Analyses of Malnutrition Screening in Internal Medicine

Completed

• Conditions: Malnutrition

• Registration Number: NCT05918900
• Lead Sponsor: University Medicine Greifswald

Brief Summary

The goal of this observational study is to study the presence and consequences of malnutrition risk in hospitalized internal medicine patients.

The main questions it aims to answer are:

1. How many patients are at risk of malnutrition at admission?

2. Is there a link between an existing malnutrition risk and nutrition therapy that the patients receive?

3. Is there a link between an existing malnutrition risk and clinical outcome (e.g. length of hospital stay, mortality, need for rehospitalization)?

Participants will be screened for malnutrition risk at admission using a validated questionnaire (Nutritional Risk Screening 2002). All relevant data regarding hospital stay will be obtained from the clinical information system after discharge.

Detailed Description

Malnutrition is associated with adverse clinical outcome in hospitalized patients. Therefore, systematic screening for malnutrition risk at admission is recommended by almost all medical expert societies to identify patients who will benefit from nutritional therapy.

Although clinical and economic benefit of systematic malnutrition screening have been shown in various settings and for different patient groups, such screening is still not mandatory in most countries. In part, establishment of malnutrition screening is hampered by discrepant findings on the prevalence of malnutrition risk and the lack of evidence on a local level.

Hence, in this observational study the investigators examine the results of systematic malnutrition screening in internal medicine patients admitted to a university hospital in Northeast Germany. In particular, the investigators aim to determine the prevalence of malnutrition risk at hospital admission, the association between malnutrition risk and nutrition therapy as well as clinical outcome in different disciplines of internal medicine.

For this purpose, all patients undergo screening for malnutrition risk at admission using a validated instrument (Nutritional Risk Screening 2002). All relevant data regarding the patients' hospital stay will be obtained from the clinical information system after discharge.

Study Timeline

• Study Start: 2023-06-05
• Study First Submitted: 2023-06-15
• Study First Submitted QC: 2023-06-15
• Study First Posted: 2023-06-26
• Primary Completion: 2023-09-22
• Study Completion: 2023-09-22
• Status Verified: 2023-12
• Last Update Submitted: 2023-12-07
• Last Update Posted: 2023-12-08

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 323

Inclusion Criteria

• hospital admission for gastrointestinal, endocrine, rheumatic, or nephrological condition
• provision of informed consent

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Exclusion Criteria

• inability to provide consent
• unfeasibility to perform malnutrition screening within 48h after admission

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Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Overall presence of malnutrition risk	Baseline	Prevalence of malnutrition risk, i.e. Nutritional Risk Screening 2002 (NRS-2002) score \>= 3 points, in all internal medicine patients at hospital admission. NRS-2002 score ranges from 0 to 7, with higher values indicating greater nutritional risk.

Secondary Outcome Measures

Name	Time	Method
Presence of malnutrition risk in gastroenterology	Baseline	Prevalence of malnutrition risk, i.e. Nutritional Risk Screening 2002 (NRS-2002) score \>= 3 points, in patients with gastrointestinal disease at hospital admission. NRS-2002 score ranges from 0 to 7, with higher values indicating greater nutritional risk.
Presence of malnutrition risk in rheumatology	Baseline	Prevalence of malnutrition risk, i.e. Nutritional Risk Screening 2002 (NRS-2002) score \>= 3 points, in patients with rheumatic disease at hospital admission. NRS-2002 score ranges from 0 to 7, with higher values indicating greater nutritional risk.
Presence of malnutrition risk in nephrology	Baseline	Prevalence of malnutrition risk, i.e. Nutritional Risk Screening 2002 (NRS-2002) score \>= 3 points, in patients with nephrological disease at hospital admission. NRS-2002 score ranges from 0 to 7, with higher values indicating greater nutritional risk.
Relation of malnutrition risk to nutritional consultation	Baseline	Association between malnutrition risk, i.e. Nutritional Risk Screening 2002 (NRS-2002) score \>= 3 points, and number of nutritional consultations. NRS-2002 score ranges from 0 to 7, with higher values indicating greater nutritional risk.
Relation of malnutrition risk to intermediate care treatment	Baseline	Association between malnutrition risk, i.e. Nutritional Risk Screening 2002 (NRS-2002) score \>= 3 points, and admission to an intermediate care unit. NRS-2002 score ranges from 0 to 7, with higher values indicating greater nutritional risk.
Presence of malnutrition risk in endocrinology	Baseline	Prevalence of malnutrition risk, i.e. Nutritional Risk Screening 2002 (NRS-2002) score \>= 3 points, in patients with endocrine disease at hospital admission. NRS-2002 score ranges from 0 to 7, with higher values indicating greater nutritional risk.
Relation of malnutrition risk to nutritional diagnosis	Baseline	Association between malnutrition risk, i.e. Nutritional Risk Screening 2002 (NRS-2002) score \>= 3 points, and nutritional diagnosis resulting from nutritional assessment by an expert dietitian. NRS-2002 score ranges from 0 to 7, with higher values indicating greater nutritional risk.
Relation of malnutrition risk and 30-day readmission	Baseline	Association between malnutrition risk, i.e. Nutritional Risk Screening 2002 (NRS-2002) score \>= 3 points, and unplanned hospital readmission within 30 days after discharge. NRS-2002 score ranges from 0 to 7, with higher values indicating greater nutritional risk.
Relation of malnutrition risk to intensive care treatment	Baseline	Association between malnutrition risk, i.e. Nutritional Risk Screening 2002 (NRS-2002) score \>= 3 points, and admission to an intensive care unit. NRS-2002 score ranges from 0 to 7, with higher values indicating greater nutritional risk.
Relation of malnutrition risk to mortality	Baseline	Association between malnutrition risk, i.e. Nutritional Risk Screening 2002 (NRS-2002) score \>= 3 points, and in-hospital mortality. NRS-2002 score ranges from 0 to 7, with higher values indicating greater nutritional risk.
Relation of malnutrition risk and 90-day readmission	Baseline	Association between malnutrition risk, i.e. Nutritional Risk Screening 2002 (NRS-2002) score \>= 3 points, and unplanned hospital readmission within 90 days after discharge. NRS-2002 score ranges from 0 to 7, with higher values indicating greater nutritional risk.
Relation of malnutrition risk to length of hospital stay	Baseline	Association between malnutrition risk, i.e. Nutritional Risk Screening 2002 (NRS-2002) score \>= 3 points, and length of hospital stay measured in days. NRS-2002 score ranges from 0 to 7, with higher values indicating greater nutritional risk.

Trial Locations

Locations (1)

University Medicine Greifswald; 🇩🇪 Greifswald, Germany