Development, Design and Utilization of a CDSS for Refeeding Syndrome in Real Life Inpatient Care-A Feasibility Study

Area of Science:

• Clinical Informatics
• Critical Care Medicine
• Nutritional Support

Background:

• Refeeding syndrome (RFS) is a potentially fatal complication of nutritional rehabilitation in malnourished patients.
• RFS is often unrecognized, leading to delayed or missed diagnosis and management.
• Effective RFS recognition and management are critical for patient safety.

Purpose of the Study:

• To develop and evaluate a clinical decision support system (CDSS) for improving RFS recognition and management.
• To assess the impact of a CDSS on RFS diagnosis rates and clinical documentation.
• To investigate the effect of CDSS on patient care processes, including nutritional referrals.

Main Methods:

• An algorithm for RFS detection was developed based on diagnostic criteria.
• The algorithm was integrated into a knowledge-based CDSS with therapy and referral recommendations.
• The CDSS was prospectively evaluated in clinical practice over six months.

Main Results:

• The CDSS facilitated RFS diagnosis in 62% of detected cases (13/21).
• RFS-specific coding increased significantly post-CDSS implementation.
• Nutrition referrals for RFS patients doubled in the prospective cohort compared to the retrospective cohort.

Conclusions:

• CDSS implementation is a viable strategy for enhancing RFS recognition.
• The study demonstrates improved diagnostic accuracy and patient care processes.
• Further large-scale randomized controlled trials are warranted to confirm the impact on patient outcomes.