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Article: Prehospital Stroke Care, Paramedic Training Needs, and Hospital-Directed Feedback in Lithuania.

Melaika, Kazimieras / Sveikata, Lukas / Vilionskis, Aleksandras / Wiśniewski, Adam / Jurjans, Kristaps / Klimašauskas, Andrius / Jatužis, Dalius / Masiliūnas, Rytis

Healthcare (Basel, Switzerland)

2022 Volume 10, Issue 10

Abstract: Background: Emergency medical services (EMS) are the first health care contact for the majority of stroke patients. However, there is a lack of data on the current paramedics’ hospital-directed feedback and training needs across different health care ... ...

Abstract	Background: Emergency medical services (EMS) are the first health care contact for the majority of stroke patients. However, there is a lack of data on the current paramedics’ hospital-directed feedback and training needs across different health care settings. We aimed to evaluate paramedics’ prehospital stroke care knowledge, training needs, and current status of feedback on suspected stroke patients. Methods: We surveyed paramedics from the Vilnius region from September to November 2019 and compared the answers between the city and the district agencies. The questionnaire content included questions on paramedics’ demographic characteristics, prehospital stroke care self-assessment, knowledge on stroke mimics, stroke training needs, and the importance of hospital-directed feedback on suspected stroke patients. Results: A total number of 161 paramedics (or 49.4% of all paramedics from our stroke care network) were surveyed, with more district paramedics rating their prehospital stroke care knowledge as inadequate (44.8% (95% confidence interval (CI) 32.8−57.6) vs. 28.1% (95% CI 20.1−27.8), p = 0.028). In addition, more district paramedics indicated a need for additional stroke training (83.1% (95% CI 71.5−90.5) vs. 69.8% (60.0−78.1), p = 0.043). However, respondents reported being the most confident while dealing with stroke (71.3%, 95% CI 63.8−77.7) compared to other time-critical conditions (p < 0.001). Vertigo (60.8%, 95% CI 53.0−68.0), brain tumors (56.3%, 95% CI 48.5−63.8), and seizures (54.4%, 95% CI 46.7−62.0) were indicated as the most common stroke mimics. Only 6.2% (95% CI 3.4−11.1) of respondents received formal feedback on the outcome of suspected stroke patients brought to the emergency department. Conclusions: A high proportion of paramedics self-perceive having inadequate stroke knowledge and an urgent need for further stroke training. The EMS staff indicate receiving insufficient feedback on suspected stroke patients, even though its usefulness is perceived as paramount.
Language	English
Publishing date	2022-10-07
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2721009-1
ISSN	2227-9032
ISSN	2227-9032
DOI	10.3390/healthcare10101958
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Article ; Online: Conceptual model of adding antibiotics to dialysate fluid during renal replacement therapy.

Bartuseviciene, Ieva / Vicka, Vaidas / Vickiene, Alvita / Tetianec, Lidija / Dagys, Marius / Ringaitiene, Donata / Klimasauskas, Andrius / Sipylaite, Jurate

Scientific reports

2021 Volume 11, Issue 1, Page(s) 23836

Abstract: Studies have shown significant variability in antibiotic trough concentrations in critically ill patients receiving renal replacement therapy (RRT). The purpose of this study was to assess whether adding beta-lactam antibiotics to dialysate solution can ... ...

