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Screening and treatment of malnourished hospital patients.


- candidate number1375
- NTR NumberNTR210
- ISRCTNISRCTN92834544
- Date ISRCTN created20-dec-2005
- date ISRCTN requested18-okt-2005
- Date Registered NTR5-sep-2005
- Secondary IDsN/A 
- Public TitleScreening and treatment of malnourished hospital patients.
- Scientific TitleDevelopment, validation, (cost)effectivenessanalysis of the SNAQ malnutrition screening tool.
- ACRONYMN/A
- hypothesis1. The recognition of malnourished inpatients will improve by using the SNAQ malnutrition screening tool at admission;
2. Early recognition and treatment of malnutrition is effective and cost effective.
- Healt Condition(s) or Problem(s) studiedMalnutrition
- Inclusion criteria1. Hospital patients;
2. Internal and sugical ward.
- Exclusion criteriaUnder the age of 18 years.
- mec approval receivedyes
- multicenter trialno
- randomisedyes
- masking/blindingNone
- controlActive
- groupFactorial
- Type2 or more arms, randomized
- Studytypeintervention
- planned startdate 1-mrt-2002
- planned closingdate1-okt-2005
- Target number of participants600
- InterventionsEarly screening and treatment of malnourished hospital patients. The intervention group consisted of a group of 297 patients on two mixed medical - surgical wards, receiving screening on malnutrition at admission and standardized nutritional care. The control (comparable group of 291 patients) received usual clinical care.
- Primary outcome1. Costs;
2. Length of hospital stay;
3. Percentage of malnourished patients who are diagnosed correctly.
- Secondary outcome1. Care complexity;
2. Quality of life;
3. Body composition.
- TimepointsN/A
- Trial web siteN/A
- statusstopped: trial finished
- CONTACT FOR PUBLIC QUERIES Hinke Kruizenga
- CONTACT for SCIENTIFIC QUERIES Hinke Kruizenga
- Sponsor/Initiator VU University Medical Center
- Funding
(Source(s) of Monetary or Material Support)
Dutch Health Care Insurance Board (CVZ, independent governement organisation), Society of University Hospitals of the Netherlands
- Publications1. Kruizenga HM, Seidell JC, De Vet HCW, Wierdsma NJ, Van Bokhorst - de van der Schueren MAE. Development and validation of a hospital screening tool: the Short Nutritional assessment Questionnaire (SNAQ) Clinical Nutrition 2005, 24 (1) 75-82.
2. HM. Kruizenga, MW Van Tulder, JC Seidell, A Thijs, HJ Ader, MAE Van Bokhorst-de van der Schueren. Effectiveness and cost-effectiveness of early screening and treatment of malnourished patients. American Journal of Clinical Nutrition.
3. HM. Kruizenga, P. e Jonge, J.C. Seidell, F. Neelemaat, AA. van Bodegraven, NJ. Wierdsma, M.A.E. van Bokhorst de van der Schueren. Are malnourished patients complex patients? Eur. J of Internal Medicine, submitted.
- Brief summaryPatients and outcome measures.
The intervention group consisted of a group of 297 patients on two mixed medical - surgical wards, receiving screening on malnutrition at admission and standardized nutritional care. The control (comparable group of 291 patients) received usual clinical care.
Outcome measures were weight change, use of supplemental drinks, tube feeding, parenteral nutrition and in-between meals, number of consultations by the dietician and length of hospital stay.
Results:
The recognition of malnutrition improved from 50% to 80%. The standardized nutritional care protocol added approximately 600 kcal and 12 grams of protein to the daily intake of the malnourished. Early screening and treatment of malnourished patients reduced the length of hospital stay in malnourished patients with low handgrip strength (frail patients).
To shorten the mean length of hospital stay with one day in the total malnourished group, a mean investment of EUR 76 (63 USD) in nutritional screening and treatment was needed. In the total group and in the sub-group of malnourished patients with low handgrip strength the incremental costs were comparably low.
Conclusion:
Application of the SNAQ screening and early, standardized nutritional care improves the recognition of malnourished patients and gives the opportunity to start treatment at an early stage of hospitalization.
The additional costs of early nutritional care were low, especially in a sub-group of frail malnourished patients.
- Main changes (audit trail)
- RECORD5-sep-2005 - 11-sep-2008


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