EuroOOPS: An international, multicentre study to implement nutritional risk screening and evaluate clinical outcome

Sorensen, Janice; Kondrup, Jens; Prokopowicz, Jacek; Schiesser, Marc; Krähenbühl, L.; Meier, Rémy; Liberda, Martin

doi:10.1016/j.clnu.2008.03.012

Cited by 512 publications

(451 citation statements)

References 23 publications

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“…As assessed by the NRS-2002, the percent of patients nutritionally at-risk on hospital admission was reported to range from 20 to 39.9% in Denmark (24,25), 39.0% in Beijing (26), 51.0% in Baltimore (26), 24.5% in Turkey (2) and 32.6% in a recent multinational study comprised of 12 countries in Europe (27).…”

Section: Discussionmentioning

confidence: 99%

“…Although the percent of patients with malnutrition at hospital admission was reported to range from 13% to 100% in relation to heterogeneity of the patient populations from various specialities, regions and departments (27), only a minority of inpatients at risk for malnutrition were reported to actually receive appropriate nutrition during hospitalization, with sufficient nutritional support available only for 14.7 to 25% of at-risk patients (24,25,27). Hence, the results from SUSTAIN and previous studies should be considered in the context of the nutritional management strategy for each patient.…”

Section: Discussionmentioning

confidence: 99%

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A study in four European countries to examine the importance of sensory attributes of oral nutritional supplements on preference and likelihood of compliance

Ozcagli¹,

Stelling²,

Stanford³

2013

Turk J Gastroenterol

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A study in four European countries to examine the importance of sensory attributes of oral nutritional supplements on preference and likelihood of compliance

Ozcagli¹,

Stelling²,

Stanford³

2013

Turk J Gastroenterol

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“…Later, HEI was expressed as a percentage of the energy requirement. Low energy intake was defined as energy intake below 75% of the individual energy requirement (HEI/ ER<75%) (26,31) .…”

Section: Assessment Of Habitual Energy Intake (Hei)mentioning

confidence: 99%

“…For many years, many studies have reported undesirable outcomes that may occur during the hospital stay of patients diagnosed with malnutrition or even at some nutritional risk (28,31) . These findings have been observed in patients with neoplasms, digestive tract diseases, and other clinical situations (22,24,31) .…”

Section: Introductionmentioning

confidence: 99%

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Relationship Between Nutritional Status and the Clinical Outcomes of Patients With and Without Neoplasms According to Multiple Correspondence Analysis

Leandro-Merhi

Aquino

2017

Arq. Gastroenterol.

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-Background -For many years, many studies have reported undesirable outcomes that may occur during the hospital stay of patients diagnosed with malnutrition or even at some nutritional risk. Objective -To investigate the relationship between nutritional status and clinical outcomes during hospital stay using the multiple correspondence analysis technique. Methods -This cross-sectional study included 600 patients with and without neoplasms. The following data were collected: subjective global assessment, nutritional indicators, nutritional risk screening, anthropometric data (body mass index (BMI), mid-upper arm circumference (MUAC), mid-upper arm muscle circumference (MUAMC), triceps skinfold thickness (TST), recent weight loss (RWL)), and habitual energy intake (HEI/ER <75%). The clinical outcomes of interest were complications, length of hospital stay (LOHS), and death. The data were analyzed by the chi-square or Fisher's exact test at a significance level of 5%. Multiple correspondence analysis was used for the multivariate data analysis. Results -The multiple correspondence analysis map for the patients with neoplasms showed that the following characteristics were associated and represented by death, complications, and a greater likelihood of LOHS ≥7 days: underweight according to BMI; TST, MUAC, and MUAMC ≤15th percentile; malnutrition according to the subjective global assessment; at nutritional risk according to the nutritional risk screening; being male; age ≥60 years; and HEI/ER <75%. The multiple correspondence analysis map for the patients without neoplasms showed that the following characteristics were associated and represented by death: underweight according to BMI; TST ≤15th percentile; malnutrition according to the subjective global assessment; and at nutritional risk according to the nutritional risk screening. Complications and LOHS ≥7 days represented the categories male, no recent weight loss, HEI/ER <75%, MUAC and MUAMC ≤15th percentile, TST between the 15th and 85th percentiles, and age <60 years. Conclusion -The results of this study confirm an association between unsatisfactory nutritional indicators and undesirable clinical outcomes.

