Nutritional support: how much for how much?

Koretz, Ronald L.

doi:10.1136/gut.27.suppl_1.85

Cited by 38 publications

(10 citation statements)

References 59 publications

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“…Measurements of nutritional status suggest significant levels of undernutrition in the population interviewed (Fig. 5) In many of these patients this may reflect the severity of illness rather than inadequate nutritional intake; as noted by Koretz (1986), ‘a poorer nutritional state may be a consequence of a more severe underlying disease.’…”

Section: Discussionmentioning

confidence: 95%

Sip feed prescribing in primary care: an audit of current practice in Greater Glasgow Health Board, Glasgow, UK

McCombie

1999

J Human Nutrition Diet

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Summary Background and aims: Prior to September 1995, prescribing of sip feeds had been increasing at a higher rate than any other part of the drugs bill. An increase in requests for information on the use of these products led the Prescribing Advisers Department to seek funding for a 1‐year project to document current practice in this area and produce guidelines for GPs, their practice nurses and district nurses. Methods: Questionnaires were completed by GPs (n=52), district nurses (n=94) and dietetic departments (n= 8) concerning current practice. In addition, 90 patients were interviwed and in all but one instance case notes were also consulted. Results: The most significant findings were that Primary Care staff see palliative care as one of the main areas of usage of these products and that 40% of patients were found to have some degree of undernutrition. The majority of patients interviewed were elderly and 10% of patients interviewed were in nursing homes. A significant proportion of patients interviewed had commenced sip feeds whilst in hospital. The majority of patients reported receiving no advice on diet with only one GP making written dietary advice available to patients. Finally, district nurses view company representatives as the most useful source of information on these products. Conclusions: In response to these findings, the project included the development of a standard communication form from secondary to primary care, dietary information resource development, development of guidelines on oral nutrition support in Primary Care and GP and district nurse training

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Section: Discussionmentioning

confidence: 95%

Sip feed prescribing in primary care: an audit of current practice in Greater Glasgow Health Board, Glasgow, UK

McCombie

1999

J Human Nutrition Diet

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“… PURPOSE : To review data about the relationship between pressure sores and (1) nutritional status, (2) nutrient intake, and (3) tube feeding. DATA SOURCES : Medline search of terms associated with “decubitus ulcer” combined with terms associated with “pressure sore” from 1985 through August 1994. Hand review of all issues of the journal Decubitus (now Advances in Wound Care ) through June 1994 and the Journal of Parenteral and Enteral Nutrition from January 1987 through May‐June 1994. Review of bibliography of pertinent articles.…”

mentioning

confidence: 99%

“…PURPOSE : To review data about the relationship between pressure sores and (1) nutritional status, (2) nutrient intake, and (3) tube feeding.…”

mentioning

confidence: 99%

Malnutrition, Tube Feeding and Pressure Sores: Data Are Incomplete

Finucane

1995

J American Geriatrics Society

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“…Unfortunately, large reviews of nutritional support studies (e.g. Koretz, 1986) have found that few controlled studies have proven its clinical efficacy, not least because patient numbers were small; the groups were heterogenous for disease type and severity and nutritional status; and inappropriate or inadequate nutritional support was given for an inadequate length of time in order to have a clinical impact. The Veterans Affairs Study Group (1991) found that only in patients with severe malnutrition did preoperative parenteral feeding lead to a reduction in non-infectious complications without a concomitant increase in infectious complications compared to controls.…”

Section: Introductionmentioning

confidence: 97%

Audit of nasogastric feeding practice at two acute hospitals: is early enteral feeding associated with reduced mortality and hospital stay?

Taylor

1993

J Human Nutrition Diet

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Hospital malnutrition is common and thought to be a cause of morbidity and mortality. Nasogastric (NG) feeding is the most commonly used invasive technique of nutritional support used at the acute Bolton hospitals. A prospective observational study was initiated to audit the use of NG feeding in patients in whom oral energy intake was virtually nil at the time of commencement of tube feeding. Patients who were starved for 0–5 days prior to commencement of NG feeding had a lower mortality than patients starved >5 days (a) during their feeding episode and (b) during their hospital stay subsequent to cessation of oral intake. The difference in mortality was not related to age or sex. However, in patients of <65 years mortality was only non‐significantly higher in patients starved >5 days compared with those starved 0–5 days. In patients of >64 years the difference in mortality between those starved 0–5 vs. >5 days remained significant: (a) during the feeding episode and (b) during the hospital stay. The fact that starvation has a disproportionate effect on mortality in old patients may indicate that older patients are more susceptible to starvation. In surviving patients there was a positive correlation between the length of starvation and: (a) the duration of the NG feeding episode and (b) hospital stay subsequent to cessation of oral intake. Disease severity was not measured therefore its effect on outcome and speed of rehabilitation cannot be excluded. The study indicates a possible relationship between the duration of starvation and mortality, the duration of NG feeding and the length of hospital stay. Definitive testing of this association would require a prospective trial which controls for age and disease severity.

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Nutritional support: how much for how much?

Cited by 38 publications

References 59 publications

Sip feed prescribing in primary care: an audit of current practice in Greater Glasgow Health Board, Glasgow, UK

Sip feed prescribing in primary care: an audit of current practice in Greater Glasgow Health Board, Glasgow, UK

Malnutrition, Tube Feeding and Pressure Sores: Data Are Incomplete

Audit of nasogastric feeding practice at two acute hospitals: is early enteral feeding associated with reduced mortality and hospital stay?

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