Challenges of nutritional support administration and clinical outcomes in malnourished patients during hospitalization: A prospective study

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Nutrition Pub Date : 2025-04-22 DOI:10.1016/j.nut.2025.112817

Luciana de Abreu Silva R.D., M.Sc. , Simone de Vasconcelos Generoso R.D., M.Sc., Ph.D. , Viktoriia Viktorovna Fomishina , Gicele Mendes Chagas R.D. , Vanessa Rodrigues R.D., M.Sc. , Jaqueline Almeida Guimarães Barbosa R.N., M.Sc., Ph.D. , Camila Kümmel Duarte R.D., Ph.D.

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Abstract

Background and Aims

Malnutrition is highly prevalent among hospitalized patients, and adequate nutrient intake plays a crucial role in their recovery. However, disruptions in diet, suspension of nutritional support, and delayed initiation of nutritional therapy can significantly undermine the effectiveness of nutritional treatment. This study aims to assess the administration of nutritional support and its clinical impact on malnourished patients admitted to a public hospital in Brazil.

Methods

This was a prospective observational study utilizing secondary data of patients hospitalized and receiving nutritional support between December 14, 2021, and May 14, 2023. Association analyses were performed. The exposure variables included the interval between hospitalization and the initiation of nutritional support and the number of diet interruptions. The primary outcome of this study was the mortality rate, and secondary outcomes included ICU admission, length of hospital stay, length of hospital stay with nutritional support, and presence of pressure injuries.

Results

A total of 218 malnourished patients were included in the study. 82.1% of patients started nutritional support for more than 48 hours. 69.3% of patients had their diet interrupted at some point during hospitalization. Late initiation of nutritional support was associated with a longer length of stay in malnourished patients (P = 0.007).

Conclusions

Approximately two-thirds of the patients experienced at least one interruption in their diet infusion. Delayed initiation of nutritional support and diet interruptions, even when expected, have a negative impact on patients’ clinical outcomes. Implementing standardized protocols is essential to address delays in nutritional support and minimize diet interruptions.

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营养不良患者住院期间营养支持管理的挑战和临床结果：一项前瞻性研究

背景与目的住院患者营养不良现象十分普遍，充足的营养摄入对其康复起着至关重要的作用。然而，饮食的中断、营养支持的暂停和营养治疗的延迟开始会显著破坏营养治疗的有效性。本研究旨在评估营养支持的管理及其对巴西一家公立医院收治的营养不良患者的临床影响。方法本研究是一项前瞻性观察性研究，利用了2021年12月14日至2023年5月14日住院并接受营养支持的患者的次要数据。进行关联分析。暴露变量包括住院和开始营养支持之间的间隔以及饮食中断的次数。本研究的主要结局是死亡率，次要结局包括ICU入院、住院时间、营养支持住院时间和是否存在压力损伤。结果共纳入218例营养不良患者。82.1%的患者开始营养支持时间超过48小时。69.3%的患者在住院期间饮食中断。营养不良患者开始营养支持较晚与住院时间较长相关（P = 0.007）。结论：大约三分之二的患者至少有一次饮食输注中断。即使在预期的情况下，延迟开始营养支持和饮食中断也会对患者的临床结果产生负面影响。实施标准化方案对于解决营养支持延迟问题和尽量减少饮食中断至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nutrition 医学-营养学

CiteScore

7.80

自引率

2.30%

发文量

300

审稿时长

60 days

期刊介绍： Nutrition has an open access mirror journal Nutrition: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. Founded by Michael M. Meguid in the early 1980''s, Nutrition presents advances in nutrition research and science, informs its readers on new and advancing technologies and data in clinical nutrition practice, encourages the application of outcomes research and meta-analyses to problems in patient-related nutrition; and seeks to help clarify and set the research, policy and practice agenda for nutrition science to enhance human well-being in the years ahead.