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Malnutrition: Consequences for Clinical Outcomes in the Context of German Hospitals

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Sustainable Nutrition in a Changing World

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Abstract

Some 70–75% of diseases are primarily caused by diet and lifestyle-induced problems. Undernutrition and malnutrition affect all relevant clinical factors: mortality, length of hospital stay, morbidity, and thus the quality of life. Undernutrition and malnutrition are common in hospitals, and are a growing problem. They are costly and have clinical consequences. Europe-wide studies and meta-analyses testify to the significance of the therapeutic provision of nutrition for patients admitted to hospital, and also demonstrate its cost-effectiveness. For the therapy to be successful, early, targeted assessment of the patient’s status is necessary in order to ensure the guideline-based implementation of recognized dietary concepts. This requires a qualified nutrition support team consisting of medical nutritionists, general nutritionists, dietitians and other qualified nutrition professionals. Every patient admitted to hospital should be examined and documented in accordance with the established parameters for undernutrition and malnutrition, and a diet plan developed for his or her specific needs. Undernutrition and malnutrition cost €9 billion per year in Germany alone. These costs could be reduced by the application of medical nutrition therapy in hospitals. Individuals can also protect themselves by adopting a healthy lifestyle. This begins with the consumption of healthy foods.

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References

  1. Löser Ch.: Ernährung- Herausforderung und Geißel des 21. Jh. Hessisches Ärztebl. 8; 481–484 (2007).

    Google Scholar 

  2. Meissner C. et al: Routinemäßige Ernährungsevaluation und nachfolgende Initiierung einer fall- und befundadaptierten Ernährungstherapie im klinisch-chirurgischen Alltag “STANDARD OPERATING PROCEDURE” (SOP). Ärzteblatt Sachsen-Anhalt 26 (2015) 6: 53–58.

    Google Scholar 

  3. Weimann A, Jauch KW, Kernen M, Hiesmayr JM, Horbach T, Kuse ER, Vestweber KH, DEGEM- Leitlinien Enterale Ernährung: Chirurgie und Transplantation. Aktuel Ernaehr Med 2003; 28, Supplement 1: S 51–S 60.

    Google Scholar 

  4. Stratton RJ, Green CJ, Elia M: Disease-related malnutrition: an evidence-based approach to treatment. Oxon: CABI Publishing 2003.

    Google Scholar 

  5. Hiesmayr M et al The Nutrition Day Audit Team. Decreased food intake is a risk factor for mortality in hospitalised patients: The Nutrition Day survey. 2006. Clin. Nutr. 2009; 28; 484–91.

    Google Scholar 

  6. Pirlich M et al. The German hospital malnutrition study. Clin. Nutr. 2006; 25: 563–74.

    Google Scholar 

  7. Rittler P et al. Krankheitsbedingte Mangelernährung - eine Herausforderung für unser Gesundheitssystem. Pabst Lengerich, 2010, p 49–59.

    Google Scholar 

  8. Svensen J et al. Euro OOPS study group. Euro OOPS: an international, multicentre study to implement nutritional risk screening and evaluate clinical outcome, Clin. Nutr. 2008; 27: 340–9.

    Google Scholar 

  9. Löser Ch. Unter- und Mangelernährung im Krankenhaus, Übersichtsarbeit, DÄBL, Jg 107, Hft 51–52, 911–9.

    Google Scholar 

  10. Senkal M, Dormann A, Stehle P, et al.: Survey on structure and performance of nutrition support teams in Germany. Clin Nutr 2002; 21: 329–35.

    Google Scholar 

  11. Rasmussen HH, Kondrup J, Staun M, et al.: A method for implementation of nutritional therapy in hospitals. Clin Nutr 2006; 25: 515–23.

    Google Scholar 

  12. Kennedy JF, Nightingale JM: Cost savings of an adult hospital nutrition support team. Nutrition 2005; 21: 1127–33.

    Google Scholar 

  13. Scott F, Beech R, Smedley F, et al.: Prospective, randomized, controlled, single-blind trial of the costs and consequences of septematic nutrition team follow-up over 12 months after percutaneous endoscopie gastrostomy. Nutrition 2006; 21: 1071–7.

    Google Scholar 

  14. Bozzetti F, Perioperative nutritional support in the ERAS approach. Clin Nutr 32: 872–873.

    Google Scholar 

  15. Milne AC, Avenell A, Potter J: Meta-analysis: protein and energy supplementation in older people. A. Inter Med 2006; 114: 37–48.

    Google Scholar 

  16. Russel CA: The impact of malnutrition on health care costs and economic considerations for the use of oral nutritional supplements. Clin Nutr 2007; Suppl 1: 25–32.

    Google Scholar 

  17. Löser Chr: Mangelernährung im Krankenhaus - Prävalent, klinische Folgen, Budgetrelevanz. Dtsch Med Wschr 2001; 126: 729–34.

    Google Scholar 

  18. Kruizenga HM, Van Tulder MW, Seidell JC, et al.: Effectiveness and cost- effectiveness of early screening and treatment of malnourished patients. Am J Clin Nutr 2005; 82: 1082–9.

