Saman Khalatbari-Soltani1, Pedro Marques-Vidal2. 1. Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Biopole 2, Route de la Corniche 10, CH-1010 Lausanne, Switzerland; Department of Internal Medicine, Internal Medicine, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland. Electronic address: Saman.KhalatbariSoltani@unil.ch. 2. Department of Internal Medicine, Internal Medicine, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland. Electronic address: Pedro-Manuel.Marques-Vidal@chuv.ch.
Abstract
BACKGROUND & AIMS: Hospitalized patients should be screened for nutritional risk and adequately managed. Being nutritionally 'at-risk' increases in-hospital mortality, length of stay (LOS) and costs, but the impact on actual costs has seldom been assessed. We aimed to determine nutritional risk screening and management in a Swiss university hospital. The impact of being nutritionally 'at-risk' on in-hospital mortality, LOS and costs was also assessed. METHODS: Retrospective analysis of administrative data for years 2013 and 2014 from the department of internal medicine of the Lausanne university hospital (8541 hospitalizations, mean age 72.8 ± 16.5 years, 50.4% women). Being nutritionally 'at-risk' was defined as a Nutritional risk screening-2002 score ≥ 3 and nutritional managements were collected from medical records. RESULTS: Screening increased from 16.5% in 2013 to 41.9% in 2014 (p < 0.001), while prevalence of 'at-risk' patients remained stable (64.6% in 2013 and 62.7% in 2014, p = 0.37). Prevalence of 'at-risk' patients was highest in patients with cancer (85.3% in 2013 and 70.2% in 2014) and lowest in patients with disease of skin (42% in 2013 and 44.8% in 2014). Less than half of patients 'at-risk' received any nutritional management, and this value decreased between 2013 and 2014 (46.9% vs. 40.3%, p < 0.05). After multivariate adjustment, 'at-risk' patients had a 3.7-fold (95% confidence interval: 1.91; 7.03) higher in-hospital mortality and higher costs (excess 5642.25 ± 1479.80 CHF in 2013 and 5529.52 ± 847.02 CHF in 2014, p < 0.001) than 'not at-risk' patients, while no difference was found for LOS. CONCLUSION: Despite an improvement in screening, management of nutritionally 'at-risk' patients is not totally covered yet. Being nutritionally 'at-risk' affects three in every five patients and is associated with increased mortality and hospitalization costs.
BACKGROUND & AIMS: Hospitalized patients should be screened for nutritional risk and adequately managed. Being nutritionally 'at-risk' increases in-hospital mortality, length of stay (LOS) and costs, but the impact on actual costs has seldom been assessed. We aimed to determine nutritional risk screening and management in a Swiss university hospital. The impact of being nutritionally 'at-risk' on in-hospital mortality, LOS and costs was also assessed. METHODS: Retrospective analysis of administrative data for years 2013 and 2014 from the department of internal medicine of the Lausanne university hospital (8541 hospitalizations, mean age 72.8 ± 16.5 years, 50.4% women). Being nutritionally 'at-risk' was defined as a Nutritional risk screening-2002 score ≥ 3 and nutritional managements were collected from medical records. RESULTS: Screening increased from 16.5% in 2013 to 41.9% in 2014 (p < 0.001), while prevalence of 'at-risk' patients remained stable (64.6% in 2013 and 62.7% in 2014, p = 0.37). Prevalence of 'at-risk' patients was highest in patients with cancer (85.3% in 2013 and 70.2% in 2014) and lowest in patients with disease of skin (42% in 2013 and 44.8% in 2014). Less than half of patients 'at-risk' received any nutritional management, and this value decreased between 2013 and 2014 (46.9% vs. 40.3%, p < 0.05). After multivariate adjustment, 'at-risk' patients had a 3.7-fold (95% confidence interval: 1.91; 7.03) higher in-hospital mortality and higher costs (excess 5642.25 ± 1479.80 CHF in 2013 and 5529.52 ± 847.02 CHF in 2014, p < 0.001) than 'not at-risk' patients, while no difference was found for LOS. CONCLUSION: Despite an improvement in screening, management of nutritionally 'at-risk' patients is not totally covered yet. Being nutritionally 'at-risk' affects three in every five patients and is associated with increased mortality and hospitalization costs.
Authors: Riccardo Caccialanza; Alessandro Laviano; Cristina Bosetti; Mariateresa Nardi; Valentina Casalone; Lucilla Titta; Roberto Mele; Giovanni De Pergola; Francesco De Lorenzo; Paolo Pedrazzoli Journal: Support Care Cancer Date: 2022-07-06 Impact factor: 3.603
Authors: Min Chang Kang; Ji Hoon Kim; Seung Wan Ryu; Jae Young Moon; Je Hoon Park; Jong Kyung Park; Jong Hoon Park; Hyun Wook Baik; Jeong Meen Seo; Myoung Won Son; Geun Am Song; Dong Woo Shin; Yeon Myung Shin; Hong Yup Ahn; Han Kwang Yang; Hee Chul Yu; Ik Jin Yun; Jae Gil Lee; Jae Myeong Lee; Jung Hwa Lee; Tae Hee Lee; Haejun Yim; Hyun Jeong Jeon; Kyuwhan Jung; Mi Ran Jung; Chi Young Jeong; Hee Sook Lim; Suk Kyung Hong Journal: J Korean Med Sci Date: 2018-01-08 Impact factor: 2.153