Search

Abstract: Objective: This multicenter, prospective cohort study evaluated the effect of preoperative nutritional support in abdominal surgical patients at nutritional risk as defined by the Nutritional Risk Screening Tool 2002 (NRS-2002). Methods: A consecutive series of patients admitted for selective abdominal surgery in the Peking Union Medical College Hospital and the Beijing University Third Hospital in Beijing, China were recruited from March 2007 to July 2008. Data were collected on the nutritional risk screening (NRS-2002), the application of perioperative nutritional support, surgery, complications, and length of stay. A minimum of 7 d of parenteral nutrition or enteral nutrition before surgery was considered adequate preoperative nutritional support. Results: In total 1085 patients were recruited, and 512 of them were at nutritional risk. Of the 120 patients with an NRS score at least 5, the complication rate was significantly lower in the preoperative nutrition group compared with the control group (25.6% versus 50.6%, P = 0.008). The postoperative hospital stay was significantly shorter in the preoperative nutrition group than in the control group (13.7 ± 7.9 versus 17.9 ± 11.3 d, P = 0.018). Of the 392 patients with an NRS score from 3 to 4, the complication rate and the postoperative hospital stay were similar between patients with and those without preoperative nutritional support (P = 1.0 and 0.770, respectively). Conclusion: This finding suggests that preoperative nutritional support is beneficial to patients with an NRS score at least 5 by lowering the complication rate. [Copyright &y& Elsevier]

Objective: To evaluate the impact of nutritional support on clinical outcomes in patients at nutritional risk defined by the Nutritional Risk Screening 2002. Methods: In this prospective cohort study, hospitalized patients from three departments in Johns Hopkins Hospital in Baltimore and two teaching hospitals in Beijing were recruited from March 2007 to May 2008. Data were collected on the nutritional risk screening, application of parenteral nutrition and enteral nutrition, surgery, complications, and length of stay. Results: There were 1831 patients recruited, with 45.2% of them at nutritional risk. Of the “at-risk” patients, the complication rate was significantly lower in the nutritional-support group than in the no-support group (20.3% versus 28.1%, P = 0.009), mainly because of the lower rate of infectious complications (10.5% versus 18.9%, P < 0.001). Subgroup analysis showed the complication rate was significantly lower in the enteral nutrition group (P < 0.001) but not in the parenteral nutrition group (P = 0.29) when compared with the no-support group. Of the patients without nutritional risk, the complication rate was not different between the nutritional-support group and the no-support group (P = 0.10). Multivariate analysis showed nutritional support was a protective factor for complications in at-risk patients when adjusted for confounders (odds ratio 0.54, P < 0.001). No difference in length of stay was found. Conclusion: The findings suggested that nutritional support was beneficial to the patients at nutritional risk according to Nutritional Risk Screening 2002 by a lower complication rate. [Copyright &y& Elsevier]

The purpose of this study was to test the suitability of Nutritional Risk Screening 2002 (NRS 2002) among hospitalized patients and to determine the prevalence of nutritional risk, undernutrition, overweight, obesity, nutritional support and the changes of nutritional risk from admission to discharge or over a two-week period. A prospective descriptive design was used to describe patients' data collected at three Beijing teaching hospitals. A total number of 1500 consecutive patients, who met the inclusion criteria on admission and provided informed consent, were enrolled. The NRS 2002 was completed by 97.7% of all patients in this study. The overall prevalence of nutritional risk was 27.3%, the prevalence of undernutrition, overweight and obesity was 9.2%, 34.8%, and 10.2%, respectively at admission. Only 24.9% of patients who were at nutritional risk received nutritional support while 6% of non-risk patients received nutritional support. The overall prevalence of nutritional risk changed from 27.3% to 31.9% (p < 0.05), and the prevalence of undernutrition, overweight and obesity changed from 9.2% to 11.7% (p < 0.05). from 34.8% to 31.8% (p > 0.05) and from 10.2% to 8.6% (p > 0,05), respectively during hospitalization. Nutritional Risk Screening 2002 was a feasible nutritional risk screening tool in selected Beijing teaching hospitals. The prevalence of nutritional risk observed was nearly 30%. Inappropriate use of nutritional support was observed in hospitalized patients. The prevalence of nutritional risk increased in surgical patients during hospitalization. [ABSTRACT FROM AUTHOR]

