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Cited by 103Clinical Nutrition and GastroenterologyNutrition and Health in AgingDietetics, Nutrition, and Education

Detection and treatment of medical inpatients with or at-risk of malnutrition: Suggested procedures based on validated guidelines

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Bounoure, Lisa, Gomes, Filomena, Stanga, Zeno, Keller, Ulrich, Meier, Rémy, Ballmer, Peter, Fehr, Rebecca, Mueller, Beat +32 more·2016·Nutrition
DOI 10.1016/j.nut.2016.01.019
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Abstract

Objective Despite the high prevalence of malnutrition in the general inpatient population, there is a lack of knowledge in regard to detecting disease-related malnutrition and implementing nutritional support. Our aim was to suggest practical procedures for screening and treating malnourished or at-risk patients hospitalized in medical wards, thereby fostering a straightforward implementation of nutritional therapy independent of the underlying disease and comorbidities. Methods A working group of experts in clinical nutrition selected and analyzed published disease-specific European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines relevant for our aim. Eight questions in population, intervention, control, outcome format were defined to cover topics such as screening, nutritional targets, and routes of feeding. Individual studies were extracted from the guidelines by applying inclusion and exclusion criteria targeting the heterogeneous population of medical inpatients with or at-risk of disease-related malnutrition. We used those studies as evidence, as well as recommendations from the selected ESPEN guidelines, to formulate answers to the questions. Final agreement with the statement was obtained by consensus of the whole working group. Results Procedures on how to provide integrated nutritional therapy (oral, enteral, and parenteral) to a heterogeneous patient population were suggested, including how to identify malnourished or at-risk patients, nutrient targets, choice of feeding route, monitoring, and assessment of patients. We also developed a simple algorithm to facilitate the implementation of a nutritional care plan for the general medical inpatient population. Conclusion By compiling evidence and recommendations from disease-specific guidelines, we were able to suggest a nutritional strategy applicable to large and heterogeneous group of malnourished or at-risk patients admitted to hospitals. A large randomized controlled trial is currently investigating whether this strategy improves clinical outcomes of patients.

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  • In situations where oral intake is insufficient, use of enteral nutrition or parenteral nutrition can help increase nutritional intake until oral intake is sufficient.

    “In these situations, use of EN or PN can help increase nutritional intake until oral intake is sufficient [51,52].”

    From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [51]

    The Route, monitoring, and reassessment section (p. 7) recommends enteral tube feeding when medical inpatients cannot meet nutritional requirements orally and says intake should be reassessed. The retrieved passage discusses parenteral nutrition as a comparator, but does not say it should be used to increase intake until oral intake is sufficient; that part of the claim is not supported by our copy. (LLM, conf=0.82)

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Authors
Bounoure, L., Gomes, F., Stanga, Z., Keller, U., Meier, R., Ballmer, P., Fehr, R., Mueller, B., Genton, L., Bertrand, P. C., Norman, K., Henzen, C., Laviano, A., Bischoff, S., Schneider, S. M., Kondrup, J., Schuetz, P., Bounoure, L., Gomes, F., Fehr, R., Bally, M., Pulvermüller, I., Deiss, M., Schuetz, P., Mueller, B., Stanga, Z., Keller, U., Meier, R., Ballmer, P., Ruehlin, M., Imoberdorf, R., Spielmann, A., Genton, L., Norman, K., Bertrand, P. C., Henzen, C., Laviano, A., Bischoff, S., Schneider, S., & Kondrup, J.
ORCID
Imoberdorf, Reinhard
Venue
Nutrition
Publisher
Elsevier BV
Published
2016-07
Volume
32
Issue
7-8
Pages
790-798
ISSN
0899-9007 (ISSN-L)
DOI
10.1016/j.nut.2016.01.019
OpenAlex
W2283431252
Cited by
103
References
3
Citations by year
2026: 3 · 2025: 7 · 2024: 12 · 2023: 8 · 2022: 9 · 2021: 17 · 2020: 12 · 2019: 14 · 2018: 9 · 2017: 12
FWCI
12.21
Type
journal article
Language
en
Open access
Licence
Locations
  • Nutrition (publishedVersion)
  • PubMed (publishedVersion)
  • Archive ouverte UNIGE (University of Geneva) (publishedVersion, other-oa)
  • IRIS Research product catalog (Sapienza University of Rome) (submittedVersion, other-oa)
  • BORIS (University Library Bern) (submittedVersion)
  • IRIS (submittedVersion)
  • SERVAL (Université de Lausanne) (submittedVersion)
  • Archive ouverte UNIGE (University of Geneva) (submittedVersion, cc-by)
Funders
  • National Science Foundation
  • Universität Basel
  • Universität Hohenheim
  • Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (PP00 P3_150531/1)
  • Rigshospitalet
  • Centre Hospitalier Universitaire Vaudois
  • European Society for Clinical Nutrition and Metabolism
  • Forschungsrat des Kantonsspitals Aarau (1410.000.044)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
  • Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
  • Health Sciences › Health Professions › Health Information Management › Dietetics, Nutrition, and Education
Keywords
disease-related malnutrition, medical inpatients, nutritional screening, nutritional therapy, enteral nutrition, parenteral nutrition, oral nutrition, nutritional care plan, ESPEN guidelines, consensus recommendations, malnutrition risk assessment
MeSH terms
Acute Disease, Algorithms, Humans, Inpatients, Nutritional Status, Reproducibility of Results, Nutrition Assessment, Practice Guidelines as Topic, Malnutrition, Nutrition Therapy

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