ESPEN guidelines on nutritional support for polymorbid internal medicine patients

Area of Science:

• Clinical Nutrition
• Internal Medicine
• Evidence-Based Medicine

Background:

• Polymorbidity, the presence of multiple chronic conditions, is common in hospitalized patients.
• Existing clinical guidelines often focus on single diseases, neglecting the complexities of polymorbidity.
• There is a need for specific nutritional support guidelines for polymorbid individuals.

Purpose of the Study:

• To develop evidence-based guidelines for nutritional support in hospitalized patients with polymorbidity.
• To address key aspects of nutritional intervention, including indications, feeding routes, and nutrient requirements.

Main Methods:

• Adherence to ESPEN (European Society for Parenteral and Enteral Nutrition) guideline development procedures.
• Systematic literature searches across multiple databases (Medline, Embase, Cochrane Library) and secondary sources.
• Development of recommendations through Delphi voting rounds and consensus conferences.

Main Results:

• Analysis of 38 relevant studies from 4532 retrieved abstracts.
• Generation of a guideline draft with 22 recommendations and 4 statements.
• High consensus achieved for all recommendations (>89%) during the final conference.

Conclusions:

• Developed practical, evidence-based clinical recommendations for nutritional support in polymorbid medical inpatients.
• Addresses the methodological challenges of creating non-disease-specific guidelines.
• Aims to provide an evidence-based nutritional approach to improve patient outcomes.