Abstract	Studies have shown significant variability in antibiotic trough concentrations in critically ill patients receiving renal replacement therapy (RRT). The purpose of this study was to assess whether adding beta-lactam antibiotics to dialysate solution can maintain stable antibiotic concentrations during RRT in experimental conditions. A single compartment model reflecting the patient was constructed and connected to the RRT machine. Dialysate fluid was prepared in three different concentrations of meropenem (0 mg/L; 16 mg/L; 64 mg/L). For each dialysate concentration various combinations of dialysate and blood flow rates were tested by taking different samples. Meropenem concentration in all samples was calculated using spectrophotometry method. Constructed experimental model results suggest that decrease in blood meropenem concentration can be up to 35.6%. Moreover, experimental data showed that antibiotic loss during RRT can be minimized and stable plasma antibiotic concentration can be achieved with the use of a 16 mg/L Meropenem dialysate solution. Furthermore, increasing meropenem concentration up to 64 mg/L is associated with an increase antibiotic concentration up to 18.7-78.8%. Administration of antibiotics to dialysate solutions may be an effective method of ensuring a constant concentration of antibiotics in the blood of critically ill patients receiving RRT.
MeSH term(s)	Anti-Bacterial Agents/administration & dosage ; Anti-Bacterial Agents/analysis ; Computer Simulation ; Dialysis Solutions/administration & dosage ; Dialysis Solutions/chemistry ; Humans ; Meropenem/administration & dosage ; Meropenem/analysis ; Renal Replacement Therapy/methods
Chemical Substances	Anti-Bacterial Agents ; Dialysis Solutions ; Meropenem (FV9J3JU8B1)
Language	English
Publishing date	2021-12-13
Publishing country	England
Document type	Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-021-03450-1
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Article ; Online: Comparison of mortality risk evaluation tools efficacy in critically ill COVID-19 patients.

Vicka, Vaidas / Januskeviciute, Elija / Miskinyte, Sigute / Ringaitiene, Donata / Serpytis, Mindaugas / Klimasauskas, Andrius / Jancoriene, Ligita / Sipylaite, Jurate

BMC infectious diseases

2021 Volume 21, Issue 1, Page(s) 1173

Abstract: Background: As the COVID-19 pandemic continues, the number of patients admitted to the intensive care unit (ICU) is still increasing. The aim of our article is to estimate which of the conventional ICU mortality risk scores is the most accurate at ... ...

Abstract	Background: As the COVID-19 pandemic continues, the number of patients admitted to the intensive care unit (ICU) is still increasing. The aim of our article is to estimate which of the conventional ICU mortality risk scores is the most accurate at predicting mortality in COVID-19 patients and to determine how these scores can be used in combination with the 4C Mortality Score. Methods: This was a retrospective study of critically ill COVID-19 patients treated in tertiary reference COVID-19 hospitals during the year 2020. The 4C Mortality Score was calculated upon admission to the hospital. The Simplified Acute Physiology Score (SAPS) II, Acute Physiology and Chronic Health Evaluation (APACHE) II, and Sequential Organ Failure Assessment (SOFA) scores were calculated upon admission to the ICU. Patients were divided into two groups: ICU survivors and ICU non-survivors. Results: A total of 249 patients were included in the study, of which 63.1% were male. The average age of all patients was 61.32 ± 13.3 years. The all-cause ICU mortality ratio was 41.4% (n = 103). To determine the accuracy of the ICU mortality risk scores a ROC-AUC analysis was performed. The most accurate scale was the APACHE II, with an AUC value of 0.772 (95% CI 0.714-0.830; p < 0.001). All of the ICU risk scores and 4C Mortality Score were significant mortality predictors in the univariate regression analysis. The multivariate regression analysis was completed to elucidate which of the scores can be used in combination with the independent predictive value. In the final model, the APACHE II and 4C Mortality Score prevailed. For each point increase in the APACHE II, mortality risk increased by 1.155 (OR 1.155, 95% CI 1.085-1.229; p < 0.001), and for each point increase in the 4C Mortality Score, mortality risk increased by 1.191 (OR 1.191, 95% CI 1.086-1.306; p < 0.001), demonstrating the best overall calibration of the model. Conclusions: The study demonstrated that the APACHE II had the best discrimination of mortality in ICU patients. Both the APACHE II and 4C Mortality Score independently predict mortality risk and can be used concomitantly.
MeSH term(s)	Aged ; COVID-19 ; Critical Illness ; Hospital Mortality ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Pandemics ; Prognosis ; ROC Curve ; Retrospective Studies ; SARS-CoV-2
Language	English
Publishing date	2021-11-22
Publishing country	England
Document type	Journal Article
ISSN	1471-2334
ISSN (online)	1471-2334
DOI	10.1186/s12879-021-06866-2
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Article: Impact of enteral nutrition interruptions on underfeeding in intensive care unit

Salciute-Simene, Erika / Stasiunaitis, Raimundas / Ambrasas, Eduardas / Tutkus, Jonas / Milkevicius, Ignas / Sostakaite, Gintare / Klimasauskas, Andrius / Kekstas, Gintautas

Clinical nutrition. 2020 Aug. 15,

2020

Abstract: Malnutrition leads to poor outcomes for critically ill patients; however, underfeeding remains a prevalent issue in the intensive care unit (ICU). One of the reasons for underfeeding is enteral nutrition interruption (ENI). Our aim was to investigate the ...

