Cited by 607Clinical Nutrition and GastroenterologyNutrition and Health in AgingDietetics, Nutrition, and Education

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EuroOOPS: An international, multicentre study to implement nutritional risk screening and evaluate clinical outcome

Sorensen, Janice, Kondrup, Jens, Prokopowicz, Jacek, Schiesser, Marc, Krähenbühl, Lukas, Meier, Rémy, Liberda, Martin·2008·Clinical Nutrition

DOI 10.1016/j.clnu.2008.03.012

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Abstract

Background & aims The aim of the study was to implement nutritional risk screening (NRS-2002) and to assess the association between nutritional risk and clinical outcome. Methods NRS-2002 was implemented in 26 hospital departments (surgery, internal medicine, oncology, intensive care, gastroenterology and geriatrics) in Austria, the Czech Republic, Egypt, Germany, Hungary, Lebanon, Libya, Poland, Romania, Slovakia, Spain and Switzerland. Being a prospective cohort study, randomly selected adult patients were included at admission and followed during their hospitalisation. Data were collected on the nutritional risk screening, complications, mortality, length of stay and discharge. The correlation between risk status and clinical outcome was assessed and adjusted for confounders (age, speciality, diagnoses, comorbidity, surgery, cancer and region) by multivariate regression analysis. Results Of the 5051 study patients, 32.6% were defined as 'at-risk' by NRS-2002. 'At-risk' patients had more complications, higher mortality and longer lengths of stay than 'not at-risk' patients and these variables were significantly related to components of NRS-2002, also when adjusted for confounders. Conclusions Components of NRS-2002 are independent predictors of poor clinical outcome.

