Repercusiones clínicas y económicas de la desnutrición relacionada con la enfermedad en un servicio de Medicina Interna: estudio de cohortes prospectivas

Ballesteros-Pomar, María D.; Calleja-Fernández, Alicia; González-Valdés, M.; Maza, Begoña Pintor-de la; Taibo, Rocío Villar; Vidal-Casariego, Alfonso; Urioste-Fondo, Ana; Torres-Torres, Beatriz; Luis, Daniel Antonio de; Cano-Rodríguez, Isidoro

doi:10.1016/j.rce.2016.07.005

Cited by 20 publications

(7 citation statements)

References 7 publications

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“…In Spain, the PREDyCES study found nutritional risk in 23% of hospitalized patients, with patients whose nutritional status worsened during hospitalization having the worst prognosis and the highest health costs [ 26 ]. In a previous study, our group found that 27% of patients admitted for medical diseases had an abnormal MUST screening result, confirming a worse evolution in patients with a worsening nutritional status during admission [ 32 ]. In the present study, these data were confirmed, with 27.5% of the patients with DRM on admission.…”

Section: Discussionmentioning

confidence: 80%

Disease-Related Malnutrition and Sarcopenia Predict Worse Outcome in Medical Inpatients: A Cohort Study

et al. 2021

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(1) Background: Both sarcopenia and disease-related malnutrition (DRM) are unfortunately underdiagnosed and undertreated in our Western hospitals, which could lead to worse clinical outcomes. Our objectives included to determine the impact of low muscle mass (MM) and strength, and also DRM and sarcopenia, on clinical outcomes (length of stay, death, readmissions at three months, and quality of life). (2) Methodology: Prospective cohort study in medical inpatients. On admission, MM and hand grip strength (HGS) were assessed. The Global Leadership Initiative on Malnutrition (GLIM) criteria were used to diagnose DRM and EWGSOP2 for sarcopenia. Assessment was repeated after one week and at discharge. Quality of life (EuroQoL-5D), length of stay (LoS), readmissions and mortality are reported. (3) Results: Two hundred medical inpatients, median 76.0 years-old and 68% with high comorbidity. 27.5% met GLIM criteria and 33% sarcopenia on admission, increasing to 38.1% and 52.3% on discharge. Both DRM and sarcopenia were associated with worse QoL. 6.5% died and 32% readmission in 3 months. The odds ratio (OR) of mortality for DRM was 4.36 and for sarcopenia 8.16. Readmissions were significantly associated with sarcopenia (OR = 2.25) but not with DRM. A higher HGS, but not MM, was related to better QoL, less readmissions (OR = 0.947) and lower mortality (OR = 0.848) after adjusting for age, sex, and comorbidity. (4) Conclusions: In medical inpatients, mostly polymorbid, both DRM but specially sarcopenia are associated with poorer quality of life, more readmissions, and higher mortality. Low HGS proved to be a stronger predictor of worse outcomes than MM.

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Section: Discussionmentioning

confidence: 80%

Disease-Related Malnutrition and Sarcopenia Predict Worse Outcome in Medical Inpatients: A Cohort Study

et al. 2021

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“…The nutritional control tool (CONUT) defines the degree of malnutrition based on the circulating concentrations of albumin, total cholesterol and lymphocytes, and their relation between elderly patients and the exceed hospital stay, premature readmissions, and the associated cost (Redondo, Navalon, Canovas, Jimenez, & Alvarez, 2015). Prospective studies (Badosa et al, 2017;Ballesteros-Pomar et al, 2016;Torres et al, 2018) focus on relating the degree of malnutrition obtained with the malnutrition universal screening tool, with LOS, mortality, and readmission. The two systematic reviews by Rodriguez-Manas, Abizanda, Barcons, and Lizan (2014) and by Abizanda, Sinclair, Barcons, Lizan, and Rodriguez-Manas (2016) include studies conducted in Europe and showed that the total costs associated with malnutrition in institutionalized older adults living in the community were considerably higher than those of well-nourished people, mainly due to a greater use of medical care resources (general practitioner, consultations, hospitalizations, monitoring of medical attention, and treatments).…”