Abstract	Malnutrition leads to poor outcomes for critically ill patients; however, underfeeding remains a prevalent issue in the intensive care unit (ICU). One of the reasons for underfeeding is enteral nutrition interruption (ENI). Our aim was to investigate the causes, frequency, and duration of ENIs and their association with underfeeding in critical care.This was a prospective observational study conducted at the Vilnius University Hospital Santaros Clinics, Lithuania, between December 2017 and February 2018. It included adult medical and surgical ICU patients who received enteral nutrition (EN). Data on ENIs and caloric, as well as protein intake were collected during the entire ICU stay. Nutritional goals were assessed using indirect calorimetry, where available.In total 73 patients were enrolled in the study. Data from 1023 trial days and 131 ENI episodes were collected; 68% of the patients experienced ENI during the ICU stay, and EN was interrupted during 35% of the trial days. The main reasons for ENIs were haemodynamic instability (20%), high gastric residual volume (GRV) (17%), tracheostomy (16%), or other surgical interventions (16%). The median duration of ENI was 12 [6–24] h, and the longest ENIs were due to patient-related factors (22 [12–42] h). The rate of underfeeding was 54% vs. 15% in the trial days with and without ENI (p < 0.001), respectively. Feeding goal was achieved in 26% of the days with ENI vs. 45% of days without ENI (p < 0.001). The daily average caloric provision was 77 ± 36% vs. 106 ± 29% in the trial days with and without ENI (p < 0.001) and protein provision was 0.96 ± 0.5 vs. 1.3 ± 0.5 g/kg, respectively (p < 0.001).The episodes of ENI in critically ill patients are frequent and prolonged, often leading to underfeeding. Similar observations have been reported by other studies; however, the causes and duration of ENI vary, mainly because of different practices worldwide. Hence, safe and internationally recognised reduced-fasting guidelines and protocols for critically ill patients are needed in order to minimise ENI-related underfeeding and malnutrition.
Keywords	adults ; calorimetry ; clinical nutrition ; duration ; enteral feeding ; frequency ; hemodynamics ; hospitals ; malnutrition ; objectives ; observational studies ; patients ; protein intake ; protocols ; restricted feeding ; volume ; Lithuania
Language	English
Dates of publication	2020-0815
Publishing place	Elsevier Ltd
Document type	Article
Note	NAL-light ; Pre-press version
ZDB-ID	604812-2
ISSN	1532-1983 ; 0261-5614
ISSN (online)	1532-1983
ISSN	0261-5614
DOI	10.1016/j.clnu.2020.08.014
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Impact of enteral nutrition interruptions on underfeeding in intensive care unit.

Salciute-Simene, Erika / Stasiunaitis, Raimundas / Ambrasas, Eduardas / Tutkus, Jonas / Milkevicius, Ignas / Sostakaite, Gintare / Klimasauskas, Andrius / Kekstas, Gintautas

Clinical nutrition (Edinburgh, Scotland)

2020 Volume 40, Issue 3, Page(s) 1310–1317

Abstract: Background & aims: Malnutrition leads to poor outcomes for critically ill patients; however, underfeeding remains a prevalent issue in the intensive care unit (ICU). One of the reasons for underfeeding is enteral nutrition interruption (ENI). Our aim ... ...