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Häufigkeit eines Risikos für Mangelernährung bei Patienten in onkologischen Schwerpunktpraxen – eine Querschnittserhebung
Hauner, H., Kocsis, A., Jaeckel, B., Martignoni, M., Hauner, D., & Holzapfel, C. (2019) · Tumordiagnostik & Therapie · doi:10.1055/a-1098-1510 · Cited by 11
“Die europaweite „EuroOOPS“-Studie mit 5051 Patienten in 26 Krankenhäusern ergab, dass Patienten mit einem Risiko für das Vorliegen einer Mangelernährung während ihres stationären Aufenthalts beinahe 3-mal häufiger Komplikationen erleiden als gut ernährte Patienten (31% Komplikationen im Vergleich zu 11%) [11].”
Background
Aktualisierte S3-Leitlinie Colitis ulcerosa
Kucharzik, T., Dignass, A., Atreya, R., Bokemeyer, B., Esters, P., Herrlinger, K., Kannengiesser, K., Kienle, P., Langhorst, J., Lügering, A., et al. (2019) · Zeitschrift für Gastroenterologie - German Journal of Gastroenterology · doi:10.1055/a-1015-7265 · Cited by 11
Things We Do for No Reason: Prealbumin Testing to Diagnose Malnutrition in the Hospitalized Patient
Lacy, M. E., Roesch, J. J., & Langsjoen, J. O. (2019) · Journal of Hospital Medicine · doi:10.12788/jhm.3088 · Cited by 11
Use of the nutritional risk score by surgeons and nutritionists.
Benoit, M., Grass, F., Demartines, N., Coti-Bertrand, P., Schäfer, M., & Hübner, M. (2016) · Clinical Nutrition · doi:10.1016/j.clnu.2015.01.014 · Cited by 11
“The nutritional risk score (NRS) is officially recommend as screening tool since 2003 [7].”
Method
Evaluation of nutritional status as an independent predictor of post-operative complications and morbidity after gastro-intestinal surgery.
van der Kroft, G., Janssen-Heijnen, M., van Berlo, C. V., & Konsten, J. (2015) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2015.05.005 · Cited by 11
“InWestern Europe approximately 30% of all patients admitted to hospital are undernourished [1,2].”
Background
[Intestinal failure: from adaptation to transplantation].
Messing, B., Corcos, O., Amiot, A., & Joly, F. (2009) · Gastroentérologie Clinique et Biologique · doi:10.1016/j.gcb.2009.07.012 · Cited by 11
Factors Influencing Nutritional Status in Hospitalized Individuals Aged 70 and Above
Ruiz-Rosso, R., Moreno-Cámara, S., Gutiérrez-Sánchez, B., da-Silva-Domingues, H., del-Pino-Casado, R., & Palomino-Moral, P. Á. (2024) · Nutrients · doi:10.3390/nu16050645 · Cited by 10
S3-Leitlinie Diagnostik und Therapie der Plattenepithelkarzinome und Adenokarzinome des Ösophagus
Ebert, M. P. A., Fischbach, W., Hollerbach, S. H., Höppner, J., Lorenz, D., Stahl, M., Stuschke, M., Pech, O., Vanhoefer, U. J., Porschen, R., et al. (2024) · Zeitschrift für Gastroenterologie · doi:10.1055/a-2239-9802 · Cited by 12
Prognostic nutrition index predicts short-term surgical complications in patients with rectal cancer after laparoscopic surgery
Xu, F., Meng, C., Yang, Z.-Y., Li, H., Gao, J., Sun, L.-T., Zhang, X., Wei, Q., Wu, G.-C., Yao, H., et al. (2022) · Frontiers in Surgery · doi:10.3389/fsurg.2022.1000108 · Cited by 10
Prevalence of undernutrition in surgical patients and the effect on length of hospital stay
Wang, X.-Y., Naito, Y., Nakatani, H., Ida, M., & Kawaguchi, M. (2021) · Journal of Anesthesia · doi:10.1007/s00540-021-03013-8 · Cited by 10
“As a result, malnutrition is known to be a factor that increases complications during hospitalization and worsens outcomes, such as length of stay [3], readmission [4], health care costs [5], and mortality [6].”
Background
Impact of Nutritional Assessment on the Clinical Outcomes of Patients with Non-albicans Candidemia: A Multicenter Study
Lee, Y.-C., Chen, Y.-C., Wang, J.-T., Wang, F.-D., Hsieh, M.-H., Hii, I.-M., Lee, Y.-L., Ho, M., Liu, C.-E., Chen, Y.-H., et al. (2021) · Nutrients · doi:10.3390/nu13093218 · Cited by 10
“1% in critically ill patients [14], and around 20–50% of hospitalized patients are diagnosed with undernutrition upon admission [15].”
Background
Nutrition and gastroenterological support in end of life care.
Schütte, K., Middelberg-Bisping, K., & Schulz, C. (2020) · Best practice & research. Clinical gastroenterology · doi:10.1016/j.bpg.2020.101692 · Cited by 10
A survey on total parenteral nutrition in 55,000 hospitalized patients: Retrospective cohort study using a medical claims database.
Sasabuchi, Y., Ono, S., Kamoshita, S., Tsuda, T., Murano, H., & Kuroda, A. (2020) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2020.06.013 · Cited by 10
Malnutrition predicts long-term survival in hospitalized patients with gastroenterological and hepatological diseases.
Knappe-Drzikova, B., Maasberg, S., Vonderbeck, D., Krafft, T., Knüppel, S., Sturm, A., Müller-Nordhorn, J., Wiedenmann, B., & Pape, U. (2019) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2019.02.010 · Cited by 10
Cost-effectiveness of the hospital nutrition screening tool CIPA
Suárez-Llanos, J. P., Vallejo-Torres, L., García-Bello, M., Hernández-Carballo, C., Calderón-Ledezma, E. M., Rosat-Rodrigo, A., Delgado-Brito, I., Pereyra-García-Castro, F., Benítez-Brito, N., Felipe-Pérez, N., et al. (2019) · Archives of medical science : AMS · doi:10.5114/aoms.2018.81128 · Cited by 10