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Association of Baseline Inflammation With Effectiveness of Nutritional Support Among Patients With Disease-Related Malnutrition

et al. 2020

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IMPORTANCE Inflammation is a key driver of malnutrition during illness and is often accompanied by metabolic effects, including insulin resistance and reduction of appetite. However, it still remains unclear if inflammation influences the response to nutritional support among patients with disease-related malnutrition. OBJECTIVE To examine whether patients' baseline inflammatory status is associated with the effect of nutritional support on 30-day mortality. DESIGN, SETTING, AND PARTICIPANTS This is a secondary analysis of the Effect of Early Nutritional Support on Frailty, Functional Outcomes, and Recovery of Malnourished Medical Inpatients Trial (EFFORT), a randomized clinical trial conducted in 8 Swiss hospitals from April 2014 to February 2018. A total of 1950 participants who had C-reactive protein measurements at the time of admission were included in this secondary analysis. Data analysis was conducted between June and July 2019. INTERVENTIONS Hospitalized patients at risk for malnutrition were randomly assigned to receive protocol-guided individualized nutritional support to reach protein and energy goals (intervention group) or standard hospital food (control group). MAIN OUTCOMES AND MEASURES The primary end point was 30-day mortality. Based on C-reactive protein levels at admission, patients were stratified into groups with low, moderate, or high inflammation (<10 mg/L, 10-100 mg/L, and >100 mg/L, respectively). RESULTS A total of 1950 patients (median [interquartile range] age, 75 [65-83] years; 1025 [52.6%] men) were included; 533 (27.3%) had low levels of inflammation, 894 (45.9%) had moderate levels of inflammation, and 523 (26.8%) had high levels of inflammation. Compared with the control group, patients receiving nutritional support showed a significant reduction in 30-day mortality, regardless of C-reactive protein level (adjusted odds ratio, 0.61; 95% CI, 0.43-0.86; P = .005). In the subgroup of patients with high inflammation, there was no beneficial effect of nutritional support (adjusted odds ratio, 1.32; 95% CI, 0.70-2.50; P = .39), providing evidence that inflammation has a significant modifying association (P for interaction = .005). CONCLUSIONS AND RELEVANCE Based on this secondary analysis of a multicenter randomized trial, a patient's admission inflammatory status was associated with their response to nutritional support. If validated in future clinical trials, nutritional support may need to be individualized based (continued) Key Points Question Does nutritional support have a similar effect on 30-day mortality among patients with high inflammation compared with patients with low or moderate inflammation? Findings In this secondary analysis of a Swiss multicenter trial, including 1950 patients at risk of malnutrition, patients with high levels of inflammation based on their levels of C-reactive protein at admission were not associated with a beneficial effect of nutritional support on 30-day mortality compared with the overall population, suggesting that inflammation has a significan...

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EuroOOPS: An international, multicentre study to implement nutritional risk screening and evaluate clinical outcome

Cited by 512 publications

References 23 publications

A study in four European countries to examine the importance of sensory attributes of oral nutritional supplements on preference and likelihood of compliance

A study in four European countries to examine the importance of sensory attributes of oral nutritional supplements on preference and likelihood of compliance

Relationship Between Nutritional Status and the Clinical Outcomes of Patients With and Without Neoplasms According to Multiple Correspondence Analysis

Association of Baseline Inflammation With Effectiveness of Nutritional Support Among Patients With Disease-Related Malnutrition

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