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

Study Overview
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Brief Summary
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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.

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

Conditions
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Denutrition

Intervention / Treatment
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* Other: Nutritional evaluation
* Other: Muscular assessment
* Other: Pre-albumine dosage


Participation Criteria
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Eligibility Criteria
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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...

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Hospital revalidation units<br>The study will take place within the CHU Brugmann hospital (Brussels) who has 4 revalidation units (104 beds). All patients coming within these units during the study duration will be included. | Other: Nutritional evaluation<br>* A first nutritional evaluation will be performed within 48h of patient admission. Weight and BMI will be measured once a week.<br>Other: Muscular assessment<br>* An assessment of muscular force will be performed once a week.<br>Other: Pre-albumine dosage<br>* Dosage performed once a month.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Barthel index score | Assessment of patient autonomy | within 48h of admission within the revalidation unit | 
| Nutritional Risk Screening score | Nutritional state assessment | within 48h of admission within the revalidation unit | 
| Body Mass Index |  | once a week up to patient discharge (the average hospitalization length within the revalidation unit is 48 days) | 
| Weight |  | once a week up to patient discharge (the average hospitalization length within the revalidation unit is 48 days) | 
| 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) | 
| 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) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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denutrition, hospital length of stay, patient's autonomy