Malnutrition, Rehabilitation
Conditions
Keywords
Rehabilitation, Dietitians, Healthcare costs, MUST-Malnutrition Universal Screening Tool, malnutrition, Nutritional care
Brief summary
The goal of this observational study is to learn about the clinical and economic aspects of specialized nutritional care in participiants at high risk of malnutrition (Malnutrition Universal Screening Tool-MUST equal or higher than 2) admitted to a rehabilitation hospital. The main questions it aim to answer are: * Does a specialized nutritional care lower hospital readmission rate at three months post-discharge in participiants at high risk of malnutrition admitted to a rehabilitation hospital? * Does a specialized nutritional care lower the number of emergency department admissions, number of general practitioner (GP) and outpatient visits, number of diagnostic tests and daily medication use and mortality rate in participiants at high risk of malnutrition admitted to a rehabilitation hospital? Participiants at high risk of malnutrition, three months after discharge were monitored through telephone interview about the hospital readmission and mortality rate, the number of emergency department admissions, GP and outpatient visits, diagnostic tests and daily medication use for treatment burden.
Interventions
OTHERParticipiants at high risk of malnutrition who received standard nutritional care
The overall clinical managment of people by ward's staff includes also nutritional care. Within 24-48 h after hospitalization, the ward's nursing staff screens people for nutritional risk using the Malnutrition Universal Screening Tool (MUST) tool. The attending ward's physician prescribes nutritional support and laboratory analyses in accordance with people's clinical needs and the underlying disease. Ward's physician cllinical judgement guides the decision to reassess and monitor the people's nutritional risk and status.
OTHERParticipiants at high risk of malnutrition who received specialized nutritional care
People referred to the Dietetic and Clinical Nutrition Service (DCNS) receive a structured, evidence-based diagnostic and therapeutic nutritional support. A dietitian performs a dietary assessment and the attending physicians of the DCNS prescribe a baseline set of laboratory analyses relevant for nutritional status. People referred to the DCNS are monitored regularly and systematically, daily or weekly according to the people's clinical condition and nutritional problems.
OTHER3 month-post discharge evaluation
Three months after discharge (follow-up), participiants of both groups were monitored through telephone interview to collect data regarding rate of hospital readmission, number of emergency department admissions, general practitioner visits, outpatient visits, diagnostic tests, daily medication use and survival.
Sponsors
Fondazione Don Carlo Gnocchi Onlus
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
50 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Admission to the rehabilitation hospital IRCCS Fondazione Don Carlo Gnocchi ONLUS, Florence * high risk of malnutrition (Malnutrition Universal Screening Tool-MUST equal or higher than 2)
Exclusion criteria
* age under 50 years; * oncological diagnosis associated with a poor six-month prognosis and/or with advanced or irreversible cachexia; * end-stage renal disease (dialysis); * people already participating in a cardiac rehabilitation program at the time of enrollment; * people with severe acquired brain injuries admitted for neurological rehabilitation.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Hospital readmissions rate | 90 days post discharge | The rate of hospital readmissions at three months post-discharge was computed as number of hospital readmissions from discharge to three-month follow-up. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| General practitioner visits rate | 90 days post-discharge | General practitioner visits rate was computed as the number of general practitioner visits from discharge to three-month follow-up |
| Outpatient visits rate | 90 days post-discharge | The outpatient visits rate was computed as the number of outpatient visits from discharge to three-month follow-up |
| Emergency department admissions rate | 90 days post-discharge | The rate of emergency department admissions was computed as the number of emergency department admissions from discharge to three-month follow-up. |
| Daily medication rate | 90 days post-discharge | Daily medication rate is the number of drugs/day computed from discharge to three-month follow-up |
| Mortality rate | 90 days post-discharge | Mortality rate was computed as the number of participiants dead from discharge to three-month follow-up |
| Diagnostic tests rate | 90 days post-discharge | The diagnostic tests rate was computed as the number of diagnostic tests performed from discharge to three-month follow-up |
Countries
Italy
Outcome results
None listed