Logo: to the web site of Uppsala University

uu.sePublications from Uppsala University
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
ESPEN guideline on nutritional support for polymorbid medical inpatients
Cantonal Hosp Aarau, Tellstr 25,H7, CH-5001 Aarau, Switzerland.;Univ Basel, Basel, Switzerland..
Cantonal Hosp Aarau, Tellstr 25,H7, CH-5001 Aarau, Switzerland.;Univ Basel, Basel, Switzerland.;Univ NOVA Lisboa, NOVA Med Sch, Lisbon, Portugal..ORCID iD: 0000-0003-1702-1433
Cantonal Hosp Aarau, Tellstr 25,H7, CH-5001 Aarau, Switzerland.;Univ Basel, Basel, Switzerland.;Univ Basel, Med Fac, Basel, Switzerland..
Cantonal Hosp Aarau, Tellstr 25,H7, CH-5001 Aarau, Switzerland.;Univ Basel, Basel, Switzerland.;Univ Hohenheim, Inst Clin Nutr, D-70599 Stuttgart, Germany..
Show others and affiliations
2023 (English)In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 42, no 9, p. 1545-1568Article in journal (Refereed) Published
Abstract [en]

Background: Disease-related malnutrition in polymorbid medical inpatients is a highly prevalent syndrome associated with significantly increased morbidity, disability, short- and long-term mortality, impaired recovery from illness, and cost of care.

Aim: As there are uncertainties in applying disease-specific guidelines to patients with multiple conditions, our aim was to provide evidence-based recommendations on nutritional support for the polymorbid patient population hospitalized in medical wards.

Methods: This update adheres to the standard operating procedures for ESPEN guidelines. We did a systematic literature search for 15 clinical questions in three different databases (Medline, Embase and the Cochrane Library), as well as in secondary sources (e.g. published guidelines), until July 12th. Retrieved abstracts were screened to identify relevant studies that were used to develop recommendations (incl. SIGN grading), which was followed by submission to Delphi voting.

Results: From a total of 3527 retrieved abstracts, 60 new relevant studies were analyzed and used to generate a guideline draft that proposed 32 recommendations (7x A, 11x B, 10x O and 4x GPP), which encompass different aspects of nutritional support including indication, route of feeding, energy and protein requirements, micronutrient requirements, disease-specific nutrients, timing, monitoring and procedure of intervention. The results of the first online voting showed a strong consensus (agreement of >90%) on 100% of the recommendations. Therefore, no final consensus conference was needed.

Conclusions: Recent high-quality trials have provided increasing evidence that nutritional support can reduce morbidity and other complications associated with malnutrition in polymorbid patients. The timely screening of patients for risk of malnutrition at hospital admission followed by individualized nutritional support interventions for at-risk patients should be part of routine clinical care and multimodal treatment in hospitals worldwide. Use of this updated guideline offers an evidence-based nutritional approach to the polymorbid medical inpatients and may improve their outcomes.& COPY; 2023 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/).

Place, publisher, year, edition, pages
Elsevier BV , 2023. Vol. 42, no 9, p. 1545-1568
Keywords [en]
Guideline, Polymorbidity, Multimorbidity, Nutritional support, Hospitalized patients
National Category
Nutrition and Dietetics
Identifiers
URN: urn:nbn:se:uu:diva-510717DOI: 10.1016/j.clnu.2023.06.023ISI: 001046077000001PubMedID: 37478809OAI: oai:DiVA.org:uu-510717DiVA, id: diva2:1793979
Available from: 2023-09-04 Created: 2023-09-04 Last updated: 2023-09-04Bibliographically approved

Open Access in DiVA

fulltext(830 kB)55 downloads
File information
File name FULLTEXT01.pdfFile size 830 kBChecksum SHA-512
97b0a10b87ec247a63d3173a7239c55be741f82d3bb6f991b721865836aec4453f50935baab12fb08be79a63d179d7e72d351da1c8f51793341165fd436d8edc
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMed

Authority records

Cederholm, Tommy

Search in DiVA

By author/editor
Gomes, FilomenaBallesteros-Pomar, Maria D.Cederholm, TommyFletcher, Jane
By organisation
Department of Public Health and Caring Sciences
In the same journal
Clinical Nutrition
Nutrition and Dietetics

Search outside of DiVA

GoogleGoogle Scholar
Total: 57 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 90 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf