Impact of nutritional support on clinical outcome in patients at nutritional risk: A multicenter, prospective cohort study in Baltimore and Beijing teaching hospitals

Bin, Jie; Zhu, Jiang; Nolan, Marie T.; Efron, David T.; Zhu, Shai Nan; Yu, Kang; Kondrup, Jens

doi:10.1016/j.nut.2009.08.027

Cited by 102 publications

(88 citation statements)

References 17 publications

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“…3 Our multicenter prospective cohort study has showed that of the patients at nutritional risk, the complication rate was significantly lower in the nutritional-support group than in the no-support group, and multivariate analysis showed nutritional support was a protective factor for complications in at-risk patients when adjusted for confounders. 4 The term nutritional risk is defined by the European Society for Clinical Nutrition and Metabolism (ESPEN) as 'chances of a better or worse outcome from disease or surgery according to actual or potential nutritional and metabolic status' 5 and nutritional screening as a 'rapid and simple process conducted by admitting staff or community health-care teams'. 6 Nutritional risk screening is an essential first step in the structured process of nutrition care for identifying cancer patients that will likely benefit from nutrition therapy, 7,8 but it is not routine in most hospitals in China.…”

Section: Introductionmentioning

confidence: 99%

A multicentre study to implement nutritional risk screening and evaluate clinical outcome and quality of life in patients with cancer

Kang

Zhou

2013

Eur J Clin Nutr

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BACKGROUND/OBJECTIVES: To implement nutritional risk screening and evaluate the relationship of nutritional risk to complication rate and quality of life in patients with cancer. SUBJECTS/METHODS: A total of 687 patients with cancer from two teaching hospitals in China were consecutively enrolled. Data were collected on the nutritional risk screening, application of nutritional support, complication and quality of life. RESULTS: The prevalence of nutritional risk at admission among the total, younger and elderly patients was 45.6%, 38.7% and 58.0%, respectively. There was a significant increase in the prevalence from admission to 2 weeks after admission in all patients (P ¼ 0.011). The prevalence in those patients X70 years was significantly higher than that in the younger ones (Po0.001). The highest prevalence of nutritional risk was in pancreas cancer (81.8%). Only 46.7% of at-risk patients received nutritional support and the average PN:EN ratio was 7.0:1. Complications were noted in 29.0% of all patients and were significantly more frequent in 'at-risk' patients (Po0.001). Among the scales of quality of life (SF-36), the scores of physical functioning (Po0.001), role-physical (Po0.001), bodily pain (P ¼ 0.012), energy/fatigue (Po0.001) and general health (Po0.001) were significant lower in the patients at risk. CONCLUSIONS: A large proportion of cancer inpatients were at nutritional risk and tended to worsen during the course of admission, which has been associated with increased complication rate and lower scores of quality of life. The application of PN and EN was inappropriate in patients with cancer in China.

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Section: Introductionmentioning

confidence: 99%

A multicentre study to implement nutritional risk screening and evaluate clinical outcome and quality of life in patients with cancer

Kang

Zhou

2013

Eur J Clin Nutr

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“…[19] Several studies have shown favorable effects of NS for patients who are at nutritional risk within the ICU. [6,7] According to the systemic review from DeLegge and Kelley, [14] many hospitals and other organizations in the healthcare field have been gradually reducing the number of NSTs lately even with their proven efficacy through literature, because they try to find ways to lower expenses. According to the 2008 survey by the American Society for Parenteral and Enteral Nutrition (ASPEN), only 42% of the respondents, who practice in a hospital setting, reported that they had official NSTs.…”

Section: Discussionmentioning

confidence: 99%

“…According to recommendations by Kondrup et al, an NRS score ≥3 indicates a patient who is nutritionally at risk, and a NRS score <3 means there is no nutritional risk. [7,15] 2.4.2. Severance nutrition screening index.…”

Section: Nutritional Support Teammentioning

confidence: 99%

“…[2] A proactive therapeutic strategy to provide early nutrition support, mainly by the enteral route, may decrease disease severity, reduce complications, shorten length of stay (LOS) in the intensive care unit (ICU), and favorably impact patient outcomes. [2] Several previous studies have shown the effects of nutritional support on clinical outcomes for patients at nutritional risk, [6,7] thus demonstrating the importance of useful nutritional parameters and a nutritional support team (NST) approach to avoid the risk of malnutrition [1,8] in critically ill patients within the ICU. NST as a standardized feeding approach has been shown to both increase appropriate macro-and micronutrient delivery and minimize risks.…”

Section: Introductionmentioning

confidence: 99%

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Impact and Outcomes of Nutritional Support Team Intervention in Patients with Gastrointestinal Disease in the Intensive Care Unit

Park¹,

Lee²,

Hong³

et al. 2017

Gastroenterology

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“…T and/or B lymphocytes in the intestinal mucosa are reduced in patients receiving TPN [20], and intestinal and respiratory IgA levels decrease [21]. Nutrition is a well-known influence on the healing of colonic anostomosis [3,22]. Good nutrition must include adequate intake of energy, nitrogen, vitamins and trace elements [18,23,24].…”

Section: Discussionmentioning

confidence: 99%

The Effects of Early Enteral Nutrition Products on the Healing of Colo-Colonic Anastomosis

Şit¹,

İlgün²,

Çatal³

et al. 2015

Adv Clin Exp Med

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Objectives. Complications after colorectal surgery have not been reduced in recent years. Anastomotic leakage is responsible for nearly all morbidity in colonic surgery and for about one third of the mortality. Material and Methods. For the study, 34 albino Wistar rats (about 155-190 g in weight) were divided into four experimental groups. Each of the rats underwent an abdominal incision and resection of the colon 4 cm distal to the cecum to form a colo-colonic anastomosis. In the post-operative period, the first group (n = 8) were fed with standard rat food and water, the second group (n = 9) with dextrose + Ringer solution, the third group (n = 9) with Biosorb ® (Nutricia, Zoetermeer, The Netherlands), and the fourth group (n = 8) with Impact ® (Novartis Nutrition, USA). Results. The blow-out pressure of the anastomoses was significantly different in the group fed 5% dextrose + + Ringer solution group than in the Biosorb ® and Impact ® groups. Conclusions. None of the various nutrients investigated in the present study were significantly superior to standard foods in terms of the blow-out pressures. On the other hand, immunonutrients were more beneficial effects than other nutrients in terms of the healing of colonic anastomoses and post-operative weight loss (Adv Clin Exp Med 2015, 24, 3, 463-467).

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Impact of nutritional support on clinical outcome in patients at nutritional risk: A multicenter, prospective cohort study in Baltimore and Beijing teaching hospitals

Cited by 102 publications

References 17 publications

A multicentre study to implement nutritional risk screening and evaluate clinical outcome and quality of life in patients with cancer

A multicentre study to implement nutritional risk screening and evaluate clinical outcome and quality of life in patients with cancer

Impact and Outcomes of Nutritional Support Team Intervention in Patients with Gastrointestinal Disease in the Intensive Care Unit

The Effects of Early Enteral Nutrition Products on the Healing of Colo-Colonic Anastomosis

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