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

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.

Study Overview

• Status: Completed
• Conditions: Denutrition
• Intervention / Treatment: Other: Nutritional evaluation; Other: Muscular assessment; Other: Pre-albumine dosage

• Study Type: Observational
• Enrollment (Actual): 180

Contacts and Locations

Study Locations

• Belgium
  • Brussels, Belgium, 1020
    • CHU Brugmann

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

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

Description

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...

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

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.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Barthel index score	Assessment of patient autonomy	within 48h of admission within the revalidation unit
Nutritional Risk Screening score	Nutritional state assessment	within 48h of admission within the revalidation unit
Body Mass Index		once a week up to patient discharge (the average hospitalization length within the revalidation unit is 48 days)
Weight		once a week up to patient discharge (the average hospitalization length within the revalidation unit is 48 days)
Hand prehension force	performed on the right hand with a Jamart dynamometer	once a week up to patient discharge (the average hospitalization length within the revalidation unit is 48 days)
Pre-albumine level (mg/l)	Laboratory testing	once a week up to patient discharge (the average hospitalization length within the revalidation unit is 48 days)

Collaborators and Investigators

• Sponsor: Brugmann University Hospital
• Investigators: Study Director: Samar Hatem, MD, CHU Brugmann

Publications and helpful links

General Publications

• Alvarez-Hernandez J, Planas Vila M, Leon-Sanz M, Garcia de Lorenzo A, Celaya-Perez S, Garcia-Lorda P, Araujo K, Sarto Guerri B; PREDyCES researchers. Prevalence and costs of malnutrition in hospitalized patients; the PREDyCES Study. Nutr Hosp. 2012 Jul-Aug;27(4):1049-59. doi: 10.3305/nh.2012.27.4.5986.

Study record dates

Study Major Dates

• Study Start (ACTUAL): March 18, 2016
• Primary Completion (ACTUAL): September 12, 2017
• Study Completion (ACTUAL): September 12, 2017

Study Registration Dates

• First Submitted: September 14, 2016
• First Submitted That Met QC Criteria: September 22, 2016
• First Posted (ESTIMATE): September 26, 2016

Study Record Updates

• Last Update Posted (ACTUAL): January 23, 2018
• Last Update Submitted That Met QC Criteria: January 18, 2018
• Last Verified: January 1, 2018

More Information

Terms related to this study

• Keywords: hospital length of stay; denutrition; patient's autonomy
• Other Study ID Numbers: CHUB-Nut-Reva

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No