Abstract	Background & aims: Malnutrition leads to poor outcomes for critically ill patients; however, underfeeding remains a prevalent issue in the intensive care unit (ICU). One of the reasons for underfeeding is enteral nutrition interruption (ENI). Our aim was to investigate the causes, frequency, and duration of ENIs and their association with underfeeding in critical care. Methods: This was a prospective observational study conducted at the Vilnius University Hospital Santaros Clinics, Lithuania, between December 2017 and February 2018. It included adult medical and surgical ICU patients who received enteral nutrition (EN). Data on ENIs and caloric, as well as protein intake were collected during the entire ICU stay. Nutritional goals were assessed using indirect calorimetry, where available. Results: In total 73 patients were enrolled in the study. Data from 1023 trial days and 131 ENI episodes were collected; 68% of the patients experienced ENI during the ICU stay, and EN was interrupted during 35% of the trial days. The main reasons for ENIs were haemodynamic instability (20%), high gastric residual volume (GRV) (17%), tracheostomy (16%), or other surgical interventions (16%). The median duration of ENI was 12 [6-24] h, and the longest ENIs were due to patient-related factors (22 [12-42] h). The rate of underfeeding was 54% vs. 15% in the trial days with and without ENI (p < 0.001), respectively. Feeding goal was achieved in 26% of the days with ENI vs. 45% of days without ENI (p < 0.001). The daily average caloric provision was 77 ± 36% vs. 106 ± 29% in the trial days with and without ENI (p < 0.001) and protein provision was 0.96 ± 0.5 vs. 1.3 ± 0.5 g/kg, respectively (p < 0.001). Conclusions: The episodes of ENI in critically ill patients are frequent and prolonged, often leading to underfeeding. Similar observations have been reported by other studies; however, the causes and duration of ENI vary, mainly because of different practices worldwide. Hence, safe and internationally recognised reduced-fasting guidelines and protocols for critically ill patients are needed in order to minimise ENI-related underfeeding and malnutrition.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Critical Care/methods ; Critical Illness/therapy ; Energy Intake/physiology ; Enteral Nutrition/methods ; Female ; Humans ; Intensive Care Units ; Lithuania ; Male ; Malnutrition/etiology ; Middle Aged ; Nutritional Requirements ; Prospective Studies
Language	English
Publishing date	2020-08-27
Publishing country	England
Document type	Journal Article ; Observational Study
ZDB-ID	604812-2
ISSN	1532-1983 ; 0261-5614
ISSN (online)	1532-1983
ISSN	0261-5614
DOI	10.1016/j.clnu.2020.08.014
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Article: Is minimally invasive surgical treatment justified for severe acute necrotizing pancreatitis patients with dysfunction of two or more organ systems?

Šileikis, Audrius / Pečiulytė, Emilija / Misenkienė, Agnė / Klimašauskas, Andrius / Beiša, Virgilijus / Strupas, Kęstutis

Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques

2017 Volume 12, Issue 3, Page(s) 225–230

Abstract: Introduction: When minimally invasive therapy was introduced, it became possible to cure some patients without open surgery, or at least delay the operation for longer than a month.: Aim: To determine the optimal timing to operate on patients with ... ...

Abstract	Introduction: When minimally invasive therapy was introduced, it became possible to cure some patients without open surgery, or at least delay the operation for longer than a month. Aim: To determine the optimal timing to operate on patients with severe acute necrotizing pancreatitis based on the severity of organ insufficiency. Material and methods: A retrospective analysis was performed in all severe acute necrotizing pancreatitis patients treated in Vilnius University Hospital Santaros Klinikos (VUL SK) from 2007 to 2016. The patients were divided into groups based on the number of dysfunctional organ systems (one or more) and whether the minimally invasive step-up approach to treatment was used. Results: The patients with one organ dysfunction had a delay of 35 (without the step-up approach) and 36 (with the step-up approach) days before the open surgery, while the patients with two or more organ systems' dysfunction had almost an identical delay of 28 days, using both surgical treatment methods. The mortality of the patients who had one organ dysfunction and in whom the step-up approach was used was 0%, while in patients without the step-up approach it was 41.7%. In the two or more organ systems' dysfunction group, the mortality for those treated with a step-up approach was 64.3%, and without it 70.7%. Conclusions: The surgical treatment should be initiated with a minimally invasive procedure. Additionally, the surgery on patients with two or more organ systems' dysfunction should not be delayed for more than one month.
Language	English
Publishing date	2017-07-03
Publishing country	Poland
Document type	Journal Article
ZDB-ID	2596147-0
ISSN	2299-0054 ; 1895-4588
ISSN (online)	2299-0054
ISSN	1895-4588
DOI	10.5114/wiitm.2017.68792
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Article ; Online: Concordance of the new ESPEN criteria with low phase angle in defining early stages of malnutrition in cardiac surgery.

