TY - JOUR
T1 - ESPEN practical guideline
T2 - Nutritional support for polymorbid medical inpatients
AU - Wunderle, Carla
AU - Gomes, Filomena
AU - Schuetz, Philipp
AU - Stumpf, Franziska
AU - Austin, Peter
AU - Ballesteros-Pomar, María D.
AU - Cederholm, Tommy
AU - Fletcher, Jane
AU - Laviano, Alessandro
AU - Norman, Kristina
AU - Poulia, Kalliopi Anna
AU - Schneider, Stéphane M.
AU - Stanga, Zeno
AU - Bischoff, Stephan C.
N1 - Funding Information:
This work was supported by the ESPEN society as well as by the SNF Swiss National Science Foundation (SNSF Professorship, PP00 P3_150531/1) and the Research Council of the Kantonsspital Aarau, Switzerland (1410.000.044).
Publisher Copyright:
© 2024 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism
PY - 2024/3
Y1 - 2024/3
N2 - 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 (7× A, 11× B, 10× O and 4× 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 evidence-based nutritional approach to polymorbid medical inpatients and may improve their outcomes.
AB - 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 (7× A, 11× B, 10× O and 4× 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 evidence-based nutritional approach to polymorbid medical inpatients and may improve their outcomes.
KW - Guideline
KW - Hospitalized patients
KW - Multimorbidity
KW - Nutritional support
KW - Polymorbid
UR - http://www.scopus.com/inward/record.url?scp=85184065133&partnerID=8YFLogxK
U2 - 10.1016/j.clnu.2024.01.008
DO - 10.1016/j.clnu.2024.01.008
M3 - Article
C2 - 38309229
AN - SCOPUS:85184065133
SN - 0261-5614
VL - 43
SP - 674
EP - 691
JO - CLINICAL NUTRITION
JF - CLINICAL NUTRITION
IS - 3
ER -