Clinical and cost-effectiveness analysis of early detection of patients at nutrition risk during their hospital stay through the new screening method CIPA: a study protocol

BMC Health Services Research

Laura Vallejo-Torres¹  Yolanda Ramallo-Fariña¹  José Pablo Suárez-Llanos²  Francisca Pereyra-García-Castro²  Néstor Benítez-Brito²  Ignacio Llorente-Gómez de Segura²  Irina Delgado-Brito²  Manuel Ángel Barrera-Gómez³  Jennifer García-Niebla³  Adriá Rosat-Rodrigo³  Teresa de Jesús González-Melián⁴  Carolina Hernández-Carballo⁵  Eduardo Mauricio Calderón-Ledezma⁵  Juan Carlos-Romero⁵  Nieves Felipe-Pérez⁵ 

[1] Canary Foundation for Health Research (FUNCANIS) Evaluation Service of the Canary Health System (SESCS), Research Network on Health Services Chronic Disease (REDISSEC), Canary Center for Biomedical Research (CIBICAN);Endocrinology and Nutrition Department, Hospital Universitario Nuestra Señora de Candelaria;General and digestive surgery Department, Hospital Universitario Nuestra Señora de Candelaria;Hospital Universitario Nuestra Señora de Candelaria;Internal Medicine Department, Hospital Universitario Nuestra Señora de Candelaria;

关键词: Nutrition assessment;    Malnutrition;    Inpatients;    Body composition;    Anthropometry;    Cost-benefit analysis;   

DOI  :  10.1186/s12913-017-2218-z

来源: DOAJ

【 摘 要 】

Abstract Background Malnutrition is highly prevalent in hospitalized patients and results in a worsened clinical course as well as an increased length of stay, mortality, and costs. Therefore, simple nutrition screening systems, such as CIPA (control of food intake, protein, anthropometry), may be implemented to facilitate the patient’s recovery process. The aim of this study is to evaluate the effectiveness and cost-effectiveness of implementing such screening tool in a tertiary hospital, consistent with the lack of similar, published studies on any hospital nutrition screening system. Methods The present study is carried out as an open, controlled, randomized study on patients that were admitted to the Internal Medicine and the General and Digestive Surgery ward; the patients were randomized to either a control or an intervention group (n = 824, thereof 412 patients in each of the two study arms). The control group underwent usual inpatient clinical care, while the intervention group was evaluated with the CIPA screening tool for early detection of malnutrition and treated accordingly. CIPA nutrition screening was performed upon hospital admission and classified positive when at least one of the following parameters was met: 72 h food intake control < 50%, serum albumin < 3 g/dL, body mass index < 18.5 kg/m2 (or mid-upper arm circumference ≤ 22.5 cm). In this case, the doctor decided on whether or not providing nutrition support. The following variables will be evaluated: hospital length of stay (primary endpoint), mortality, 3-month readmission, and in-hospital complications. Likewise, the quality of life questionnaires EQ-5D-5 L are being collected for all patients at hospital admission, discharge, and 3 months post-discharge. Analysis of cost-effectiveness will be performed by measuring effectiveness in terms of quality-adjusted life years (QALYs). The cost per patient will be established by identifying health care resource utilization; cost-effectiveness will be determined through the incremental cost-effectiveness ratio (ICER). We will calculate the incremental cost per QALY gained with respect to the intervention. Discussion This ongoing trial aims to evaluate the cost-effectiveness of implementing the malnutrition screening tool CIPA in a tertiary hospital. Trial registration Clinical Trial.gov ( NCT02721706 ). First receivevd: March 1, 2016 Last updated: April 8, 2017 Last verified: April 2017

【 授权许可】

Unknown