Ringaitiene, Donata / Gineityte, Dalia / Vicka, Vaidas / Sabestinaite, Akvile / Klimasauskas, Andrius / Gaveliene, Edita / Rucinskas, Kestutis / Ivaska, Justinas / Sipylaite, Jurate

Clinical nutrition (Edinburgh, Scotland)

2017 Volume 37, Issue 5, Page(s) 1596–1601

Abstract: Background & aims: The aim of this study was to evaluate the incidence of malnutrition (MN) in cardiac surgery patients by implementing the new ESPEN diagnostic criteria and to determine whether these criteria are concordant with the bioelectrical ... ...

Abstract	Background & aims: The aim of this study was to evaluate the incidence of malnutrition (MN) in cardiac surgery patients by implementing the new ESPEN diagnostic criteria and to determine whether these criteria are concordant with the bioelectrical impedance analysis (BIA) provided phase angle (PA) in predicting early stages of malnutrition. Methods: A prospective study was conducted in a tertiary hospital. The nutritional state of the cardiac surgery patients was evaluated one day prior to cardiac surgery using the malnutrition screening tools NRS-2002, MUST and SF-MNA, and bioelectrical impedance analysis. Patients at risk of malnutrition were further studied in accordance with the ESPEN malnutrition diagnostic criteria. A BIA provided PA value of less than the 15th percentile of the age and gender group was set as a theoretical marker of early malnutrition. ROC AUC (receiver operating characteristic area under curve) analysis and other parameters were calculated to determine the concordance between the new ESPEN malnutrition diagnostic criteria and a low PA. Results: The study comprised 549 enrolled cardiac surgery patients. MN or risk of MN in accordance with at least one nutritional status assessment tool was diagnosed in 372 (67.75%) patients. MN, according to the new ESPEN malnutrition diagnostic criteria, was only diagnosed in 31 (5.6%) patients. Low PA was detected in 124 patients (22.6%), providing a higher MN rate. The ROC analysis and other concordance parameters showed that the new ESPEN diagnostic criteria (AUC 0.560, p = 0.042) were not concordant with a low PA. Conclusion: Fewer patients are classified as malnourished by the new ESPEN definition as those identified by the BIA provided PA. Incorporation of the BIA provided PA into the new ESPEN definition may aid to diagnose the early stages of MN in the field of cardiac surgery.
MeSH term(s)	Aged ; Body Mass Index ; Cardiac Surgical Procedures/statistics & numerical data ; Electric Impedance ; Female ; Heart Diseases/complications ; Heart Diseases/surgery ; Humans ; Male ; Malnutrition/diagnosis ; Malnutrition/epidemiology ; Middle Aged ; Nutrition Assessment ; Nutritional Status ; Prospective Studies ; ROC Curve ; Tertiary Care Centers
Language	English
Publishing date	2017-08-12
Publishing country	England
Document type	Journal Article
ZDB-ID	604812-2
ISSN	1532-1983 ; 0261-5614
ISSN (online)	1532-1983
ISSN	0261-5614
DOI	10.1016/j.clnu.2017.08.007
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Article ; Online: Global availability of parenteral nutrition: Pre- and post-COVID-19 pandemic surveys.

Klek, Stanislaw / Del Rio Requejo, Isabel Martinez / Hardy, Gil / Francisco, Liza Mei P / Abbasoglu, Osman / Acosta, Juan Carlos Ayala / Granados, Luis Miguel Becerra / Boeykens, Kurt / Carey, Sharon / Chourdakis, Michael / Compher, Charlene / De Cloet, Joeri / Dubrov, Sergiej / Fuentes, Catalina / Sámano, Ana Karina García / Velasquez, María Eloisa García / Goos, Cezanne / Reyes, José Guillermo Gutierrez / Joon, Lee V /

Klimasauskas, Andrius / Komsa, Regina / Krznaric, Zeljko / Ljubas, Dina / Moscoso, Claudia P Maza / Larreategui, Rosa / Mirea, Liliana / Meier, Remy / Nyulasi, Ibolya / Oivind, Irtun / Panisic-Sekeljic, Marina / Poulia, Kalliopi Anna / Rasmussen, Henrik Højgaard / Savino, Patricia / Singer, Pierre / Tamasi, Peter / Uyar, Mehmet / Thu, Nguyen Viet Quynh / Waitzberg, Dan / Weimann, Arved / Wong, Theodoric / Yu, Jianchun / Wojcik, Paulina / Schneider, Stephane

Nutrition (Burbank, Los Angeles County, Calif.)