    Google Scholar 

  19. Stute A, Tumorpatienten: Mangelernährung und Kachexie verhindern, ECM- Ernährung und Medizin 2014; 29: 70–73.

    Google Scholar 

  20. Valentini L, Volk D, Schütz T et al: Leitlinien der Deutschen Gesellschaft für Ernährungsmedizin (DGEM): DGEM-Terminologie in der Klinischen Ernährung. Aktuel Ernährungsmed 2013; 38: 97–111.

    Google Scholar 

  21. Norman K, Schütz T, Kemps M et al. The Subjective Global Assessment reliably identifies malnutrition- related muscle dysfunction. Clin Nutr 2005; 24: 143–150.

    Google Scholar 

  22. Sanddröm R, Drott C, Hyltander A, Arfridsson B, Schersten T, Wickström I, Lundholm K. The effect of postoperative intravenous feeding (TPN) on outcome following major surgery evaluated in a randomized study. Ann Surg 1993 Feb; 217 (2): 185–95.

    Google Scholar 

  23. ASPEN Board of Directors and the Clinical Guidelines Task Force. Guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients. JPEN J Parenter Enteral Nutr 2002 Jan–Feb; 26 (1 Suppl.): 1 SA–138 SA. No abstract available. JPEN J Parenter Enteral Nutr 2002 Mär–Apr; 26 (2): 144.

    Google Scholar 

  24. Braga M, Gianotti L, Radaelli G, Vignali A, Mari G, Gentilini O, Di Carlo V. Perioperative immunonutrition in patients undergoing cancer surgery: results of a randomized double- blend phase 3 trial. Arch Surg. 199 April; 134 (4): 428–33.

    Google Scholar 

  25. Braga M, Gianotti L, Nespoli L, Radaelli G, Di Carlo V. Nutritional approach in malnourished surgical patients: a prospective randomized study. Arch Surg. 2002 Feb; 137 (2): 174–80.

    Google Scholar 

  26. Erans WJ, Morley JE, Argile’s J et al. Cachexia: a new definition. Clin Nutr 2008; 27: 793–799.

    Google Scholar 

  27. Weimann A, Breitenstein S, Breuer JP et al (2013) S3 - Leitlinie der Deutschen Gesellschaft für Ernährungsmedizin Klinische Ernährung in der Chirurgie. Aktuel Ernährungsmed 38: 399–16.

    Google Scholar 

  28. Löser Chr, Aschl G, He’butema X, et al.: ESPEN Guidelines on artificial enteral nutrition - Percutaneous endoscopic gastrostomy PEG. Clin Nutr 2005; 24: 848–61.

    Google Scholar 

  29. Volkert D, Berner YN, Berry E et al.: ESPEN Guidelines on enteral nutrition: geriatrics Clin Nutr 2006; 25: 330–60.

    Google Scholar 

  30. Löser Ch, Lübbers H, Mahlke R, et al.: Der ungewollte Gewichtsverlust des alten Menschen. Dtsch Ärzteblatt 2007; 49: 3411–20.

    Google Scholar 

  31. Dewys WD, Begg C, Lavin PT, et al.: Prognostic effect of weight loss prior to chemotherapy in cancer patients. Eastern Cooperative Oncology Group. Am J Med. 1980 Oct;69(4):491–7.

    Google Scholar 

  32. Andreyev HJ, Norman AR, Oates J, et al.: Why do patients with weight loss have a worse outcome when undergoing chemotherapy for gastrointestinal malignancies? Eur J Cancer. 1998 Mar;34(4):503–9.

    Google Scholar 

  33. Ross P J, Ashley S, Norton A et al. Do patients with weight loss have a worse outcome when undergoing chemotherapy for lung cancers?. Br J Cancer. 2004; 90 1905–1911.

    Google Scholar 

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Authors and Affiliations

  1. Klinikum Magdeburg Gemeinnützige GmbH, Klinik Für Allgemein- Und Viszeralchirurgie, Birkenallee 34, 39130, Magdeburg, Germany

    Carl Meißner

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  1. Carl Meißner
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Correspondence to Carl Meißner .

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Editors and Affiliations

  1. Universität Hohenheim, Stuttgart, Baden-Württemberg, Germany

    Hans Konrad Biesalski

  2. Nutritional Sciences, University of Washington, Seattle, Washington, USA

    Adam Drewnowski

  3. Tufts Medical School, Boston, Massachusetts, USA

    Johanna T. Dwyer

  4. Northern Irerland Centre for Food a, University of Ulster Northern Irerland Centre for Food a, Coleraine, United Kingdom

    JJ Strain

  5. DSM Nutritional Products Europe Ltd. , Kaiseraugst, Switzerland

    Peter Weber

  6. DSM Nutritional Products Europe Ltd. , Kaiseraugst, Switzerland

    Manfred Eggersdorfer

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Meißner, C. (2017). Malnutrition: Consequences for Clinical Outcomes in the Context of German Hospitals. In: Biesalski, H., Drewnowski, A., Dwyer, J., Strain, J., Weber, P., Eggersdorfer, M. (eds) Sustainable Nutrition in a Changing World. Springer, Cham. https://doi.org/10.1007/978-3-319-55942-1_16

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