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Titolo:
Impact of a randomized, controlled trial of liberal vs conservative hospital discharge criteria on energy, protein, and fluid intake in patients who received marrow transplants
Autore:
Stern, JM; Bruemmer, B; Moinpour, CM; Sullivan, KM; Lenssen, P; Aker, SN;
Indirizzi:
Fred Hutchinson Canc Res Ctr, Clin Nutr Program, Div Clin Res, Seattle, WA98109 USA Fred Hutchinson Canc Res Ctr Seattle WA USA 98109 s, Seattle, WA98109 USA Univ Washington, Dept Biobehav Nursing & Hlth Syst, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 g & Hlth Syst, Seattle, WA 98195 USA
Titolo Testata:
JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION
fascicolo: 9, volume: 100, anno: 2000,
pagine: 1015 - 1022
SICI:
0002-8223(200009)100:9<1015:IOARCT>2.0.ZU;2-3
Fonte:
ISI
Lingua:
ENG
Soggetto:
STEM-CELL TRANSPLANTATION; MULTIPLE-MYELOMA; CANCER; RECIPIENTS; NUTRITION; COSTS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Agriculture,Biology & Environmental Sciences
Clinical Medicine
Citazioni:
28
Recensione:
Indirizzi per estratti:
Indirizzo: Stern, JM Fred Hutchinson Canc Res Ctr, Clin Nutr Program, Div Clin Res, 1100 Fairview Ave N,POB 19024,Mailstop E-211, Seattle, WA 98109 USA Fred Hutchinson Canc Res Ctr 1100 Fairview Ave N,POB 19024,Mailstop E-211 Seattle WA USA 98109
Citazione:
J.M. Stern et al., "Impact of a randomized, controlled trial of liberal vs conservative hospital discharge criteria on energy, protein, and fluid intake in patients who received marrow transplants", J AM DIET A, 100(9), 2000, pp. 1015-1022

Abstract

Object To determine if adult patients who received marrow transplants had faster resumption of oral energy and nutrient intake and shorter duration of intravenous (IV) fluid requirement if discharged from the hospital earlier than is customary. Design Randomized, controlled trial of patients remaining hospitalized because of inadequate oral intake. Consenting patients were assigned randomly to remain hospitalized (hospital group) or be discharged to an ambulatory setting (ambulatory group). Subjects Seventy-eight patients of the Fred Hutchinson Cancer Research Center who were consuming less than 33% of estimated energy requirement and requiring up to 3,000 mL of fluids per day intravenously. Intervention Participants received nutrition counseling by a registered dietitian to promote resumption of oral intake. Daily oral intake records were analyzed to determine energy and nutrient content. Main outcome measures Days after study enrollment to consume 33% of energyand protein requirements and total number of days of IV fluid support wereanalyzed by group until discharge from the center, approximately 100 days after transplantation. Statistical analyses Demographic data were defined by group means. Differences between treatment procedures were determined by Cox regression analysis. No variables were confounding. Results The hospital group took fewer days than the ambulatory group to resume oral energy intake (4.5 vs 8.0, P=.004) and to discontinue IV fluids (30.5 vs 48.5, P=.019). There was no difference between groups in days of parenteral nutrition support (P=.817) or days to resume oral protein intake (P=.470). Applications/conclusions Oral and gastrointestinal complications delay resumption of oral energy and protein intakes after transplantation. Earlier hospital discharge can achieve cost savings but may delay resumption of oralenergy intake. Because of continued high-risk nutrition status and potential for rapid change in medical status, nutrition assessment and counseling are necessary in both the hospital and ambulatory setting to promote resumption of oral intake and discontinuation of IV fluids. J Am Diet Assoc. 2000;100:1015-1022.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/11/20 alle ore 06:53:53