2024 Volume 123, Page(s) 112396

Abstract: Objective: Parenteral nutrition represents a therapeutic option for patients with type 3 intestinal failure. If used exclusively, parenteral nutrition has to be complete to provide all essential nutrients. The aim was to assess the availability of ... ...

Abstract	Objective: Parenteral nutrition represents a therapeutic option for patients with type 3 intestinal failure. If used exclusively, parenteral nutrition has to be complete to provide all essential nutrients. The aim was to assess the availability of parenteral nutrition in all parts of the world, to better comprehend the global situation, and to prepare an action plan to increase access to parenteral nutrition. Methods: An international survey using an electronic questionnaire was conducted in August 2019 and repeated in May 2022. An electronic questionnaire was sent to 52 members or affiliates of the International Clinical Nutrition Section of the American Society for Parenteral and Enteral Nutrition. Questions addressed the availability of parenteral nutrition admixtures and their components, reimbursement, and prescribing pre- and post-COVID-19 pandemic. All participating countries were categorized by their economic status. Results: Thirty-six country representatives responded, answering all questions. Parenteral nutrition was available in all countries (100%), but in four countries (11.1%) three-chamber bags were the only option, and in six countries a multibottle system was still used. Liver-sparing amino acids were available in 18 (50%), kidney-sparing in eight (22.2%), and electrolyte-free in 11 (30.5%) countries (30.5%). In most countries (n = 28; 79.4%), fat-soluble and water-soluble vitamins were available. Trace elements solutions were unavailable in four (11.1%) countries. Parenteral nutrition was reimbursed in most countries (n = 33; 91.6%). No significant problems due to the coronavirus pandemic were reported. Conclusions: Despite the apparent high availability of parenteral nutrition worldwide, there are some factors that may have a substantial effect on the quality of parenteral nutrition admixtures. These shortages create an environment of inequality.
Language	English
Publishing date	2024-02-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	639259-3
ISSN	1873-1244 ; 0899-9007
ISSN (online)	1873-1244
ISSN	0899-9007
DOI	10.1016/j.nut.2024.112396
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Article ; Online: The impact of medical conditions on the quality of life of survivors at discharge from intensive care unit.

Klimašauskas, Andrius / Sereikė, Ieva / Klimašauskienė, Aušra / Kėkštas, Gintautas / Ivaškevičius, Juozas

Medicina (Kaunas, Lithuania)

2011 Volume 47, Issue 5, Page(s) 270–277

Abstract: Background and objective: Impaired health-related quality of life (HRQOL) is one of the possible outcomes after discharge from an intensive care unit (ICU). Evaluation of patient health status on discharge from the ICU would help identify factors ... ...

