Effectiveness and cost-effectiveness of early screening and treatment of malnourished patients

Kruizenga, Hinke; Tulder, Maurits W. van; Seidell, J.C.; Thijs, Abel; Adèr, H.J.; Schueren, Marian A.E. de van der

doi:10.1093/ajcn/82.5.1082

Cited by 296 publications

(235 citation statements)

References 15 publications

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“…Along with this, it has been demonstrated that early screening and intervention allow reducing the LOS of at least 1 day per patient (Kruizenga et al, 2005).…”

Section: Discussionmentioning

confidence: 92%

Nutritional care routines in Italy: results from the PIMAI (Project: Iatrogenic MAlnutrition in Italy) study

Cereda

Lucchin

Pedrolli³

et al. 2010

Eur J Clin Nutr

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Background/Objectives: Disease-related malnutrition is a common comorbidity at hospital admission. The purpose of the present report was to describe the data on nutritional care routines collected during the Project: Iatrogenic MAlnutrition in Italy (PIMAI) study, as these may be helpful to avoid iatrogenic malnutrition and improve nutritional policies. Subjects/Methods: Standards of nutritional care were assessed on the basis of (1) adherence to study protocol (completeness of data collected); (2) attitude in assessing the nutritional status; (3) prescription of nutritional therapy (within 3 days) at least in patients presenting with overt malnutrition (body mass index (BMI) o18.5 kg/m 2 or significant weight loss (X10% in 3 months and/or X5% in the last month)), regardless of its adequacy, and adherence to current guidelines and (4) attitude in monitoring nutritional status during the stay (number of weight measurements performed compared with those expected). Results: In total, 1583 subjects were assessed. A minimum data set for performing the Nutritional Risk Screening 2002 tool was available in 1284 patients (81.1%), but nutritional screening was possible in every patient by alternative analytical criteria related to food intake, anthropometry and biochemistry. However, several missing values were recorded, particularly in biochemical parameters due to lack of prescription by admission wards. According to ward practices, only 38.2% of the patients had the BMI calculated. A nutritional support was prescribed only to 26/191 patients (13.6%) presenting with overt malnutrition. Finally, we recorded that only 21.6% of the patients (207/960 were randomly selected) had their weight monitored on a scheduled basis. This reality was worse in surgical rather than medical departments (17 vs 26%; Po0.001). Conclusion: Present results confirm that in Italy, nutritional care routines are still poor and need improvements.

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“…Along with this, it has been demonstrated that early screening and intervention allow reducing the LOS of at least 1 day per patient (Kruizenga et al, 2005).…”

Section: Discussionmentioning

confidence: 92%

Nutritional care routines in Italy: results from the PIMAI (Project: Iatrogenic MAlnutrition in Italy) study

Cereda

Lucchin

Pedrolli³

et al. 2010

Eur J Clin Nutr

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“…Early identification of subjects at risk of malnutrition and those who are already undernourished in different healthcare settings, together with their nutritional management, is essential to be able to minimise the deleterious effects of malnutrition and its negative impact on healthcare spending and the sustainability of the system (17)(18)(19). The European Society for Clinical Nutrition and Metabolism (ESPEN) recommends the Mini Nutritional Assessment (MNA) as the screening (MNA-screening) and assessment (MNA-assessment) instrument in patients over the age of 65 years (20).…”

Section: Introduction and Aimsmentioning

confidence: 99%

Prevalencia de desnutrición en sujetos mayores de 65 años en la Comunidad de Madrid. Estudio DREAM + 65

