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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:
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Participiants at high risk of malnutrition admitted to a rehabilitation hospital | Participiants at high risk of malnutrition who received standard nutritional care were compared with participiants at high risk of malnutrition who received specialized nutritional care |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Participiants at high risk of malnutrition who received standard nutritional care | Other | 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. |
| Measure | Description | Time Frame |
|---|---|---|
| Hospital readmissions rate | The rate of hospital readmissions at three months post-discharge was computed as number of hospital readmissions from discharge to three-month follow-up. | 90 days post discharge |
| Measure | Description | Time Frame |
|---|---|---|
| Emergency department admissions rate | The rate of emergency department admissions was computed as the number of emergency department admissions from discharge to three-month follow-up. | 90 days post-discharge |
| General practitioner visits rate |
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Inclusion Criteria:
Exclusion Criteria:
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A consecutive series of people at high risk of malnutrition (Malnutrition Universal Screening Tool-MUST equal or higher than 2) admitted to the rehabilitation wards of the IRCCS Fondazione Don Carlo Gnocchi ONLUS.
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| Name | Affiliation | Role |
|---|---|---|
| Maria Luisa E Luisi, MD | IRCCS Fondazione Don Carlo Gnocchi ONLUS | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Fondazione Don Carlo Gnocchi | Florence | 50143 | Italy |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25799486 | Background | Cederholm T, Bosaeus I, Barazzoni R, Bauer J, Van Gossum A, Klek S, Muscaritoli M, Nyulasi I, Ockenga J, Schneider SM, de van der Schueren MA, Singer P. Diagnostic criteria for malnutrition - An ESPEN Consensus Statement. Clin Nutr. 2015 Jun;34(3):335-40. doi: 10.1016/j.clnu.2015.03.001. Epub 2015 Mar 9. | |
| 27642056 | Background |
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|
| Participiants at high risk of malnutrition who received specialized nutritional care | Other | 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. |
|
| 3 month-post discharge evaluation | Other | 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. |
|
General practitioner visits rate was computed as the number of general practitioner visits from discharge to three-month follow-up
| 90 days post-discharge |
| Outpatient visits rate | The outpatient visits rate was computed as the number of outpatient visits from discharge to three-month follow-up | 90 days post-discharge |
| Diagnostic tests rate | The diagnostic tests rate was computed as the number of diagnostic tests performed from discharge to three-month follow-up | 90 days post-discharge |
| Daily medication rate | Daily medication rate is the number of drugs/day computed from discharge to three-month follow-up | 90 days post-discharge |
| Mortality rate | Mortality rate was computed as the number of participiants dead from discharge to three-month follow-up | 90 days post-discharge |
| Cederholm T, Barazzoni R, Austin P, Ballmer P, Biolo G, Bischoff SC, Compher C, Correia I, Higashiguchi T, Holst M, Jensen GL, Malone A, Muscaritoli M, Nyulasi I, Pirlich M, Rothenberg E, Schindler K, Schneider SM, de van der Schueren MA, Sieber C, Valentini L, Yu JC, Van Gossum A, Singer P. ESPEN guidelines on definitions and terminology of clinical nutrition. Clin Nutr. 2017 Feb;36(1):49-64. doi: 10.1016/j.clnu.2016.09.004. Epub 2016 Sep 14. |
| 20502467 | Background | Cereda E, Lucchin L, Pedrolli C, D'Amicis A, Gentile MG, Battistini NC, Fusco MA, Palmo A, Muscaritoli M. Nutritional care routines in Italy: results from the PIMAI (Project: Iatrogenic MAlnutrition in Italy) study. Eur J Clin Nutr. 2010 Aug;64(8):894-8. doi: 10.1038/ejcn.2010.85. Epub 2010 May 26. |
| 22122869 | Background | Lim SL, Ong KC, Chan YH, Loke WC, Ferguson M, Daniels L. Malnutrition and its impact on cost of hospitalization, length of stay, readmission and 3-year mortality. Clin Nutr. 2012 Jun;31(3):345-50. doi: 10.1016/j.clnu.2011.11.001. Epub 2011 Nov 26. |
| ID | Term |
|---|---|
| D044342 | Malnutrition |
| ID | Term |
|---|---|
| D009748 | Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
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