Section: Resultsmentioning

confidence: 99%

Clinical and financial implications of hospital malnutrition in Spain

Yárnoz-Esquíroz

Lacasa

Riestra

et al. 2019

Euro Eating Disorders Rev

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Objective The aim of this review is to analyse the studies about cost and clinical implications that malnutrition causes in the Spanish hospitals. Material and methods The review of the literature was carried out through a bibliographic search in Web of Science following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) criteria and analyse the cost of treatment of malnourished and anorexia nervosa (AN) patients Results Seventeen studies with economic data related to malnutrition were included. The employment of a nutritional screening is the first tool to determinate the prevalence. Malnutrition is related to an incremental cost due to a longer hospital stay, expensive treatment, and higher rate of readmissions. Malnourished patients present more clinical complications, more infections, and higher mortality. No studies were found with economic data of AN in Spain. Conclusions The prevalence of malnutrition is over 20%, with the elderly patients being the most affected. Nutritional screening is not implanted in all Spanish hospitals in spite of its proven cost‐effectiveness. The cost and the clinical implications of malnutrition make this disease a health national problem. The knowledge of the real cost of AN treatment would increase the interest of public institutions on the development of specific Nutritional Screening tools for an early detection of AN.

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“…Despite the high prevalence of malnutrition, its clinical and financial consequences and recommendations for diagnosis and treatment of this condition in malnourished patients [ 29 , 30 ], this is still an underdiagnosed and undertreated condition in Spain. Observational studies carried out in Spain have noted that only 5% of hospital discharges recognise malnutrition as a diagnosis [ 6 ], and only 25% of malnourished patients receive any type of ONS [ 5 ]. Therefore, it is necessary to implement measures to improve the diagnosis and treatment of malnutrition in specialised units.…”

Section: Discussionmentioning

confidence: 99%

“…Malnutrition is a common condition in hospitalised patients. Observational studies carried out in Spanish hospitals have estimated a prevalence of malnutrition of between 23% and 70% [ 1 , 2 , 3 , 4 , 5 , 6 , 7 ], depending on the population assessed and the screening and assessment tools used. Advanced age is a known risk factor for malnutrition [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Cost-Effectiveness of a Specialized Oral Nutritional Supplementation for Malnourished Older Adult Patients in Spain

Ballesteros-Pomar¹,

Llinàs

Goates³

et al. 2018

Nutrients

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Malnutrition has been related to prolonged hospital stays, and to increases in readmission and mortality rates. In the NOURISH (Nutrition effect On Unplanned Readmissions and Survival in Hospitalized patients) study, administering a high protein oral nutritional supplement (ONS) containing beta-hydroxy-beta-methylbutyrate (HP-HMB) to hospitalised older adult patients led to a significant improvement in survival compared with a placebo treatment. The aim of this study was to determine whether HP-HMB would be cost-effective in Spain. We performed a cost-effectiveness analysis from the perspective of the Spanish National Health System using time horizons of 90 days, 180 days, 1 year, 2 years, 5 years and lifetime. The difference in cost between patients treated with HP-HMB and placebo was €332.75. With the 90 days time horizon, the difference in life years gained (LYG) between both groups was 0.0096, resulting in an incremental cost-effectiveness ratio (ICER) of €34,700.62/LYG. With time horizons of 180 days, 1 year, 2 years, 5 years and lifetime, the respective ICERs were €13,711.68, €3377.96, €2253.32, €1127.34 and €563.84/LYG. This analysis suggests that administering HP-HMB to older adult patients admitted to Spanish hospitals during hospitalisation and after discharge could be a cost-effective intervention that would improve survival with a reduced marginal cost.

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Repercusiones clínicas y económicas de la desnutrición relacionada con la enfermedad en un servicio de Medicina Interna: estudio de cohortes prospectivas

Cited by 20 publications

References 7 publications

Disease-Related Malnutrition and Sarcopenia Predict Worse Outcome in Medical Inpatients: A Cohort Study

Disease-Related Malnutrition and Sarcopenia Predict Worse Outcome in Medical Inpatients: A Cohort Study

Clinical and financial implications of hospital malnutrition in Spain

Cost-Effectiveness of a Specialized Oral Nutritional Supplementation for Malnourished Older Adult Patients in Spain

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