Are patients affected by mitochondrial disorders at nutritional risk?
Aubry, E., Aeberhard, C., Bally, L., Nuoffer, J., Risch, L., Mühlebach, S., Burgunder, J., & Stanga, Z. (2018) · Nutrition (Burbank, Los Angeles County, Calif.) · doi:10.1016/j.nut.2017.09.011 · Cited by 10
Parenteral nutrition including an omega-3 fatty-acid-containing lipid emulsion for intensive care patients in China: a pharmacoeconomic analysis
Feng, Y., Li, C., Zhang, T., & Pradelli, L. (2017) · ClinicoEconomics and Outcomes Research · doi:10.2147/ceor.s139902 · Cited by 14
Nutritional Screening Tool for In-Hospital Patients
Seol, E., Ju, D., & Lee, H. (2016) · Journal of Clinical Nutrition · doi:10.15747/jcn.2016.8.1.2 · Cited by 10
Screening of nutritional risk and nutritional support in general surgery patients: a survey from Shanghai, China.
Jia, Z.-Y., Yang, J. J., Tong, D.-N., Peng, J.-Y., Zhang, Z.-W., Liu, W.-J., Xia, Y., & Qin, H. (2015) · International surgery · doi:10.9738/intsurg-d-14-00245.1 · Cited by 10
“The prevalence of nutritional risk rate in general surgery has been shown to range from 6 to 30%.(11,15) In this study, the nutritional risk rate was 19.”
BackgroundResult
Characteristics of NRS-2002 Nutritional Risk Screening in Patients Hospitalized for Secondary Cardiovascular Prevention and Rehabilitation
Boban, M., Laviano, A., Peršić, V., Rotim, A., Jovanović, Ž., & Včev, A. (2014) · Journal of the American College of Nutrition · doi:10.1080/07315724.2013.876902 · Cited by 10
“Despite increased awareness, increased nutritional risk is frequently a significant comorbidity in hospitalized or institutionalized patients, as well as during the exacerbated courses of illness [8].”
Background
Malnutrition in hospitalized patients receiving nutritionally complete menus: prevalence and outcomes
Fernández, A., Casariego, A. V., Rodríguez, I. C., & Pomar, M. B. (2014) · Nutrición Hospitalaria · doi:10.3305/nh.2014.30.6.7901 · Cited by 9
Theory-driven development of an educative nutritional intervention (ENI) supporting older hospital patients to eat sufficiently, assisted by an eHealth solution: an intervention mapping approach
Terp, R., Lindhardt, T., & Kayser, L. (2022) · BMC Health Services Research · doi:10.1186/s12913-022-08679-8 · Cited by 10
Preoperative Short Physical Performance Battery as a predictor of prolonged hospitalization after coronary artery bypass grafting in older patients
Han, P., Yu, H., Zhang, Y., Xie, F., Shao, B., Liu, X.-J., Yuan, B., Liu, Z.-G., Liu, X.-C., & Guo, Q. (2021) · Journal of International Medical Research · doi:10.1177/03000605211044043 · Cited by 9
A multinational observational study of clinical nutrition practice in patients undergoing major gastrointestinal surgery: The Nutrition Insights Day.
Seo, J.-M., Joshi, R., Chaudhary, A., Hsu, H., Trung, L. V., Inciong, J., Usman, N., Hendrawijaya, I., & Ungpinitpong, W. (2021) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2020.11.029 · Cited by 9
The Effect of Nutritional Support on the Disease Progression and Survival in Pediatric Patients with Solid Tumors
Gallo, N., Czuppon, K., Tomsits, E., Garami, M., Hauser, P., Jakab, Z., Nagy, K., & Kovács, G. (2021) · Nutrition and Cancer · doi:10.1080/01635581.2020.1869275 · Cited by 9
Does malnutrition influence hospital reimbursement? A call for malnutrition diagnosis and coding.
Fernandes, A., Pessoa, A., Vigario, M. A., Jager-Wittenaar, H., & Pinho, J. (2020) · Nutrition (Burbank, Los Angeles County, Calif.) · doi:10.1016/j.nut.2020.110750 · Cited by 9
“Although we did not determine mortality rate in the present study, the increased ROM is considered plausible because multiple studies have reported that malnutrition contributes to an increased risk of mortality during hospitalization and after discharge [1,4,8,9].”
Background
Identifying Malnutrition: Nutritional status in newly diagnosed patients with cancer
Krishnasamy, K., Yoong, T. L., Chong, M.-C., Lau, P.-C., & Chinna, K. (2017) · Clinical Journal of Oncology Nursing · doi:10.1188/17.cjon.e23-e29 · Cited by 9
“Many studies have found that the presence of malnutrition not only increases length of stay, but also may lead to deterioration in clinical outcomes, increased cost and use of hospital resources, and increased number of complications (Sorenson et al., 2008).”
Background
COST-EFFECTIVENESS OF EARLY NUTRITIONAL THERAPY IN MALNOURISHED ADULT PATIENTS IN A HIGH COMPLEXITY HOSPITAL.
Giraldo, N. A. G., Velásquez, J., Cano, P. A. R., Astudillo, C., & Cardona, Y. P. S. (2015) · Nutrición Hospitalaria · doi:10.3305/nh.2015.32.6.9859 · Cited by 9
Prognostic validity of 3-Minute Nutrition Screening (3-MinNS) in predicting length of hospital stay, readmission, cost of hospitalisation and mortality: a cohort study.
Lim, S., Lee, C. J., & Chan, Y. (2014) · Asia Pacific Journal of Clinical Nutrition · doi:10.6133/apjcn.2014.23.4.19 · Cited by 9
“A similar study that controlled for all three variables (age, gender and disease) found a significant twofold increase in mortality in patients who were at risk of malnutrition using NRS-2002.”
