Clinical trial NCT02913846: The Impact of Denutrition on the Hospital Length of Stay for Patients Undergoing Rehabilitation
Official title: The Impact of Denutrition on the Hospital Length of Stay for Patients Undergoing Rehabilitation
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Denutrition
Keywords: denutrition
hospital length of stay
patient's autonomy
Lead sponsor: Brugmann University Hospital
Sponsor class: OTHER
First posted: 2016-09-26
Enrollment: 180
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: All patients admitted within a revalidation unit of the CHU Brugmann hospital

Brief 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.


Eligibility criteria: 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...

Primary outcomes:
measure: Barthel index score
timeFrame: within 48h of admission within the revalidation unit
measure: Nutritional Risk Screening score
timeFrame: within 48h of admission within the revalidation unit
measure: Body Mass Index
timeFrame: once a week up to patient discharge (the average hospitalization length within the revalidation unit is 48 days)
measure: Weight
timeFrame: once a week up to patient discharge (the average hospitalization length within the revalidation unit is 48 days)
measure: Hand prehension force
timeFrame: once a week up to patient discharge (the average hospitalization length within the revalidation unit is 48 days)
measure: Pre-albumine level (mg/l)
timeFrame: once a week up to patient discharge (the average hospitalization length within the revalidation unit is 48 days)
Secondary outcomes:
Other outcomes:
Locations:
city: Brussels
country: Belgium
facility: CHU Brugmann
Study officials:
affiliation: CHU Brugmann
name: Samar Hatem, MD
role: STUDY_DIRECTOR
References:
citation: Alvarez-Hernandez J, Planas Vila M, Leon-Sanz M, Garcia de Lorenzo A, Celaya-Perez S, Garcia-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.