Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial

Management of Refeeding Syndrome in Medical Inpatients

“…confirmed RFS have significant mortality rates and increased non-elective hospital readmission, thus confirming the negative effect of RFS on clinical outcome [5,6].…”

“…The awareness of the medical and nursing staff is often too low in clinical practice, leading to under-diagnosis of this complication, which often has an unspecific clinical presentation. This review provides important insights into the RFS, practical recommendations for the management of RFS in the medical inpatient population (excluding eating disorders) based on consensus opinion and on current evidence from clinical studies, including risk stratification, prevention, diagnosis, and management and monitoring of nutritional and fluid therapy.confirmed RFS have significant mortality rates and increased non-elective hospital readmission, thus confirming the negative effect of RFS on clinical outcome [5,6].Nutritional treatment is a central aspect of modern multimodal inpatient therapy. It aims to reduce complications and mortality rates, and to improve patients' quality of life and autonomy [5,7].…”

“…This review provides important insights into the RFS, practical recommendations for the management of RFS in the medical inpatient population (excluding eating disorders) based on consensus opinion and on current evidence from clinical studies, including risk stratification, prevention, diagnosis, and management and monitoring of nutritional and fluid therapy.confirmed RFS have significant mortality rates and increased non-elective hospital readmission, thus confirming the negative effect of RFS on clinical outcome [5,6].Nutritional treatment is a central aspect of modern multimodal inpatient therapy. It aims to reduce complications and mortality rates, and to improve patients' quality of life and autonomy [5,7]. Even though well tolerated, nutritional treatment has a potential risk of complications, including RFS, which is an exacerbated response to the metabolic change from a starvation to a fed state as a consequence of large amount of food in the replenishment phase.…”

Nutritional Management and Outcomes in Malnourished Medical Inpatients in 2020: The Evidence Is Growing!

“…First, the multicenter, randomized, placebo-controlled NOURISH trial (Nutrition effect On Unplanned ReadmIssions and Survival in Hospitalized patients) including 652 older adults affected by malnutrition found that a high-protein oral nutritional supplement containing beta-hydroxy-beta-methylbutyrate was associated with a significant reduction in 90 day mortality, with a number needed to treat (NNT) of 20 [8]. Second, the EFFORT (Effect of early nutritional support on Frailty, Functional Outcomes and Recovery of malnourished medical inpatients Trial) including 2028 medical inpatients at nutritional risk in eight Swiss hospitals showed that protocol-guided individualized nutritional support designed to achieve protein and energy targets results in significantly lower rates of severe complications (NNT = 25) and mortality (NNT = 37) compared to regular hospital food [9,10]. Moreover, functional decline was significantly lower, and quality of life as well as activities of daily living significantly improved.…”

JPEN Journal Club 49. Pilot Trials

“…In the paper that we will consider in this installment of the JPEN Journal Club, Schuetz and coworkers addressed the efficacy of providing nutrition support to hospitalized patients. They described the long‐established association between malnutrition and more unfavorable morbidity and mortality, impaired functional status, prolonged durations of hospital stay, and increased costs as well as the recommendations for providing nutrition support in guidelines .…”