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Development, design and utilization of a CDSS for refeeding syndrome in real life inpatient care—a feasibility study.
Nutrients 15:13 (2023)
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
Keywords
Cdss ; Clinical Nutrition ; Computerized Decision Support System ; Diagnostic Support ; Malnutrition ; Refeeding Syndrome; Decision-support-systems; All-cause Mortality; Prevention; Hypophosphatemia; Admission; Impact; Adult
Language
english
Publication Year
2023
HGF-reported in Year
2023
ISSN (print) / ISBN
2072-6643
e-ISSN
2072-6643
Journal
Nutrients
Quellenangaben
Volume: 15,
Issue: 17,
Article Number: 13
Publisher
MDPI
Publishing Place
Basel
Reviewing status
Peer reviewed
Institute(s)
Helmholtz Institute for Metabolism, Obesity and Vascular Research (HI-MAG)
POF-Topic(s)
30201 - Metabolic Health
Research field(s)
Helmholtz Diabetes Center
PSP Element(s)
G-506500-001
Grants
Saxon State Parliament
WOS ID
001061238400001
Scopus ID
85170347065
PubMed ID
37686744
Erfassungsdatum
2023-10-18