scholarly journals An algorithm for the clinical assessment of nutritional status in hospitalized patients

2003 ◽  
Vol 90 (4) ◽  
pp. 829-836 ◽  
Author(s):  
J. Th. C. M. de Kruif ◽  
A. Vos
Keyword(s):  
At Risk ◽  
Nutritional Status ◽  
Nursing Staff ◽  
Clinical Assessment ◽  
Early Stage ◽  
Hospitalized Patients ◽  
Nutritional Screening ◽  
Patients At Risk ◽  
Two Phases ◽  
Definition Of

Upon admission to hospital, 30–50% of patients either are or become malnourished. There is no generally accepted definition of malnutrition or guidelines on the best way to establish nutritional status. We consider it self-evident that the nursing staff have an important role in screening patients at risk of malnutrition on admission and thereafter at regular times. This is why we developed the nursing nutritional screening form (NNSF). The NNSF was tested by nurses, dietitians and clinicians, in pairs, to establish the extent of agreement in two phases on sixty-nine and forty patients. Later, the form was used in practice by nursing staff on five wards (334 patients). Based on the results of the NNSF, patients were referred to a dietitian. The dietitian established whether the patient was indeed at risk, or was actually malnourished, using a complete nutritional history. The degree of concurrence within pairs was reasonable to good. The same applied to the concurrence between nursing staff and dietitians, but concurrence between clinicians and nursing staff was less. In total, 334 patients were screened and sixty-nine of them were referred to the dietitian. It was established that 86% of the referred patients were potentially at risk of malnutrition or were malnourished. Without the NNSF, 39% (n 27) of the patients referred to the dietitian would not have been referred, or would have been referred much later. The NNSF makes it possible for nurses to detect malnourished patients or patients at risk of malnutrition at an early stage of their hospitalization.

scholarly journals A digital dietary assessment tool may help identify malnutrition and nutritional deficiencies in hospitalized patients

2021 ◽  
Vol 7 ◽  
Author(s):  
Adam Bernstein ◽  
Randall Moore ◽  
Lauren Rhee ◽  
Dina Aronson ◽  
David Katz
Keyword(s):  
At Risk ◽  
Nutritional Status ◽  
Assessment Tool ◽  
Hospital Setting ◽  
Hospitalized Patients ◽  
Nutritional Deficiencies ◽  
Study Cohort ◽  
Nutrient Deficiencies ◽  
Historical Cohort ◽  
Patients At Risk

Malnutrition is common among hospitalized patients and associated with longer hospital stays, higher rates of rehospitalization, and increased mortality. Validated questionnaires of varying sensitivity and specificity to help identify patients at risk of malnutrition have been developed, but none has been broadly adopted. Tools to identify patients at risk for malnutrition should be quick, inexpensive, easy to administer and use, not require specialized nutrition knowledge, and provide results which can be entered into an electronic medical record; ideally, the tool should be deployed within 24 hours of admission and repeated if warranted. We hypothesize that a novel digital nutrition assessment tool which uses the Diet Quality Photo Navigation (DQPN) method, can help triage hospitalized patients toward further evaluation of nutritional status. We further propose that micronutrient deficiencies may be identified at the same time as malnutrition and that the reimbursement and cost savings from DQPN will prove substantially greater than the combined costs of its use and triggered dietitian consult. Deploying DQPN upon admission will represent an addition to standard hospital intake procedure that is frictionless for patients and health professionals, and one which may be overseen by clerical rather than clinical staff. The digital format of DQPN, which can be integrated into electronic medical records, will facilitate easier tracking and management of nutritional status over the course of hospitalization and post-discharge. To evaluate the hypotheses, DQPN will be deployed in a hospital setting to a group of patients who will also be seen by a registered dietitian to assess the nutritional status of each patient. Receiver operating characteristic curves will determine the point, or criterion, at which maximal true positivity rate and least false positivity rate for a diagnosis of malnutrition and specific nutrient deficiencies align. The study cohort will also be compared to a matched historical cohort to compare total medical spend and reimbursement between the intervention cohort and matched control. Testing of these hypotheses will thus allow for insight into whether DQPN may be used to identify malnutrition and nutrient deficiencies in hospitalized patients and, in so doing, improve patient outcomes, reduce healthcare utilization, and bring financial benefit to hospitals.

Prognostic Molecular Assay Might Improve Identification of Patients At Risk for Recurrence in Early-Stage Non–Small-Cell Lung Cancer

2014 ◽  
Vol 15 (6) ◽  
pp. 426-432 ◽  
Author(s):  
Gavitt A. Woodard ◽  
Matthew A. Gubens ◽  
Thierry M. Jahan ◽  
Kirk D. Jones ◽  
Jasleen Kukreja ◽  
...  
Keyword(s):  
Lung Cancer ◽  
At Risk ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Early Stage ◽  
Small Cell ◽  
Molecular Assay ◽  
Small Cell Lung ◽  
Patients At Risk

scholarly journals Nutritional Screening and Clinical Outcome in Hospitalized Patients with Crohn’s Disease

2017 ◽  
Vol 71 (3-4) ◽  
pp. 266-272 ◽  
Author(s):  
Azusa Takaoka ◽  
Masaya Sasaki  ◽  
Naoko Nakanishi ◽  
Mika Kurihara ◽  
Akiko Ohi ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Nutritional Status ◽  
Serum Albumin ◽  
Intestinal Resection ◽  
Hospitalized Patients ◽  
Screening Tools ◽  
Characteristic Analysis ◽  
Nutritional Screening ◽  
Nrs 2002