Abstract: Objective: We tested the feasibility of using the Nutritional Risk Screening 2002 tool among hospitalized medical patients in Beijing and Baltimore and determined the prevalence of nutritional risk, nutritional support, and nutritional risk changes from admission to discharge or over a 2-wk period. Methods: A comparative design was used to compare data collected at Beijing and Baltimore teaching hospitals from April 2006 to April 2007. A total of 500 consecutive medical patients, 300 from Beijing and 200 from Baltimore, who met the inclusion criteria on admission and provided informed consent were enrolled. Results: Among the hospitalized patients, 94.0% in Beijing and 99.5% in Baltimore were able to complete the Nutritional Risk Screening 2002. Prevalences of nutritional risk were 39.0% and 51.0%, respectively (P < 0.05). For the patients at nutritional risk, only 17.9% in Beijing and 14.7% in Baltimore used parenteral nutrition or enteral nutrition (P = 0.518). For non-risk patients, 3.3% in Beijing used nutritional support, whereas no patient in Baltimore used this support (P = 0.095). Prevalences of nutritional risk changed from 39.0% to 38.5% (P = 0.892) during hospitalization in Beijing and from 51.0% to 41.4% in Baltimore (P = 0.055). Conclusion: The Nutritional Risk Screening 2002 was feasible in the Beijing and Baltimore teaching hospitals. The prevalence of nutritional risk observed in Baltimore was higher than that in Beijing. No difference was observed in the application rate of nutritional support and changes in nutritional risk during hospitalization between these two hospitals. [Copyright &y& Elsevier]

Aim: Uncontrolled hypertension is an independent risk factor for cardiovascular disease and is the leading cause of mortality in haemodialysis patients. The aim of this study was to examine the effectiveness of self-management support (SMS) for blood pressure (BP) control and health behaviours., Methods: We conducted a cluster randomized controlled trial (RCT) in which 90 adult haemodialysis patients were assigned to either an SMS or common intervention (CI) group. The SMS group received an intervention consisting of self-management education and motivational interviewing. The CI group received standard care and routine health education. The primary outcome was the BP monitored before each haemodialysis. Secondary outcomes included salt intake (measured using a balance formula), home BP monitoring (HBPM) (assessed using two self-administered questions), and medication adherence (measured using the Medication-taking Behavior Scale). Data were collected at baseline and at 1, 3 and 6 months post-intervention., Results: The SMS group showed continuous reductions in systolic BP from baseline: -9.2, -8.7, and -8.4 mmHg at 1, 3 and 6 months after the intervention, respectively (P < 0.01). Compared with the CI group, the SMS group had a greater decrease in systolic BP at 1 month: -5.9 mmHg (P = 0.0388), but no significant difference was found at 3 or 6 months (P > 0.05). SMS patients showed an improvement in health behaviours relative to baseline (less salt intake, more consistent HBPM, and greater medication adherence) (P < 0.05)., Conclusions: Self-management support obtained short-term success in improving salt restriction, regular performance of HBPM and medication adherence, which led to better BP control., (© 2017 Asian Pacific Society of Nephrology.)

In July 2008, five nurses graduated from the first full-time doctoral program for nurses in China at Peking Union Medical College (PUMC) in Beijing. The purpose of this article is to describe the doctoral program partnership between the Schools of Nursing at PUMC and Johns Hopkins University (Hopkins) in the United States that led to this historic event. The planning, implementation, evaluation, and early outcomes of the program are described to provide a model for rapidly increasing capacity for doctoral education in nursing in countries without sufficient or any doctoral education in nursing. One of the main objectives of this doctoral program partnership was to transition the Chinese University to an independent doctoral program as rapidly as possible. Lessons learned are presented as well as the next steps for this program., (Copyright © 2011 Elsevier Inc. All rights reserved.)