Effects of malnutrition on complication rates, length of hospital stay, and revenue in elective surgical patients in the G-DRG-system

Thomas, Michael N.; Kufeldt, Johannes; Kisser, Ulrich; Hornung, H; Hoffmann, J. N.; Andraschko, Monika; Werner, Jens; Rittler, P.

doi:10.1016/j.nut.2015.08.021

Cited by 125 publications

(98 citation statements)

References 21 publications

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“…[2][3][4] It is estimated that 24%-65% of patients undergoing surgery are at nutrition risk. 3,[5][6][7] Additionally, recent prospective observational data indicate that undernourished patients or patients at risk of malnutrition are twice as likely to be readmitted within 30 days after elective colorectal surgery. 8 As defined by the National Surgical Quality Improvement Program, malnutrition is among the few modifiable preoperative risk factors associated with poor surgical outcomes, including mortality, in surgical patients.…”

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confidence: 99%

American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Nutrition Screening and Therapy Within a Surgical Enhanced Recovery Pathway

Wischmeyer

Carli

Evans

et al. 2018

Anesthesia &Amp; Analgesia

332

327

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Perioperative malnutrition has proven to be challenging to define, diagnose, and treat. Despite these challenges, it is well known that suboptimal nutritional status is a strong independent predictor of poor postoperative outcomes. Although perioperative caregivers consistently express recognition of the importance of nutrition screening and optimization in the perioperative period, implementation of evidence-based perioperative nutrition guidelines and pathways in the United States has been quite limited and needs to be addressed in surgery-focused recommendations. The second Perioperative Quality Initiative brought together a group of international experts with the objective of providing consensus recommendations on this important topic with the goal of (1) developing guidelines for screening of nutritional status to identify patients at risk for adverse outcomes due to malnutrition; (2) address optimal methods of providing nutritional support and optimizing nutrition status preoperatively; and (3) identifying when and how to optimize nutrition delivery in the postoperative period. Discussion led to strong recommendations for implementation of routine preoperative nutrition screening to identify patients in need of preoperative nutrition optimization. Postoperatively, nutrition delivery should be restarted immediately after surgery. The key role of oral nutrition supplements, enteral nutrition, and parenteral nutrition (implemented in that order) in most perioperative patients was advocated for with protein delivery being more important than total calorie delivery. Finally, the role of often-inadequate nutrition intake in the posthospital setting was discussed, and the role of postdischarge oral nutrition supplements was emphasized.

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mentioning

confidence: 99%

American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Nutrition Screening and Therapy Within a Surgical Enhanced Recovery Pathway

Wischmeyer

Carli

Evans

et al. 2018

Anesthesia &Amp; Analgesia

332

327

View full text Add to dashboard Cite

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“…Malnutrition has previously been shown to be associated with increased hospital LOS and mortality rates. These reports were in smaller and international studies using other validated screening tools for malnutrition . However, few studies have validated the 2012 AND/ASPEN characteristics for diagnosing malnutrition in large populations.…”

Section: Discussionmentioning

confidence: 99%

“…These reports were in smaller and international studies using other validated screening tools for malnutrition. [4][5][6][7][8][9][10][11] However, few studies have validated the 2012 AND/ASPEN characteristics for diagnosing malnutrition in large populations. Our study justifies the clinical relevance of the AND/ASPEN characteristics by demonstrating, with highly sensitive and specific use of the criteria, the effects of severe malnutrition in critically ill patients on hospital LOS, total ICU LOS, and mortality rates.…”

Section: Discussionmentioning

confidence: 99%

“…Among critically ill patients assessed by the AND/ASPEN criteria in the intensive care unit (ICU) (n = 327), Ceniccola et al showed that patients with malnutrition had significantly increased mortality rates compared with patients without malnutrition . Most studies that have explored the effects of malnutrition on LOS or mortality have had small sample sizes, were conducted internationally, or have used other validated screening tools . By validating these characteristics in larger hospital settings, we can demonstrate the importance of standardizing the data collection process and begin to elucidate relevant diseases or conditions associated with malnutrition.…”