Background/Aims: Hospitalized patients with Crohn’s disease (CD) can develop severe nutritional deficits. However, the nutritional screening tools with the most utility for such patients are still unknown. Methods: Nutritional status of 40 CD patients was assessed on admission using several screening tools and laboratory tests. Their validity was evaluated in relation to length of hospital stay (LOS) and intestinal resection. Receiver operating characteristic analysis was performed to predict prolonged LOS (≥28 days). Results: Prolonged LOS was correlated with each of the following screening parameters: Subjective Global Assessment, Nutrition Risk Screening 2002 (NRS 2002), Onodera’s Prognostic Nutritional Index (O-PNI), Controlling Nutritional Status, serum albumin level, and weight loss. These parameters were not correlated with intestinal resection. Evaluation of prognostic yield showed cutoff values of serum albumin 3.3 g/dL (AUC 0.797, sensitivity 57.1%, specificity 89.5%) and O-PNI 36.5 (0.749, 71.4%, 73.7%). By combining the serum albumin cutoff value and NRS 2002 score, patients were divided into 4 groups, with a prolonged LOS rate of 68.2% in the group with the worst prognosis. Conclusions: A combination of serum albumin (given the simplicity of testing) and NRS 2002 as nutritional screening tools may be useful for hospitalized CD patients.

Genetic determinants of psychic resilience after a diagnosis of cancer

2017 ◽  
Vol 41 (S1) ◽  
pp. S596-S596
Author(s):  
M. Christensen ◽  
A. Drago
Keyword(s):  
At Risk ◽  
Psychiatric Disorders ◽  
Depressive Disorders ◽  
Adjustment Disorder ◽  
Genetic Determinants ◽  
Co Morbidity ◽  
Patients At Risk ◽  
Diagnosis Of Cancer ◽  
Competing Interest ◽  
Definition Of

IntroductionCo-morbidity between cancer and psychiatric disorders including adjustment disorder, depressive disorders or angst can seriously influence the prognosis and the quality of life of patients.AimThe identification of the psychological and biological profile of patients at risk for such co-morbidity is not yet available. Classical candidate genes such as the BDNF, the 5-HTLPR and genes whose products are involved in inflammatory events have received some attention, but results are inconclusive.Object and methodsIn the present review the association between cancer and psychiatric disorders is reviewed, a focus on the investigation of the Gene X environment and the epigenetic control over the activation of the HPA axis is proposed as a tool to refine the definition of the biologic profile at risk for co-morbidity between psychiatry and cancer.Results and conclusionA number of genes and socio-demographic variables that may influence risk to suffer from a psychiatric disorder after a diagnosis of cancer is identified and discussed. The identification of such biologic and socio-demographic profile is instrumental in the identification of subjects at risk of a double diagnosis, both somatic and psychiatric. An early identification of such profile risk would pave the way to the implementation of early intervention strategies.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Biomarkers of Ischemic Stroke

US Neurology ◽  
2010 ◽  
Vol 05 (02) ◽  
pp. 52
Author(s):  
Glen Jickling ◽  
Huichun Xu ◽  
Frank Sharp ◽  
◽  
◽  
...  
Keyword(s):  
At Risk ◽  
Ischemic Stroke ◽  
Clinical Diagnosis ◽  
Clinical Assessment ◽  
Molecular Biomarkers ◽  
Patient Treatment ◽  
Diagnosis And Management ◽  
Genomic Markers ◽  
Patients At Risk ◽  
Risk Of Disease

The diagnosis and management of patients with ischemic stroke is primarily based on clinical assessment in conjunction with imaging tests. Development of molecular biomarkers as additional tools to support a clinical diagnosis, identify patients at risk of disease, and help guide patient treatment and prognosis would be of great value. Currently, no such biomarkers are used in the management of patients with ischemic stroke; however, several promising proteomic and genomic markers have been identified, as presented in this review.

scholarly journals Lung Injury Prediction Score in Hospitalized Patients at Risk of Acute Respiratory Distress Syndrome

2016 ◽  
Vol 44 (12) ◽  
pp. 2182-2191 ◽  
Author(s):  
Graciela J. Soto ◽  
Daryl J. Kor ◽  
Pauline K. Park ◽  
Peter C. Hou ◽  
David A. Kaufman ◽  
...  
Keyword(s):  
At Risk ◽  
Acute Respiratory Distress Syndrome ◽  
Lung Injury ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Hospitalized Patients ◽  
Prediction Score ◽  
Injury Prediction ◽  
Patients At Risk

Development and validation of a complexity score to rank hospitalized patients at risk for preventable adverse drug events

2017 ◽  
Vol 74 (23) ◽  
pp. 1970-1984 ◽  
Author(s):  
Almut G. Winterstein ◽  
Ben Staley ◽  
Carl Henriksen ◽  
Dandan Xu ◽  
Gloria Lipori ◽  
...  
Keyword(s):  
At Risk ◽  
Adverse Drug Events ◽  
Hospitalized Patients ◽  
Complexity Score ◽  
Patients At Risk ◽  
Development And Validation
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