Impact of a nutrition consultation on the rate of high output stoma‑related readmission: an ambispective cohort study
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Nature
Date
2021-08-17Referencia bibliográfica
Santamaría, M.M... [et al.]. Impact of a nutrition consultation on the rate of high output stoma-related readmission: an ambispective cohort study. Sci Rep 11, 16620 (2021). [https://doi.org/10.1038/s41598-021-96136-7]
Abstract
The aims of this study were to assess the impact of a follow-up nutrition consultation for ostomy
patients on the rate of high output stoma (HOS)-related readmissions, as well as on the detection of
poor nutritional status and their management, and to determine the associated economic impact.
A single-centre ambispective cohort study was conducted in which all adult patients undergoing
intestinal resection and stoma creation were recruited. Two nutrition consultations were established
for early follow-up after hospital discharge and patients were prospectively included. Additionally, a
retrospective search was carried out to include a control group. In both groups, a 12-month follow-up
was conducted to record readmissions associated with high output stoma. A multivariate logistic
regression was performed. Statistical significance level was established at p < 0.05. 170 patients were
recruited, 85 patients in each cohort. Demographic data and clinical characteristics were recorded. A
significant difference was observed in HOS-related readmissions, with readmission rates of 28.6% vs
10.3% in the retrospective and prospective cohort, respectively. At the first follow-up consultation,
50.5% of patients presented some degree of protein-calorie malnutrition. A statistically significant
improvement in nutritional status was observed in the second evaluation. The intervention carried out
resulted in a total saving of €24,175. Early follow-up of patients after discharge resulted in a significant
reduction in the rate of HOS-related readmissions and allowed to identify a high percentage of
patients with malnutrition. The cost analysis showed the process to be a cost-effective improvement.