The Impact of Denutrition on the Hospital Length of Stay for Patients Undergoing Rehabilitation

Denutrition Clinical Trial

Official title:

The Impact of Denutrition on the Hospital Length of Stay for Patients Undergoing Rehabilitation

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02913846
• Other study ID #: CHUB-Nut-Reva
• Status: Completed
• Phase: N/A
• First received: September 14, 2016
• Last updated: January 18, 2018
• Start date: March 18, 2016
• Est. completion date: September 12, 2017

Study information

• Verified date: January 2018
• Source: Brugmann University Hospital
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

Denutrition is defined as a measurable decrease in functions and/or as change in the body composition, associated with a worsening of the prognosis of the underlying medico-surgical pathology. It is induced by a deficiency in energy, proteins or any other micro or macronutrient and is the result of malnutrition, itself caused by a poor diet or a metabolic disorder.

According to the National Nutrition and Health Plan for Belgium, denutrition is an independent risk factor for the increase of complications, morbidity and mortality rates, average length of hospitalisation and global medical care cost. It is necessary to invest in the prevention of denutrition as the costs of preventive measures are lower than the cost of treating a denutrished patient.

The Belgian financing system of hospitalisation days is based on the structure of the treated pathologies, the age of the patient and the geriatric features of the patient. It encourages all hospitals to lower the length of hospitalisation to the national average for all these criteria. As a consequence, there is a mounting tendency to shorten the average length of stay within the hospital.

The so-called 'Sp' hospital departments occupy a specific place within the organisation of Health Services in Belgium. They are specialized in the treatment and rehabilitation of patients with cardiopulmonary, neurological, locomotor, psycho-geriatric and chronic diseases. These services act as an extension of acute services (continuity of acute hospitalisation) but also as a first entry point for the medical care of patients with various specific diseases (multiple sclerosis, psycho-geriatric disorders, chronic pulmonary disorders...).

The financing of the Sp departments is, as opposed to the financing of other departments, not linked to the patient length of stay. However, an increase in hospitalization duration decreases the rate of admissions and the possibility to accept patients coming from acute hospital units.

The aim of the study is to evaluate the influence of denutrition of patients hospitalized in an Sp department on the length of revalidation stay, the associated costs and the patient's functional autonomy.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 180
• Est. completion date: September 12, 2017
• Est. primary completion date: September 12, 2017
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• All patients admitted within a revalidation unit of the CHU Brugmann hospital

Exclusion Criteria:

• Patients without programmed exit: transfer to another care unit, forced exit, death...

Related Conditions & MeSH terms

• Denutrition

Intervention

Other:
• Nutritional evaluation
A first nutritional evaluation will be performed within 48h of patient admission. Weight and BMI will be measured once a week.
• Muscular assessment
An assessment of muscular force will be performed once a week.
• Pre-albumine dosage
Dosage performed once a month.

Locations

Country	Name	City	State
Belgium	CHU Brugmann	Brussels

Sponsors (1)

Lead Sponsor	Collaborator
Brugmann University Hospital

Country where clinical trial is conducted

Belgium, 

References & Publications (1)

Álvarez-Hernández J, Planas Vila M, León-Sanz M, García de Lorenzo A, Celaya-Pérez S, García-Lorda P, Araujo K, Sarto Guerri B; PREDyCES researchers. Prevalence and costs of malnutrition in hospitalized patients; the PREDyCES Study. Nutr Hosp. 2012 Jul-Aug;27(4):1049-59. doi: 10.3305/nh.2012.27.4.5986. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Barthel index score	Assessment of patient autonomy	within 48h of admission within the revalidation unit
Primary	Nutritional Risk Screening score	Nutritional state assessment	within 48h of admission within the revalidation unit
Primary	Body Mass Index		once a week up to patient discharge (the average hospitalization length within the revalidation unit is 48 days)
Primary	Weight		once a week up to patient discharge (the average hospitalization length within the revalidation unit is 48 days)
Primary	Hand prehension force	performed on the right hand with a Jamart dynamometer	once a week up to patient discharge (the average hospitalization length within the revalidation unit is 48 days)
Primary	Pre-albumine level (mg/l)	Laboratory testing	once a week up to patient discharge (the average hospitalization length within the revalidation unit is 48 days)