and Death Between Malnourished and Nonmalnourished Veterans Assessed Using Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition Clinical Characteristics

Hiller

Shaw

Fabri

2016

J Parenter Enteral Nutr

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Difference in Composite End Point of Readmission and Death Between Malnourished and Nonmalnourished Veterans Assessed Using Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition Clinical Characteristics

Hiller

Shaw

Fabri

2016

J Parenter Enteral Nutr

View full text Add to dashboard Cite

show abstract

“…Recommendation 12C: Literature supports PN management by an interprofessional team of clinicians with expertise in nutrition support. To improve quality of patient care and clinical outcomes, it has been suggested that nutrition support teams composed of a physician, a dietitian, a nurse, and a pharmacist, at a minimum, can create an institutional culture where all stakeholders value optimizing clinical nutrition care 13 . Given the complex nature of the PN process that crosses disciplines, collaboration is key to reduce the risk of complications.…”

Section: Question 12: What Strategies Should Healthcare Organizationsmentioning

confidence: 99%

“…While there is limited literature, education in PN prescribing has been associated with decreases in overall PN prescription errors and overfeeding 18 . ‐ 21 Consequently, prescribers from all disciplines should receive education on PN prescribing and monitoring led by clinicians with expertise in nutrition support 13 …”

Section: Question 12: What Strategies Should Healthcare Organizationsmentioning

confidence: 99%

When Is Parenteral Nutrition Appropriate?

Worthington

Balint

Bechtold

et al. 2017

J Parenter Enteral Nutr

Self Cite

164

202

View full text Add to dashboard Cite

Parenteral nutrition (PN) represents one of the most notable achievements of modern medicine, serving as a therapeutic modality for all age groups across the healthcare continuum. PN offers a life-sustaining option when intestinal failure prevents adequate oral or enteral nutrition. However, providing nutrients by vein is an expensive form of nutrition support, and serious adverse events can occur. In an effort to provide clinical guidance regarding PN therapy, the Board of Directors of the American Society for Parenteral and Enteral Nutrition (ASPEN) convened a task force to develop consensus recommendations regarding appropriate PN use. The recommendations contained in this document aim to delineate appropriate PN use and promote clinical benefits while minimizing the risks associated with the therapy. These consensus recommendations build on previous ASPEN clinical guidelines and consensus recommendations for PN safety. They are intended to guide evidence-based decisions regarding appropriate PN use for organizations and individual professionals, including physicians, nurses, dietitians, pharmacists, and other clinicians involved in providing PN. They not only support decisions related to initiating and managing PN but also serve as a guide for developing quality monitoring tools for PN and for identifying areas for further research. Finally, the recommendations contained within the document are also designed to inform decisions made by additional stakeholders, such as policy makers and third-party payers, by providing current perspectives regarding the use of PN in a variety of healthcare settings. (JPEN J Parenter Enteral Nutr. 2017;41:324-377) The etiology-based nutrition diagnoses in adults in clinical practice settings are as follows: Starvation-related malnutrition: Chronic starvation without inflammation (eg, anorexia nervosa). Chronic disease-related malnutrition: Inflammation is chronicand of mild to moderate degree (eg, organ failure, pancreatic cancer, rheumatoid arthritis, sarcopenic obesity). Acute disease or injury-related malnutrition:Inflammation is acute and of severe degree (eg, major infection burns, trauma, closed head injury). 2,3Malnutrition, pediatric: An imbalance between nutrient requirement and intake, resulting in cumulative deficits of energy, protein, or micronutrients that may negatively affect growth, development, and other relevant outcomes. It is recommended that growth charts based on a standard deviation z score system be used to track and assess nutrition status in children. 4,5Nutritionally-at-risk: Consider the individual nutritionally-atrisk if any of the following is present. Nutritionally-At-Risk Adult Summary of RecommendationsThese consensus recommendations are designed to identify best practices, guide day-to-day clinical decisions, reduce variations in practice, and enhance patient safety. They are not intended to supersede the judgment of the healthcare professional based on the circumstances of the individual patient.

show abstract

“…To improve the standards of nutritional care, the Joint Commission on Accreditation of Healthcare Organizations in 1996 mandated completion of nutritional screenings within 24 hours after inpatient admission. 5 A survey conducted in 2012 to 2013 assessed implementation of the mandated screening in various hospital settings. 6 Of the 1,777 respondents 50.8% reported screening within 24 hours, and only 27% of patients were diagnosed with MN via use of a nutrition assessment form, suggesting a lack of precision in diagnosis.…”

Section: Emergence and Significance Of Malnutritionmentioning

confidence: 99%

Emerging Impact of Malnutrition on Surgical Patients: Literature Review and Potential Implications for Cystectomy in Bladder Cancer

et al. 2017

View full text Add to dashboard Cite

Purpose Malnutrition is emerging as a significant factor in patient outcomes. A contemporary review of malnutrition has not been performed for the urologist. We review the available literature and current standards of care for malnutrition screening, assessment and intervention, focusing on patients with bladder cancer treated with cystectomy. Materials and Methods Our multidisciplinary team searched PubMed® for available literature on malnutrition, focusing on definition and significance, importance to urologists, screening, assessment, diagnosis, immunological and economic impacts, and interventions. Results The prevalence of malnutrition in hospitalized patients is estimated to range from 15% to 60%, reaching upward of 71% in those with cancer. Malnutrition has been shown to increase inflammatory markers, further intensifying catabolism and weight loss. Bladder cancer is catabolic and patients undergoing cystectomy have increased resting energy expenditure postoperatively. Data are emerging on the impact of malnutrition in the cystectomy population. Recent studies have identified poor nutritional status based on low albumin or sarcopenia (loss of muscle) as having an adverse impact on length of hospitalization, complications and survival. The current standard of care malnutrition assessment tool, the 2012 consensus statement of the Academy of Nutrition and Dietetics and the American Society for Parenteral and Enteral Nutrition, has not been evaluated in the urological literature. Perioperative immunonutrition in patients undergoing colorectal surgery has been associated with significant decreases in postoperative complications, and recent pilot work has identified the potential for immunonutrition to positively impact the cystectomy population. Conclusions Malnutrition has a significant impact on surgical patients, including those with bladder cancer. There are emerging data in the urological literature regarding how best to identify and improve the nutritional status of patients undergoing cystectomy. Additional research is needed to identify malnutrition in these patients and interventions to improve surgical outcomes.

show abstract

Addressing Disease-Related Malnutrition in Hospitalized Patients: A Call for a National Goal

Cited by 49 publications

References 33 publications

Difference in Composite End Point of Readmission and Death Between Malnourished and Nonmalnourished Veterans Assessed Using Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition Clinical Characteristics

Difference in Composite End Point of Readmission and Death Between Malnourished and Nonmalnourished Veterans Assessed Using Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition Clinical Characteristics

When Is Parenteral Nutrition Appropriate?

Emerging Impact of Malnutrition on Surgical Patients: Literature Review and Potential Implications for Cystectomy in Bladder Cancer

Contact Info

Product

Resources

About