et al. 2016

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Cuerda C, Álvarez J, Ramos P, Abánades JC, García-de-Lorenzo A, Gil P, de-la-Cruz JJ. Prevalence of malnutrition in subjects over 65 years of age in the Community of Madrid. ResumenIntroducción: la desnutrición relacionada con la enfermedad (DRE) es un problema sociosanitario frecuente que afecta preferentemente a los mayores de 65 años, que aumenta la morbimortalidad y disminuye la calidad de vida.Objetivo: estudiar la prevalencia de DRE en mayores de 65 años en diferentes centros sociosanitarios del Servicio Regional de Bienestar Social de la Comunidad de Madrid.Métodos: estudio transversal en 33 centros sociosanitarios de Madrid (6 centros de atención primaria [AP], 9 centros de mayores [CM], 9 hospitales [H] y 9 residencias [R]) seleccionados mediante muestreo polietápico. Las variables estudiadas fueron edad, sexo, nivel de dependencia según la escala de incapacidad de la Cruz Roja, motivo de ingreso y enfermedad de base, hábitat (urbano-periurbano-rural) y distribución geográfica (norte-centro-sur). Como herramienta de cribado nutricional se utilizó el Mini Nutritional Assessment (MNA-cribaje) en todos los centros. En los pacientes con cribado positivo (en riesgo-desnutrición) se realizó el MNA-evaluación. El estudio estadístico se realizó con el paquete SSS 21.0 e incluyó estadística descriptiva, test de Chi-cuadrado y prueba exacta de Fisher, ANOVA de un factor, Kruskal-Wallis y análisis de regresión logística (RL) binaria univariante y multivariante. Se consideró significación estadística p < 0,05.Resultados: se reclutaron 1.103 sujetos (275 AP, 278 CM, 281 H, 269 R), edad media de 79,5 ± 8,4 años (41,2% varones, 58,8% mujeres). Los sujetos procedentes de H y R tuvieron un mayor grado de incapacidad (p < 0,001). La prevalencia global de DRE fue del 10%, encontrándose un 23,3% en riesgo de desnutrición, con diferencias entre los cuatro tipos de centros sociosanitarios (p < 0,001). El análisis univariante de RL mostró diferencias significativas en la prevalencia de desnutrición según la edad, sexo, grado de dependencia, tipo de centro sociosanitario, hábitat y zona geográfica. Sin embargo, en el análisis multivariante solo el grado de dependencia, el tipo de centro y el hábitat tuvieron significación estadística.Conclusiones: la prevalencia de DRE en mayores de 65 años en la Comunidad de Madrid es del 10%, encontrándose además un 23,3% en riesgo de desnutrición. Las únicas variables que se relacionaron de forma independiente con la desnutrición en el análisis multivariante fueron el nivel de dependencia de los pacientes y el tipo y hábitat de centro sociosanitario. AbstractIntroduction: Disease-related malnutrition (DRM) is a frequent community healthcare problem that predominantly affects adults over 65 years of age and increases morbidity and mortality rates, while also decreasing quality of life.

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“…Nutritional intervention (dietary counselling, oral nutritional supplements, enteral nutrition and parenteral nutrition) has a positive effect on outcome (Odelli et al, 2005;O'Flynn et al, 2005;Stanga et al, 2007) by reducing complication rates, LOS and costs of admission (Elia et al, 2005;Kruizenga et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Comparison of four nutritional screening tools to detect nutritional risk in hospitalized patients: a multicentre study

García²,

et al. 2010

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Background/Objectives: The prevalence of malnutrition in hospitals is high. No nutritional screening tool is considered the gold standard for identifying nutritional risk. The aims of this study were to evaluate nutritional risk in hospitalized patients using four nutritional screening tools. Subjects/Methods: Four nutritional screening tools were evaluated: nutritional risk screening (NRS-2002), the malnutrition universal screening tool (MUST), the subjective global assessment (SGA) and the mini nutritional assessment (MNA). Patients were assessed within the first 36 h after hospital admission. Date of admission, diagnosis, complications and date of discharge were collected. To compare the tools, the results were reorganized into: patients at risk and patients with a good nutritional status. The statistical analysis included the w 2 -test to assess differences between the tests and the k statistic to assess agreement between the tests.

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Effectiveness and cost-effectiveness of early screening and treatment of malnourished patients

Cited by 296 publications

References 15 publications

Nutritional care routines in Italy: results from the PIMAI (Project: Iatrogenic MAlnutrition in Italy) study

Nutritional care routines in Italy: results from the PIMAI (Project: Iatrogenic MAlnutrition in Italy) study

Prevalencia de desnutrición en sujetos mayores de 65 años en la Comunidad de Madrid. Estudio DREAM + 65

Comparison of four nutritional screening tools to detect nutritional risk in hospitalized patients: a multicentre study

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