Section: Introductionmentioning

confidence: 99%

“…3 Most studies that have explored the effects of malnutrition on LOS or mortality have had small sample sizes, were conducted internationally, or have used other validated screening tools. [4][5][6][7][8][9][10][11] By validating these characteristics in larger hospital settings, we can demonstrate the importance of standardizing the data collection process and begin to elucidate relevant diseases or conditions associated with malnutrition.…”

Section: Introductionmentioning

confidence: 99%

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Malnutrition Diagnosis in Critically Ill Patients Using 2012 Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition Standardized Diagnostic Characteristics Is Associated With Longer Hospital and Intensive Care Unit Length of Stay and Increased In‐Hospital Mortality

Hiura

Lebwohl

Seres

2019

J Parenter Enteral Nutr

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Background Standardized diagnostic criteria for malnutrition were developed by the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition (AND/ASPEN) in 2012. The criteria as a whole has had little validation, and the effect of underlying condition on the impact of malnutrition has not been well studied. We measured the association between severe malnutrition and hospital length of stay (LOS), intensive care unit (ICU) LOS, and mortality among critically ill inpatients. Methods We analyzed hospital records from 5606 patients whose admission included an ICU stay. Associations between severe malnutrition and LOS and mortality were examined by multivariable linear and logistic regression. Results Thirteen percent were diagnosed with severe malnutrition. These had significantly longer hospital LOS (18 [interquartile range 10–35] days vs 8 [5–14] days), total ICU LOS (7 [3–15] days vs 3 [1–6] days) and in‐hospital mortality (odds ratio [OR] 2.78, 95% confidence interval [CI] 2.33‐3.31), compared with those without severe malnutrition. After adjusting for demographics, we found significant interactions between severe malnutrition and ICU location. Patients with malnutrition in the cardiothoracic surgery ICU experienced the largest increases in hospital LOS (21.10 days, 95% CI 18.58‐23.61), ICU LOS (12.14 days, 95% CI 10.41‐13.87), and in‐hospital mortality (OR 8.78, 95% CI 5.11‐15.07). Conclusion Critically ill patients diagnosed with severe malnutrition based on the AND/ASPEN diagnostic characteristics experienced longer hospital and ICU LOS and increased mortality. The magnitude of effect of malnutrition was modified by ICU location, underscoring the need to identify the major comorbidities associated with malnutrition.

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The Journal of Cachexia, Sarcopenia and Muscle stays the front‐runner in geriatrics and gerontology

Anker

Coats

et al. 2019

J cachexia sarcopenia muscle

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This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. also looked at the top cited scientific papers ever published in the three journals (Tables 10-12) and found that on average, the top 10 papers in JCSM were cited 152 times, in Nutrition 670 times, and in JNHA 406 times-which is mainly due to the fact that Nutrition has been listed in Scopus 265 since 1987 and JNHA since 1997, while JCSM started only in 2010. So far, JCSM has published 563 papers, Nutrition 6198 papers, and JNHA 2396 papers. On average, JCSM has published 56 papers/year, Nutrition 188 papers/year, and JNHA 104 papers/year, which of course are major determinants of the respective journal's impact factor. This also underscores that all three journals have different approaches towards the number of papers published per year. We are grateful and look forward to more submissions of excellent research in the field of wasting and muscle disorders and are confident to maintain high quality in the Journal.

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Effects of malnutrition on complication rates, length of hospital stay, and revenue in elective surgical patients in the G-DRG-system

Cited by 125 publications

References 21 publications

American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Nutrition Screening and Therapy Within a Surgical Enhanced Recovery Pathway

American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Nutrition Screening and Therapy Within a Surgical Enhanced Recovery Pathway

The Journal of Cachexia, Sarcopenia and Muscle stays the front‐runner in geriatrics and gerontology

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