Clinical nutrition practice in Italian Gastroenterology Units

Guglielmi, F.W.; Pañella, C.; Losco, Alessandra; Budillon, G; Conte, Dario; Blanco, C. Del Vecchio; Gasbarrini, Giovanni; Loguercio, C.; Merli, Manuela; Mingrone, Geltrude; Nardone, Gerardo; Riggio, Oliviero; Francavilla, A.

doi:10.1016/s1590-8658(00)80003-1

Cited by 8 publications

(3 citation statements)

References 7 publications

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“…Percutaneous endoscopic gastrostomy (PEG) is an established procedure for providing nutrients through the intestine 1,2. Although PEG is simple to perform, it has a general complication rate of up to 50% and major complications occur in up to 7% of cases 3,4,5,6.…”

Section: Introductionmentioning

confidence: 99%

Proton Pump Inhibitor Use before Percutaneous Endoscopic Gastrostomy Is Associated with Adverse Outcomes

Myung

Kim

et al. 2014

Gut Liver

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Background/AimsKnowledge of the risk factors associated with adverse outcomes after percutaneous endoscopic gastrostomy (PEG) may be helpful for developing PEG recommendations. The purpose of this study was to identify the clinical risk factors associated with adverse clinical outcomes after PEG, especially regarding the use of proton pump inhibitors (PPIs).MethodsWe retrospectively reviewed the data from PEG patients at seven university hospitals between June 2006 and January 2012. All patients were followed up through February 2012 after PEG, and the clinical risk factors for adverse clinical outcomes after PEG were analyzed.ResultsData from 1,021 PEG patients were analyzed. PPI users were more frequently included in the complication group than the noncomplication group (p=0.040). PEG-related complications (p=0.040) and mortality (p=0.003) were more frequent in the PPI group than in the control group. In the subgroup analysis of complicated PEG cases, infectious complications were more frequently found in the PPI group than in the control group (35.8% vs 27.8%). After adjustment for multiple possible confounding factors, PPI users (odds ratio, 1.531; 95% confidence interval, 1.017 to 2.305) and diabetic patients had increased mortality after PEG.ConclusionsPPI use may be associated with adverse outcomes in patients with PEG; however, further prospective studies investigating this issue are warranted.

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Section: Introductionmentioning

confidence: 99%

Proton Pump Inhibitor Use before Percutaneous Endoscopic Gastrostomy Is Associated with Adverse Outcomes

Myung

Kim

et al. 2014

Gut Liver

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“…In the same country, 27 % of stroke patients were found undernourished [4]. An Italian multicenter study involving 27 gastroenterology units showed that PEM involved 27 % of the patients with a wide range of prevalence (from 4 to 55 %) in the different participating hospitals [5]. Discrepancies in the prevalence of PEM between different hospitals have been reported also in Ireland and Scotland (11 and 40 %, respectively) [6].…”

Section: Epidemiology Of Malnutritionmentioning

confidence: 99%

“…Many factors influence the nutritional state of the patients including ensuing disease complications but also the absence of adequate nutritional interventions [10]. In the Italian multicenter study mentioned above, for example, only 42 % of malnourished patients received artificial nutrition [5]. Some studies have underlined the relevance of factors such insufficient time allowed for meal consumption, or patient absence during meals or a poor assistance at meal times [11].…”

Section: Epidemiology Of Malnutritionmentioning

confidence: 99%

Update on Hospital Malnutrition

Guarnieri¹,

Antonione²,

Situlin³

et al. 2004

Aktuel Ernahrungsmed

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ZusammenfassungIn den europäischen Krankenhäusern ist die Protein-EnergieMangelernährung (PEM) immer noch weit verbreitet. Überdies ist nicht immer gewährleistet, dass während des Krankenhausaufenthaltes, die Voraussetzungen zur Behandlung von Patienten mit Mangelernährung gegeben sind. Dies kann zu einer Verschlechterung der Unterernährung zur Folge haben und die Risiken der Komplikationen von PEM-Patienten erhöhen sich. Das Resultat kann, durch ein erhöhtes Bewusstsein der Anwesenheit von PEM-Patienten in Krankenhäuser verbessert werden, aber auch durch entsprechende Einführung und Weiterverfolgung der Krankheit und dessen Stadium in dem sich der Patient befindet, wie auch die Durchführung von einem entsprechenden Eingreifen während des Krankenhausaufenthaltes. Neue Errungenschaften über das Wissen von Stoffwechselregulierungen und der Physiopathologie von Unterernährung ermöglichen einen maûgeschneiderten Stoffwechsel als Unterstützung für die speziellen klinischen Anforderungen. Stoffwechseltherapien mit Hormonen und Medikamente sehen auch sehr viel versprechend aus, aber es werden noch weitere Auswertungen benötigt. Ein weit umfassender Bildungsstand in klinischer Ernährung wird benötigt um das Wissen in der täglichen Anwendung weiterzugeben. Schlüsselwörter Protein-Energie-Mangelernährung´Stoffwechsel´Ernährungs-beratung´Unterernährung in Krankenhäuser´ImmunernährungAbstract Protein-energy malnutrition (PEM) has still a high prevalence in European Hospitals. Furthermore, during hopitalization the patient's nutrient requirements may not be met. This may further worsen malnutrition and increase the risk of PEM related complications. Outcome can be improved by an higher awareness of the presence of PEM in hospitalized patients, adequate initial and follow-up assessment of the nutritional status and the implementation of appropriate nutritional interventions during hospital stay. New achivements in the knowledge of the metabolic regulation and the physiopathology of malnutrition allow a tailored nutritional support in specific clinical conditions. Metabolic therapy with hormones and drugs seems also to be promising but it needs further evaluations. More widespread education in clinical nutrition is required to transfer knowledge to everyday clinical practice.

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Assessing body composition in gastrointestinal disorders

et al. 2003

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The assessment of body composition and energy requirements is important for the nutrition of healthy and pathological states such as gastrointestinal disorders, which are known to be associated with abnormalities in body composition among persons with malnutrition and malabsorption. Careful monitoring of body composition is thus recommended for assessing body water compartments, predicting caloric needs and physical performance, and evaluating the development of muscle mass in persons with malabsorption. In the present review we briefly describe the basic body composition models and various techniques used for their assessment and discuss the utility of measuring caloric requirements in persons with gastrointestinal disorders. Assessing body composition may improve the prognosis of malnutrition caused by gastrointestinal disorders and may be useful in monitoring diet treatment.

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Clinical nutrition practice in Italian Gastroenterology Units

Cited by 8 publications

References 7 publications

Proton Pump Inhibitor Use before Percutaneous Endoscopic Gastrostomy Is Associated with Adverse Outcomes

Proton Pump Inhibitor Use before Percutaneous Endoscopic Gastrostomy Is Associated with Adverse Outcomes

Update on Hospital Malnutrition

Assessing body composition in gastrointestinal disorders

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