BackgroundResultInfluential
Is duration of postoperative fasting associated with infection and prolonged length of stay in surgical patients?
de Assis, M. D., Silveira, C. R. D. M., Beghetto, M., & de Mello, D. E. (2014) · Nutrición Hospitalaria · doi:10.3305/nh.2014.30.4.7528 · Cited by 9
“Length of stay (days) 15 (13-25) 9 (5-13) 23 (15-56) <0.”
Nutritional risk among surgery patients and associations with hospital stay and postoperative complications.
Soares, B. L. D. M., & Burgos, M. G. P. D. A. (2014) · Nutrición Hospitalaria · doi:10.3305/nh.2014.30.3.7633 · Cited by 9
[Practical scores for the detection of malnutrition].
Aeberhard, C., Stanga, Z., & Leuenberger, M. (2014) · Therapeutische Umschau. Revue thérapeutique · doi:10.1024/0040-5930/a000495 · Cited by 9
Dépistage nutritionnel chez les aînés en établissements de soins de santé: comparaison entre les établissements francophones et anglophones
Villalon, L., Laporte, M., & Carrier, N. (2013) · Canadian journal of public health · doi:10.17269/cjph.104.3462 · Cited by 9
Eurasian clinical practice guidelines for dietary management of cardiovascular diseases (2024)
Starodubova, A. V., Chazova, I. E., Tutelyan, V. A., Nikityuk, D. B., Pavlovskaya, E. V., Кislyak, O. A., Blinova, N. V., Brumberg, A. A. B., Bubnova, M. G., Varaeva, Y. R., et al. (2024) · Eurasian heart journal · doi:10.38109/2225-1685-2024-4-6-66 · Cited by 10
Early enteral vs. oral nutrition after Whipple procedure: Study protocol for a multicentric randomized controlled trial (NUTRIWHI trial)
Joliat, G., Martin, D., Labgaa, I., Melloul, E., Uldry, É., Halkic, N., Fotsing, G., Cristaudi, A., Majno-Hurst, P., Vrochides, D., et al. (2022) · Frontiers in Oncology · doi:10.3389/fonc.2022.855784 · Cited by 8
“Several studies have proven its reliability to identify patients at nutritional risk who will benefit from perioperative nutritional support (15, 20).”
Background
Searching for a nutritional screening tool. The value of an analytical method when staff trained in clinical nutrition is not available.
Morán-López, J., Piedra-León, M., Izquierdo, F. J. E., Señaris, J. A. A., & Pérez, L. M. L. (2018) · Endocrinología Diabetes y Nutrición · doi:10.1016/j.endinu.2018.03.011 · Cited by 8
Undernutrition Risk and Undernutrition in Pulmonology Department Inpatients: A Systematic Review and Meta-Analysis
Maia, I., Peleteiro, B., Xará, S., & Amaral, T. (2017) · Journal of the American College of Nutrition · doi:10.1080/07315724.2016.1209728 · Cited by 8
Poor nutritional status is associated with other geriatric domain impairments and adverse postoperative outcomes in onco-geriatric surgical patients - A multicentre cohort study.
Huisman, M. G., Veronese, G., Audisio, R., Ugolini, G., Montroni, I., Bock, G. D. D., van Leeuwen, B., Vigano, A., Gilbert, L., Spiliotis, J., et al. (2016) · European Journal of Surgical Oncology · doi:10.1016/j.ejso.2016.03.005 · Cited by 8
PREVALENCIA DE DESNUTRICIÓN EN PACIENTES HOSPITALIZADOS NO CRÍTICOS
López, M. F. F., Baamil, O. F., Doldán, C. L., Alonso, M. L. B., Prada, M. T. D. S., Labrador, F. L., García, M. D. C. G., & Mato, J. A. (2014) · doi:10.3305/nh.2014.30.6.7784 · Cited by 8
Burden of Malnutrition in a Tertiary Care Hospital in Baguio City
Dominguez, R. J. (2013) · doi:10.1177/2158244013504936 · Cited by 8
“…Burgos et al., 2012; Fiaccadori et al., 1999; Gout, Barker, & Crowe, 2009; Gupta et al., 2005; Kyle et al., 2005; Middleton et al., 2001; Ocampo et al., 2008; Ozkalkanli et al., 2009; Raslan et al., 2011; Sacks et al., 2000; Segall et al., 2009; Sorensen et al., 2008; Sungurtekin et al., 2009).”
BackgroundResult
Evaluación de la eficacia de un suplemento oral en polvo enriquecido con ácido eicosapentaenoico en un grupo de pacientes con cáncer
Gómez-Candela, C., Sanz, M. V., Horrisberger, A., Kohen, V. L., Bermejo, L. M., & Auñón, P. (2011) · LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) · doi:10.3305/nh.2011.26.6.5349 · Cited by 8
Assessing malnutrition among chemotherapy and/or radiotherapy cancer Benghazi outpatients
Pandey, D., Buzgeia, M., Badr, S. A. E., Senussi, F. G., El‐Mokasabi, H. I., & El‐Shahomi, A. M. (2011) · Nutrition & Food Science · doi:10.1108/00346651111170897 · Cited by 8
Investing in patients’ nutrition: nutrition risk screening in hospital
Cant, R. (2010) · Australian Journal of Advanced Nursing · doi:10.37464/2011.282.1687 · Cited by 8
“A large study of over 5,000 randomly selected hospital patients in 12 European countries found that screened at‑risk patient status was significantly associated with higher mortality and also longer hospital stay and more complications (Sorensen et al 2008).”
Background
Large regional disparities in prevalence, management and reimbursement of hospital undernutrition
Khalatbari-Soltani, S., de Mestral, C., Waeber, G., & Marques-Vidal, P. (2018) · European Journal of Clinical Nutrition · doi:10.1038/s41430-018-0149-3 · Cited by 8
Nutrition Assessment in Oncology
Cushen, S., Power, D., & Ryan, A. (2015) · Topics in Clinical Nutrition · doi:10.1097/tin.0000000000000023 · Cited by 8

