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Heuft, L.* ; Voigt, J.* ; Selig, L.* ; Schmidt, M.* ; Eckelt, F.* ; Steinbach, D.* ; Federbusch, M.* ; Stumvoll, M.* ; Schlögl, H. ; Isermann, B.* ; Kaiser, T.*

Development, design and utilization of a CDSS for refeeding syndrome in real life inpatient care—a feasibility study.

Nutrients 15:13 (2023)
Publ. Version/Full Text DOI PMC
Open Access Gold
Creative Commons Lizenzvertrag
Background: The refeeding syndrome (RFS) is an oftentimes-unrecognized complication of reintroducing nutrition in malnourished patients that can lead to fatal cardiovascular failure. We hypothesized that a clinical decision support system (CDSS) can improve RFS recognition and management. Methods: We developed an algorithm from current diagnostic criteria for RFS detection, tested the algorithm on a retrospective dataset and combined the final algorithm with therapy and referral recommendations in a knowledge-based CDSS. The CDSS integration into clinical practice was prospectively investigated for six months. Results: The utilization of the RFS-CDSS lead to RFS diagnosis in 13 out of 21 detected cases (62%). It improved patient-related care and documentation, e.g., RFS-specific coding (E87.7), increased from once coded in 30 month in the retrospective cohort to four times in six months in the prospective cohort and doubled the rate of nutrition referrals in true positive patients (retrospective referrals in true positive patients 33% vs. prospective referrals in true positive patients 71%). Conclusion: CDSS-facilitated RFS diagnosis is possible and improves RFS recognition. This effect and its impact on patient-related outcomes needs to be further investigated in a large randomized-controlled trial.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords Cdss ; Clinical Nutrition ; Computerized Decision Support System ; Diagnostic Support ; Malnutrition ; Refeeding Syndrome; Decision-support-systems; All-cause Mortality; Prevention; Hypophosphatemia; Admission; Impact; Adult
ISSN (print) / ISBN 2072-6643
e-ISSN 2072-6643
Journal Nutrients
Quellenangaben Volume: 15, Issue: 17, Pages: , Article Number: 13 Supplement: ,
Publisher MDPI
Publishing Place Basel
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Helmholtz Institute for Metabolism, Obesity and Vascular Research (HI-MAG)
Grants Saxon State Parliament