Denutrition
Conditions
Keywords
denutrition, hospital length of stay, patient's autonomy
Brief summary
Denutrition is defined as a measurable decrease in functions and/or as change in the body composition, associated with a worsening of the prognosis of the underlying medico-surgical pathology. It is induced by a deficiency in energy, proteins or any other micro or macronutrient and is the result of malnutrition, itself caused by a poor diet or a metabolic disorder. According to the National Nutrition and Health Plan for Belgium, denutrition is an independent risk factor for the increase of complications, morbidity and mortality rates, average length of hospitalisation and global medical care cost. It is necessary to invest in the prevention of denutrition as the costs of preventive measures are lower than the cost of treating a denutrished patient. The Belgian financing system of hospitalisation days is based on the structure of the treated pathologies, the age of the patient and the geriatric features of the patient. It encourages all hospitals to lower the length of hospitalisation to the national average for all these criteria. As a consequence, there is a mounting tendency to shorten the average length of stay within the hospital. The so-called 'Sp' hospital departments occupy a specific place within the organisation of Health Services in Belgium. They are specialized in the treatment and rehabilitation of patients with cardiopulmonary, neurological, locomotor, psycho-geriatric and chronic diseases. These services act as an extension of acute services (continuity of acute hospitalisation) but also as a first entry point for the medical care of patients with various specific diseases (multiple sclerosis, psycho-geriatric disorders, chronic pulmonary disorders...). The financing of the Sp departments is, as opposed to the financing of other departments, not linked to the patient length of stay. However, an increase in hospitalization duration decreases the rate of admissions and the possibility to accept patients coming from acute hospital units. The aim of the study is to evaluate the influence of denutrition of patients hospitalized in an Sp department on the length of revalidation stay, the associated costs and the patient's functional autonomy.
Interventions
A first nutritional evaluation will be performed within 48h of patient admission. Weight and BMI will be measured once a week.
An assessment of muscular force will be performed once a week.
Dosage performed once a month.
Sponsors
Study design
Eligibility
Inclusion criteria
* All patients admitted within a revalidation unit of the CHU Brugmann hospital
Exclusion criteria
* Patients without programmed exit: transfer to another care unit, forced exit, death...
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Barthel index score | within 48h of admission within the revalidation unit | Assessment of patient autonomy |
| Nutritional Risk Screening score | within 48h of admission within the revalidation unit | Nutritional state assessment |
| Body Mass Index | once a week up to patient discharge (the average hospitalization length within the revalidation unit is 48 days) | — |
| Weight | once a week up to patient discharge (the average hospitalization length within the revalidation unit is 48 days) | — |
| Hand prehension force | once a week up to patient discharge (the average hospitalization length within the revalidation unit is 48 days) | performed on the right hand with a Jamart dynamometer |
| Pre-albumine level (mg/l) | once a week up to patient discharge (the average hospitalization length within the revalidation unit is 48 days) | Laboratory testing |
Countries
Belgium