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Detection and treatment of medical inpatients with or at-risk of malnutrition: Suggested procedures based on validated guidelines

Bounoure, L. and Gomes, F. and Stanga, Z. and Keller, U. and Meier, R. and Ballmer, P. and Fehr, R. and Mueller, B. and Genton, L. and Bertrand, P. C. and Norman, K. and Henzen, C. and Laviano, A. and Bischoff, S. and Schneider, S. M. and Kondrup, J. and Schuetz, P. and Members of the Working, Group. (2016) Detection and treatment of medical inpatients with or at-risk of malnutrition: Suggested procedures based on validated guidelines. Nutrition, 32 (7-8). pp. 790-798.

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Official URL: http://edoc.unibas.ch/56734/

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Abstract

OBJECTIVE: Despite the high prevalence of malnutrition in the general inpatient population, there is a lack of knowledge in regard to detecting disease-related malnutrition and implementing nutritional support. Our aim was to suggest practical procedures for screening and treating malnourished or at-risk patients hospitalized in medical wards, thereby fostering a straightforward implementation of nutritional therapy independent of the underlying disease and comorbidities. METHODS: A working group of experts in clinical nutrition selected and analyzed published disease-specific European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines relevant for our aim. Eight questions in population, intervention, control, outcome format were defined to cover topics such as screening, nutritional targets, and routes of feeding. Individual studies were extracted from the guidelines by applying inclusion and exclusion criteria targeting the heterogeneous population of medical inpatients with or at-risk of disease-related malnutrition. We used those studies as evidence, as well as recommendations from the selected ESPEN guidelines, to formulate answers to the questions. Final agreement with the statement was obtained by consensus of the whole working group. RESULTS: Procedures on how to provide integrated nutritional therapy (oral, enteral, and parenteral) to a heterogeneous patient population were suggested, including how to identify malnourished or at-risk patients, nutrient targets, choice of feeding route, monitoring, and assessment of patients. We also developed a simple algorithm to facilitate the implementation of a nutritional care plan for the general medical inpatient population. CONCLUSION: By compiling evidence and recommendations from disease-specific guidelines, we were able to suggest a nutritional strategy applicable to large and heterogeneous group of malnourished or at-risk patients admitted to hospitals. A large randomized controlled trial is currently investigating whether this strategy improves clinical outcomes of patients.
Faculties and Departments:03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Allgemeine innere Medizin AG > Argovia Professur für Medizin (Müller)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Allgemeine innere Medizin AG > Argovia Professur für Medizin (Müller)
UniBasel Contributors:Müller, Beat
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Elsevier
ISSN:0899-9007
e-ISSN:1873-1244
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:05 Dec 2017 11:18
Deposited On:05 Dec 2017 11:18

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