ESPEN practical guideline : Nutritional support for polymorbid medical inpatients

Copyright © 2024 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved..

BACKGROUND: Disease-related malnutrition in polymorbid medical inpatients is a highly prevalent syndrome associated with significantly increased morbidity, disability, short- and long-term mortality, impaired recovery from illness, and healthcare costs.

AIM: As there are uncertainties in applying disease-specific guidelines to patients with multiple conditions, our aim was to provide evidence-based recommendations on nutritional support for the polymorbid patient population hospitalized in medical wards.

METHODS: The 2023 update adheres to the standard operating procedures for ESPEN guidelines. We undertook a systematic literature search for 15 clinical questions in three different databases (Medline, Embase and the Cochrane Library), as well as in secondary sources (e.g., published guidelines), until July 12th, 2022. Retrieved abstracts were screened to identify relevant studies that were used to develop recommendations (including SIGN grading), which was followed by submission to Delphi voting. Here, the practical version of the guideline is presented which has been shortened and equipped with flow charts for patients care.

RESULTS: 32 recommendations (7× A, 11× B, 10× O and 4× GPP), which encompass different aspects of nutritional support were included from the scientific guideline including indication, route of feeding, energy and protein requirements, micronutrient requirements, disease-specific nutrients, timing, monitoring and procedure of intervention. Here, the practical version of the guideline is presented which has been shortened and equipped with flow charts for patients care.

CONCLUSIONS: Recent high-quality trials have provided increasing evidence that nutritional support can reduce morbidity and other complications associated with malnutrition in polymorbid patients. The timely screening of patients for risk of malnutrition at hospital admission followed by individualized nutritional support interventions for at-risk patients should be part of routine clinical care and multimodal treatment in hospitals worldwide. Use of this updated practical guideline offers an evidence-based nutritional approach to polymorbid medical inpatients and may improve their outcomes.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:43

Enthalten in:

Clinical nutrition (Edinburgh, Scotland) - 43(2024), 3 vom: 04. März, Seite 674-691

Sprache:

Englisch

Beteiligte Personen:

Wunderle, Carla [VerfasserIn]
Gomes, Filomena [VerfasserIn]
Schuetz, Philipp [VerfasserIn]
Stumpf, Franziska [VerfasserIn]
Austin, Peter [VerfasserIn]
Ballesteros-Pomar, María D [VerfasserIn]
Cederholm, Tommy [VerfasserIn]
Fletcher, Jane [VerfasserIn]
Laviano, Alessandro [VerfasserIn]
Norman, Kristina [VerfasserIn]
Poulia, Kalliopi-Anna [VerfasserIn]
Schneider, Stéphane M [VerfasserIn]
Stanga, Zeno [VerfasserIn]
Bischoff, Stephan C [VerfasserIn]

Links:

Volltext

Themen:

Guideline
Hospitalized patients
Journal Article
Multimorbidity
Nutritional support
Polymorbid
Practice Guideline
Research Support, Non-U.S. Gov't

Anmerkungen:

Date Completed 04.03.2024

Date Revised 15.04.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.clnu.2024.01.008

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM367987139