Malnutrition
Conditions
Keywords
Hospital malnutrition, Nutritional Status, Nutrition Assessment, Enteral Nutrition, Parenteral Nutrition, Severity of illness index, cost analysis
Brief summary
The purpose of this study is to determine whether there is a positive correlation between an evidence based clinical nutrition concept and relevant clinical outcomes in malnourished hospitalised patients when severity of disease is adjusted.
Detailed description
Patients have been consecutively screened at admission by SGA (Subjective-Global-Assessment)-Score and NRS 2002 (Nutritional-Risk-Screening)-Score in the departments of surgery and internal medicine. The nutrition status of each patient is combined with clinical data, utilization data and direct costs on the basis of clinical homogenous patient clusters. Risk-Adjustment was provided by the Disease-Staging-Scale (MEDSTAT/Thomson Healthcare, Ann Arbor MI), which allows patient classification by diagnosis and co morbidities including age and gender. The risk adjustment scales run by routine data sets from german inpatient G-DRG system. In the control period the effects of usual nutrition care are documented. During the intervention period an implementation of an interdisciplinary evidence-based guideline for screening and clinical nutrition was introduced in each participating hospital. The issue is to describe the relation between risk-adjusted malnutrition status and clinical outcomes and costs.
Interventions
BEHAVIORALevidence based clinical nutrition concept
The evidence based nutrition concept comprise a routine malnutrition screening for hospitalized patients, the implementation of an evidence based guideline for clinical nutrition in the participating hospital, education training of the clinical staff and thereby optimal clinical nutrition for malnourished hospitalized patients.
BEHAVIORALcare as usual
Unchanged treatment of hospital patients without interference by the study.
Sponsors
Charite University, Berlin, Germany
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* at least 18 years of age * internal or operative admission diagnosis in participating hospitals
Exclusion criteria
* Patients with demand for emergency care * Patients with demand for intensive care * Patients with hospital day-care * Patients unwilling to participate or unable to comply with the protocol in the control group
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Length of hospital stay | At least 3 months each group, 6 months for both groups |
Secondary
| Measure | Time frame |
|---|---|
| all cause hospital mortality | At least 3 months each group, 6 months for both groups |
| complication rate | At least 3 months each group, 6 months for both groups |
| hospital readmission rate | 1 Month each group |
| Economic devices (direct costs of inpatient care and reimbursement) | At least 4 months each group, 7 months for both groups |
Countries
Germany
Outcome results
None listed