Authors: Sorensen, J., Kondrup, J., Prokopowicz, J., Schiesser, M., Krähenbühl, L., Meier, R., & Liberda, M.
Affiliations: University of Copenhagen (DK)
University Hospital Zurich (CH)
HFR Freiburg Kantonsspital (CH)
ORCID: Sorensen, Janice
Schiesser, Marc
Krähenbühl, Lukas
Venue: Clinical Nutrition
Publisher: Elsevier BV
Published: 2008-06
Volume: 27
Issue: 3
Pages: 340-349
ISSN: 0261-5614 (ISSN-L)
DOI: 10.1016/j.clnu.2008.03.012
OpenAlex: W2041669990
Cited by: 607
References: 0
Citations by year: 2026: 18 · 2025: 22 · 2024: 31 · 2023: 40 · 2022: 37 · 2021: 56 · 2020: 47 · 2019: 47 · 2018: 24 · 2017: 33 · 2016: 29 · 2015: 42 · 2014: 41 · 2013: 34 · 2012: 35
FWCI: 21.49
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Clinical Nutrition (publishedVersion)
PubMed (publishedVersion)
Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
Topics: Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
Health Sciences › Medicine › Physiology (medical) › Nutrition and Health in Aging
Health Sciences › Nursing › Nutrition and Dietetics › Dietetics, Nutrition, and Education
Keywords: nutritional risk screening, NRS-2002, nutritional risk, clinical outcomes, in-hospital mortality, postoperative complications, length of hospital stay, hospital discharge, predictors of poor outcome, multicenter study
MeSH terms: Female, Humans, Length of Stay, Male, Mass Screening, Middle Aged, Nutritional Status, Predictive Value of Tests, Prognosis, Prospective Studies, Sensitivity and Specificity, Cohort Studies, Weight Loss, Nutrition Assessment, Multivariate Analysis, Treatment Outcome, Hospital Mortality, Risk Assessment, Malnutrition

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EuroOOPS: An international, multicentre study to implement nutritional risk screening and evaluate clinical outcome

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