The purpose of this study is to determine whether there is a positive correlation between an evidence based clinical nutrition concept and relevant clinical outcomes in malnourished hospitalised patients when severity of disease is adjusted.
Patients have been consecutively screened at admission by SGA (Subjective-Global-Assessment)-Score and NRS 2002 (Nutritional-Risk-Screening)-Score in the departments of surgery and internal medicine. The nutrition status of each patient is combined with clinical data, utilization data and direct costs on the basis of clinical homogenous patient clusters. Risk-Adjustment was provided by the Disease-Staging-Scale (MEDSTAT/Thomson Healthcare, Ann Arbor MI), which allows patient classification by diagnosis and co morbidities including age and gender. The risk adjustment scales run by routine data sets from german inpatient G-DRG system. In the control period the effects of usual nutrition care are documented. During the intervention period an implementation of an interdisciplinary evidence-based guideline for screening and clinical nutrition was introduced in each participating hospital. The issue is to describe the relation between risk-adjusted malnutrition status and clinical outcomes and costs.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
10,242
The evidence based nutrition concept comprise a routine malnutrition screening for hospitalized patients, the implementation of an evidence based guideline for clinical nutrition in the participating hospital, education training of the clinical staff and thereby optimal clinical nutrition for malnourished hospitalized patients.
Unchanged treatment of hospital patients without interference by the study.
Städtisches Klinikum Ansbach
Ansbach, Germany
Kliniken Südliche Weinstraße Landau
Bad Bergzaben, Germany
Evangelische und Johanniter Kliniken
Duisburg, Germany
Kreiskrankenhaus Hameln
Hamelin, Germany
Length of hospital stay
Time frame: At least 3 months each group, 6 months for both groups
all cause hospital mortality
Time frame: At least 3 months each group, 6 months for both groups
complication rate
Time frame: At least 3 months each group, 6 months for both groups
hospital readmission rate
Time frame: 1 Month each group
Economic devices (direct costs of inpatient care and reimbursement)
Time frame: At least 4 months each group, 7 months for both groups
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