Severe Malnutrition
Conditions
Keywords
severe malnutrition, Critically Ill, refeeding syndrome, guideline
Brief summary
Severe malnutrition can be seen as a low BMI, great weight loss, and even low levels of micronutrients. Current studies on severe malnutrition are mainly in patient with anorexia nervosa. The refeeding phase of these high-risk patients bears a further threat to health and potentially fatal complications (such as refeeding syndrome, infection and severe arrhythmia). The objective of this study is to investigate complications due to refeeding of patients with severe malnutrition, as well as their mortality rate, establish and modify the guideline for management of severe malnutrition in Peking University Third Hospital.
Detailed description
Severe malnutrition can be seen as a low BMI, great weight loss, and even low levels of micronutrients. Current studies on severe malnutrition are mainly in patient with anorexia nervosa. The refeeding phase of these high-risk patients bears a further threat to health and potentially fatal complications (such as refeeding syndrome, infection and severe arrhythmia). Intensive care unit of Peking University Third Hospital (PUTH) has treated several patients with severe malnutrition successfully since 2008. Most of these patients had a BMI \< 10 (kg/m2) at admission. After admission, a multidisciplinary team, consisting of specialists in the field of intensive care, pharmacy, psychology, and physical therapy assessed all patients. Most of the treatment has been regarded successful with a significant BMI gain and little in-hospital mortality. Based on long-term clinical experience, as well as on evidence-based literature, PUTH nutrition group developed a guideline version 1.0 for the treatment of severe malnutrition in August, 2015. The objective of this study is to investigate complications due to refeeding of patients with severe malnutrition, as well as their mortality rate, establish and modify the guideline for management of severe malnutrition in PUTH. This is a single-center, ambispective cohort study. Patients who meet the inclusion and exclusion criteria will be included in our registry. As a non-intervention study, these information as below will be collected: reason for admission, relevant medical history, basic demographic characteristics,anthropometric and clinical data, specific nutrition support regimen and outcomes.
Interventions
OTHERmanagement of severe malnutrition
multidisciplinary assessment; guideline for the management of severe malnutrition in PUTH
Sponsors
Peking University Third Hospital
Study design
Observational model
COHORT
Time perspective
OTHER
Eligibility
Sex/Gender
ALL
Age
16 Years to No maximum
Inclusion criteria
* Patients with severe malnutrition, admitted to PUTH from JAN 2008. (Severe malnutrition is defined as a body mass index (ratio of weight in kg divided by height in m2) \< 13) * Management and treatment are in accordance with guideline version 1.0 for the treatment of severe malnutrition in PUTH. * Patients requiring intensive care unit management who developed life-threatening complications (such as severe fluid/electrolyte disorders, severe arrhythmia) or had single-organ/multiorgan dysfunction.
Exclusion criteria
* Presence of malignancy. * Life expectancy of less than 24 hours * Presence of advanced Acquired Immunodeficiency Syndrome (AIDS) * Aged \< 16 years
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 28-day change of BMI | from admission to 28-day/discharge, an average of length of ICU stay is 28-day |
| All-cause 28-day mortality | from admission to 28-day |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The rate of complications | from admission to discharge, an average of length of ICU stay is 28-day | — |
| Length of ICU stay | from admission to discharge of ICU, an average of length of ICU stay is 28-day | — |
| The rate of infection in ICU | from admission to discharge of ICU, an average of length of ICU stay is 28-day | — |
| All-cause mortality within six month | from admission to six month | — |
| Length of hospital stay | from admission to discharge of hospital, an average of length of hospital stay is three-month | — |
| Cost-effectiveness of treatment | from admission to discharge of ICU (an average of length of ICU stay is 28-day), from admission to discharge of hospital (an average of length of hospital stay is three-month) | The outcome is the incremental cost of preventing one treatment failure of refeeding syndrome, infection, and all-cause mortality. |
| The rate of refeeding syndrome | from admission to discharge, an average of length of ICU stay is 28-day | — |
Countries
China
Contacts
Primary ContactQinggang Ge, M.D.
Backup ContactXiaoxiao Li, MSc
Outcome results
None listed