Abstract	Background and objective: Impaired health-related quality of life (HRQOL) is one of the possible outcomes after discharge from an intensive care unit (ICU). Evaluation of patient health status on discharge from the ICU would help identify factors influencing changes in HRQOL after ICU discharge. The objective of the study was to identify whether health state on discharge from prolonged stay in the ICU has any influence on survivors' HRQOL 6 months after intensive care. Material and methods: A prospective study of patients with the prolonged length of stay (exceeding 7 days) in the ICU was conducted. The study covered the impact of organ system dysfunction (SOFA score), number of therapeutic interventions (TISS-28 score), and critical illness neuromuscular abnormalities (CINMA) on discharge from the ICU on HRQOL 6 months following ICU discharge. Results: In total, 137 patients were included in the study. The SOFA score on the last day in the ICU was 2.91 (SD, 1.57); the TISS-28 score on the last day in the ICU was 21.79 (SD, 4.53). Decreased physical functioning (PF) and role physical (RP) were identified. Circulatory impairment on discharge from the ICU had an impact on decreased PF (P=0.016), role physical (P=0.066), and role emotional (P=0.001). Patients with dysfunction in more than one organ system on ICU discharge had decreased role emotional (P=0.016). Severe CINMA was diagnosed in 18 patients. They had decreased PF (P=0.007) and RP (P=0.019). Patients with the TISS-28 score above or equal to 20 points showed lower HRQOL in the PF domain (P=0.077) and general health (P=0.038). Conclusions: HRQOL in patients with prolonged stay in the ICU is particularly impaired in the domains of physical functioning and role physical. It is associated with circulatory impairment, CINMA, and greater number of therapeutic interventions on discharge from the ICU.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Female ; Health Status Indicators ; Humans ; Intensive Care Units ; Length of Stay ; Male ; Middle Aged ; Patient Discharge ; Prospective Studies ; Quality of Life ; Survivors/psychology ; Young Adult
Language	Lithuanian
Publishing date	2011
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2188113-3
ISSN	1648-9144 ; 1010-660X
ISSN (online)	1648-9144
ISSN	1010-660X
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Article: Prevalence of malnutrition in various political, economic, and geographic settings.

Klek, Stanislaw / Krznaric, Zeljko / Gundogdu, Riza Haldun / Chourdakis, Michael / Kekstas, Gintautas / Jakobson, Triin / Paluszkiewicz, Piotr / Vranesic Bender, Darija / Uyar, Mehmet / Demirag, Kubilay / Poulia, Kalliopi Anna / Klimasauskas, Andrius / Starkopf, Joel / Galas, Aleksander

JPEN. Journal of parenteral and enteral nutrition

2015 Volume 39, Issue 2, Page(s) 200–210

Abstract: Background: Disease-related malnutrition (DRM) represents a critical public health concern. Therefore, Fight Against Malnutrition (FAM) should be a state priority, but the degree to which this is true appears to differ considerably among European ... ...

Abstract	Background: Disease-related malnutrition (DRM) represents a critical public health concern. Therefore, Fight Against Malnutrition (FAM) should be a state priority, but the degree to which this is true appears to differ considerably among European countries. The aim of this study was to put the problem into perspective by comparing the prevalence of malnutrition in countries from opposite parts of the continent. Methods: Six countries-Croatia, Estonia, Greece, Lithuania, Poland, and Turkey-participated in the study. A short questionnaire was used to assess DRM: its prevalence, the current situation in hospitals, regulations for reimbursement, and general healthcare circumstances. Data from ESPEN's NutritionDay 2006 were used to broaden the perspective. Results: At admission in October 2012, 4068 patients were assessed. The study was performed in 160 hospitals and 225 units with 9143 beds. The highest proportions of patients with 3 or more points on the Nutritional Risk Screening 2002 were observed in Estonia (80.4%) and Turkey (39.4%), whereas the lowest were in Lithuania (14.2%). The provision of nutrition support was best in Turkey (39.4% required intervention, 34.4% received intervention) and Poland (21.9% and 27.8%, respectively). Nutrition support teams (NSTs) are active in some countries, whereas in others they virtually do not exist. Conclusion: The prevalence of malnutrition was quite high in some countries, and the nutrition approach differed among them. It could be the result of the lack of reimbursement, inactive or nonexistent NSTs, and low nutrition awareness. Those facts confirmed that the continuation of FAM activities is necessary.
MeSH term(s)	Adult ; Croatia/epidemiology ; Estonia/epidemiology ; Female ; Greece/epidemiology ; Hospitalization ; Humans ; Lithuania/epidemiology ; Male ; Malnutrition/diagnosis ; Malnutrition/economics ; Malnutrition/epidemiology ; Malnutrition/ethnology ; Malnutrition/etiology ; Malnutrition/therapy ; Middle Aged ; Nutrition Assessment ; Nutritional Status ; Poland/epidemiology ; Politics ; Prevalence ; Risk Assessment ; Surveys and Questionnaires ; Turkey/epidemiology
Language	English
Publishing date	2015-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	800861-9
ISSN	0148-6071
ISSN	0148-6071
DOI	10.1177/0148607113505860
Database	MEDical Literature Analysis and Retrieval System OnLINE

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