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The Impact of Denutrition on the Hospital Length of Stay for Patients Undergoing Rehabilitation

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ClinicalTrials.gov Identifier: NCT02913846
Recruitment Status : Completed
First Posted : September 26, 2016
Last Update Posted : January 23, 2018
Sponsor:
Information provided by (Responsible Party):
Samar Hatem, Brugmann University Hospital

Brief Summary:

Denutrition is defined as a measurable decrease in functions and/or as change in the body composition, associated with a worsening of the prognosis of the underlying medico-surgical pathology. It is induced by a deficiency in energy, proteins or any other micro or macronutrient and is the result of malnutrition, itself caused by a poor diet or a metabolic disorder.

According to the National Nutrition and Health Plan for Belgium, denutrition is an independent risk factor for the increase of complications, morbidity and mortality rates, average length of hospitalisation and global medical care cost. It is necessary to invest in the prevention of denutrition as the costs of preventive measures are lower than the cost of treating a denutrished patient.

The Belgian financing system of hospitalisation days is based on the structure of the treated pathologies, the age of the patient and the geriatric features of the patient. It encourages all hospitals to lower the length of hospitalisation to the national average for all these criteria. As a consequence, there is a mounting tendency to shorten the average length of stay within the hospital.

The so-called 'Sp' hospital departments occupy a specific place within the organisation of Health Services in Belgium. They are specialized in the treatment and rehabilitation of patients with cardiopulmonary, neurological, locomotor, psycho-geriatric and chronic diseases. These services act as an extension of acute services (continuity of acute hospitalisation) but also as a first entry point for the medical care of patients with various specific diseases (multiple sclerosis, psycho-geriatric disorders, chronic pulmonary disorders...).

The financing of the Sp departments is, as opposed to the financing of other departments, not linked to the patient length of stay. However, an increase in hospitalization duration decreases the rate of admissions and the possibility to accept patients coming from acute hospital units.

The aim of the study is to evaluate the influence of denutrition of patients hospitalized in an Sp department on the length of revalidation stay, the associated costs and the patient's functional autonomy.


Condition or disease Intervention/treatment
Denutrition Other: Nutritional evaluation Other: Muscular assessment Other: Pre-albumine dosage

Study Type : Observational
Actual Enrollment : 180 participants
Observational Model: Cohort
Time Perspective: Prospective
Official Title: The Impact of Denutrition on the Hospital Length of Stay for Patients Undergoing Rehabilitation
Actual Study Start Date : March 18, 2016
Actual Primary Completion Date : September 12, 2017
Actual Study Completion Date : September 12, 2017

Resource links provided by the National Library of Medicine


Group/Cohort Intervention/treatment
Hospital revalidation units
The study will take place within the CHU Brugmann hospital (Brussels) who has 4 revalidation units (104 beds). All patients coming within these units during the study duration will be included.
Other: Nutritional evaluation
A first nutritional evaluation will be performed within 48h of patient admission. Weight and BMI will be measured once a week.

Other: Muscular assessment
An assessment of muscular force will be performed once a week.

Other: Pre-albumine dosage
Dosage performed once a month.




Primary Outcome Measures :
  1. Barthel index score [ Time Frame: within 48h of admission within the revalidation unit ]
    Assessment of patient autonomy

  2. Nutritional Risk Screening score [ Time Frame: within 48h of admission within the revalidation unit ]
    Nutritional state assessment

  3. Body Mass Index [ Time Frame: once a week up to patient discharge (the average hospitalization length within the revalidation unit is 48 days) ]
  4. Weight [ Time Frame: once a week up to patient discharge (the average hospitalization length within the revalidation unit is 48 days) ]
  5. Hand prehension force [ Time Frame: once a week up to patient discharge (the average hospitalization length within the revalidation unit is 48 days) ]
    performed on the right hand with a Jamart dynamometer

  6. Pre-albumine level (mg/l) [ Time Frame: once a week up to patient discharge (the average hospitalization length within the revalidation unit is 48 days) ]
    Laboratory testing



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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Probability Sample
Study Population
All patients admitted within a revalidation unit of the CHU Brugmann hospital
Criteria

Inclusion Criteria:

  • All patients admitted within a revalidation unit of the CHU Brugmann hospital

Exclusion Criteria:

  • Patients without programmed exit: transfer to another care unit, forced exit, death...

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02913846


Locations
Belgium
CHU Brugmann
Brussels, Belgium, 1020
Sponsors and Collaborators
Brugmann University Hospital
Investigators
Study Director: Samar Hatem, MD CHU Brugmann

Publications:
Responsible Party: Samar Hatem, Head of clinic, Brugmann University Hospital
ClinicalTrials.gov Identifier: NCT02913846     History of Changes
Other Study ID Numbers: CHUB-Nut-Reva
First Posted: September 26, 2016    Key Record Dates
Last Update Posted: January 23, 2018
Last Verified: January 2018
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Samar Hatem, Brugmann University Hospital:
denutrition
hospital length of stay
patient's autonomy