Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
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SHR Neuro Krebs Kardio Lipid Stoffw Microb
Tribolet, P; Fehr, R; Bachli, V; Geiser, M; Toplak, H; Stanga, Z; Schuetz, P.
What are Barriers of Nutritional Therapy in Malnourished Medical Inpatients? An Observational Study
AKTUEL ERNAHRUNGSMED. 2017; 42(3): 167-179.
Doi: 10.1055/s-0043-109233
Web of Science
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- Co-Autor*innen der Med Uni Graz
- Toplak Hermann
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- Abstract:
- Background Malnutrition is a frequent problem in daily clinical practice and associated with complications, longer hospitalisation and poor outcomes. Use of clinical nutrition is important to prevent these negative aspects, but the efficiency of nutritional therapy is variable and may have several barriers in clinical practice. Herein, the aim of this paper was to examine the feasibility of a new-established nutritional algorithm in everyday clinical practice in a hospital setting and to study potential barriers for the success of nutritional therapy. Methods This is an observational sub-study of the EFFORT-trial, a Swiss-wide, multicenter, randomized, controlled intervention study, which is investigating the effect of nutritional therapy on malnourished, hospitalized, medical patients. The patients were treated according to a clearly defined nutritional algorithm, with the aim of an accurate supply of energy and protein. Based on food diaries the energy and protein target were calculated. To associate not-achieved energy and protein goals and predefined predictors, a multivariate, logistical regression has been used for calculation. Results A total of 581 patients were included in this analysis, whereas most of them reached the nutritional goals (83.3% of all patients reached the energy target and 78.7% the protein target on at least one of the first five days in hospital). According to the multivariate, regression analysis, there was no difference reaching the goals, in regard of age, gender, main diagnosis and comorbidities. Only the loss of appetite has been shown to be a protective factor reaching the energy goals (Odds Ratio [OR] loss of appetite, yes: 0.53, 95% CI, 0.3 to 0.94; p = 0.03). A higher BMI was considered to be a risk factor to not-achieve protein goals (OR per BMI unit [kg/m(2)]: 1.05, 95% CI 1.01 to 1.09; p = 0.02). Conclusions This study shows the feasibility of the nutritional algorithm, as most patients reached their nutritional goals with oral nutrition and without the need for further escalation of enteral or parenteral nutrition. If goals are not reached, an individual assessment is necessary to improve the nutritional care.
- Find related publications in this database (Keywords)
- malnutrition
- NRS-2002
- EFFORT-trial
- nutritional algorithm
- nutritional therapy