Hip fracture, chronic disease especially with complications, e.g. liver cirrhosis, COPD, diabetes, cancer, chronic hemodialysis
e.g. stroke, hematologic malignancy, severe pneumonia,
extended abdominal surgery
e.g. head traumas, hematopoietic stem cell transplantation, intensive care patients (APACHE-II > 10)
As estimated by the the NRS, 20 – 30% of hospitalised medical patients are malnourished or are at high risk of protein-energy malnutrition. 2 Malnourished patients have a higher rate of complications, longer duration of hospitalisation, poorer quality of life and higher mortality as compared to those who are well-nourished. 3 Malnutrition is often the result of other medical diseases but can be managed with a targeted therapy. The therapeutic algorithm presented here is based on ESPEN guidelines for polymorbid medical patients as well as on the EFFORT study. 4-5
Improved early identification of patients at risk of malnutrition and initiation of appropriate individual therapy for improvement/maintenance of functionality and quality of life as well as significant reduction of complications and mortality. Management of malnutrition is a team effort and can only be undertaken in close cooperation between nurses, dieticians and doctors.
Individual nutritional goals may be easily calculated on-line with the available nutritional calculator. The displayed results are based on the formulae used in the EFFORT study.
The EFFORT study, supported by the Swiss National Fund and published in the Lancet in April 2019, clearly demonstrates the benefit of adequate, individualised nutritional therapy:
The protein and energy balance improves significantly which in turn has a positive effect on the course of the disease.
Kondrup J, et al. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr. 2003;22(3):321-36.