Malnutrition Clinical Trial
Official title:
Nutritional Risk and Use of Health Care Services - a Missed Opportunity? A Cohort Study on Patients 65+
This longitudinal observation study investigates associations between nutritional risk in adults aged 65+ and use of health services, morbidity and mortality. The first hypothesis is that older service users at nutritional risk will use a higher number of services/consultations and have a higher morbidity and mortality, compared to older patients not at nutritional risk. Further, the study evaluates the usefulness of the tool 'nutrition plan'. The second hypothesis is that older service users at nutritional risk who have a nutrition plan have lower subsequent morbidity and mortality, compared to older service users at nutritional risk without a nutrition plan.
The study is divided into two main parts, based on two different populations.
Study A: Article 1 is based on 'The Undernutrition Registry' in Helse Bergen Local Health
Authority, Norway. The Undernutrition registry is a cohort of patients (n=20 000) screened
for nutritional risk at Haukeland University Hospital (HUS) during point prevalence surveys
between 2008 and 2018. The point prevalence surveys included all adult patients in somatic
departments, and were performed 2-4 times per year. Detailed descriptions of the data
collection can be found in Tangvik et al. (2012). Previous analysis showed that 43% of the
patients in the sample were above 70 years, thus we expect the sample in the study to
constitute approx. 9000 patients ≥ 65 years. Nutritional risk was determined by 'Nutritional
Risk Screening 2002' (NRS2002). Information on nutritional risk will be linked to data on
health care use and outcomes from the hospital's patient administrative electronic database
(length of stay, number of hospital stays, morbidity in terms of number and severity of
diagnoses and death).
Study B: Articles 2 and 3 are based on a cohort of older service users (≥65 years) with
information on nutritional variables from the 'Kommunalt pasientregister' (KPR)-registry in
the period 2016-2018 (N=270,560). Municipalities report data on nutritional risk screening
and nutritional plan for individual service users in KPR. These nutritional data will be
linked to data from 'The Norwegian Patient Registry' (NPR). NPR includes information about
diagnosis and use of specialist services for all patients who have received or are waiting
for treatment/consultations in specialist health care services (hospitals and outpatient
clinics).
Nutritional status and use of 'nutritional plan' will be entered as independent variables in
regression and survival analysis models with health service use (type, extent) or mortality
as outcome variables.
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