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type: UserItem
resource: Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial
tagged: UserTag
  label: Acute Disease/epidemiology
tagged: UserTag
  label: Aged
tagged: UserTag
  label: Aged, 80 and over
tagged: UserTag
  label: Chronic Disease/epidemiology
tagged: UserTag
  label: Comorbidity
tagged: UserTag
  label: Energy Intake
tagged: UserTag
  label: Female
tagged: UserTag
  label: Hospitalization/statistics & numerical data
tagged: UserTag
  label: Humans
tagged: UserTag
  label: Male
tagged: UserTag
  label: Malnutrition/*prevention & control
tagged: UserTag
  label: Middle Aged
tagged: UserTag
  label: Nutritional Support/*methods
tagged: UserTag
  label: Outcome Assessment, Health Care/*statistics & numerical data
tagged: UserTag
  label: Patient-Centered Care/*methods
tagged: UserTag
  label: Practice Guidelines as Topic
tagged: UserTag
  label: Risk Assessment

Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial
type: AcademicArticle
abstract: BACKGROUND: Guidelines recommend the use of nutritional support during hospital stays for medical patients (patients not critically ill and not undergoing surgical procedures) at risk of malnutrition. However, the supporting evidence for this recommendation is insufficient, and there is growing concern about the possible negative effects of nutritional therapy during acute illness on recovery and clinical outcomes. Our aim was thus to test the hypothesis that protocol-guided individualised nutritional support to reach protein and caloric goals reduces the risk of adverse clinical outcomes in medical inpatients at nutritional risk. METHODS: The Effect of early nutritional support on Frailty, Functional Outcomes, and Recovery of malnourished medical inpatients Trial (EFFORT) is a pragmatic, investigator-initiated, open-label, multicentre study. We recruited medical patients at nutritional risk (nutritional risk screening 2002 [NRS 2002] score >/=3 points) and with an expected length of hospital stay of more than 4 days from eight Swiss hospitals. These participants were randomly assigned (1:1) to receive either protocol-guided individualised nutritional support to reach protein and caloric goals (intervention group) or standard hospital food (control group). Randomisation was done with variable block sizes and stratification according to study site and severity of malnutrition using an interactive web-response system. In the intervention group, individualised nutritional support goals were defined by specialist dietitians and nutritional support was initiated no later than 48 h after admission. Patients in the control group received no dietary consultation. The composite primary endpoint was any adverse clinical outcome defined as all-cause mortality, admission to intensive care, non-elective hospital readmission, major complications, and decline in functional status at 30 days, and it was measured in all randomised patients who completed the trial. This trial is regi…
pages: 2312-2321
doi: 10.1016/S0140-6736(18)32776-4
source: 31030981
creator: Person
author list: Person
is part of: Issue
  date: 2019-04-30
  volume: 393
  issue: 10188
  is part of: Lancet
    type: Journal
    issn: 1474-547X (Electronic) 0140-6736 (Linking)

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surname: Schuetz

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surname: Fehr

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