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ESPEN practical guideline: Nutritional support for polymorbid medical inpatients
Cantonal Hosp Aarau, Dept Biomed, Aarau, Switzerland.;Univ Basel, Basel, Switzerland..
Cantonal Hosp Aarau, Dept Biomed, Aarau, Switzerland.;Univ Basel, Basel, Switzerland.;Univ Nova Lisboa, NOVA Med Sch, Lisbon, Portugal..ORCID iD: 0000-0003-1702-1433
Cantonal Hosp Aarau, Dept Biomed, Aarau, Switzerland.;Univ Basel, Basel, Switzerland.;Cantonal Hosp Aarau, Tellstrasse 25,H7, CH-5001 Aarau, Switzerland.;Univ Basel, Med Fac, Basel, Switzerland..ORCID iD: 0000-0001-6400-4949
Cantonal Hosp Aarau, Dept Biomed, Aarau, Switzerland.;Univ Basel, Basel, Switzerland.;Univ Hohenheim, Inst Clin Nutr, D-70599 Stuttgart, Germany..ORCID iD: 0009-0009-4144-869X
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2024 (English)In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 43, no 3, p. 674-691Article 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 healthcare costs.

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: The 2023 update adheres to the standard operating procedures for ESPEN guidelines. We undertook 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, 2022. Retrieved abstracts were screened to identify relevant studies that were used to develop recommendations (including SIGN grading), which was followed by submission to Delphi voting. Here, the practical version of the guideline is presented which has been shortened and equipped with flow charts for patients care.

Results: 32 recommendations (7x A, 11x B, 10x O and 4x GPP), which encompass different aspects of nutritional support were included from the scientific guideline including indication, route of feeding, energy and protein requirements, micronutrient requirements, disease-specific nutrients, timing, monitoring and procedure of intervention. Here, the practical version of the guideline is presented which has been shortened and equipped with flow charts for patients care.

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 practical guideline offers an evidencebased nutritional approach to polymorbid medical inpatients and may improve their outcomes.

Place, publisher, year, edition, pages
Elsevier, 2024. Vol. 43, no 3, p. 674-691
Keywords [en]
Guideline, Polymorbid, Multimorbidity, Nutritional support, Hospitalized patients
National Category
Nutrition and Dietetics
Identifiers
URN: urn:nbn:se:uu:diva-525901DOI: 10.1016/j.clnu.2024.01.008ISI: 001181768500001PubMedID: 38309229OAI: oai:DiVA.org:uu-525901DiVA, id: diva2:1848894
Available from: 2024-04-04 Created: 2024-04-04 Last updated: 2024-04-04Bibliographically approved

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Cederholm, Tommy

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