Readmissão hospitalar em pacientes clínicos: o papel dos fatores nutricionais

Abstract

Introduction: Hospital readmissions are common and potentially preventable, being considered marker of poor quality of a health service. The literature shows readmission rates around 20% and identified some risk factors such as length of stay, polypharmacy and more comorbidity. There is increasing interest in identifying potentially reversible risk factors, including the patient nutritional status. Several studies have shown a strong association between malnutrition and a prolonged hospitalization, increased mortality, increased hospital costs and high rates of hospital readmission. However, these studies did not evaluate only clinical patients and are difficult to extrapolate to the Brazilian reality in which the hospitalized patients have different clinical characteristics, socioeconomic and nutritional status. Objective: This study aimed to identify risk factors for hospital readmissions in medical patients admitted to a university hospital in southern Brazil. Method: This is a prospective cohort study assessing predictors of hospital readmission in patients who stays more than 24 hours in Internal Medicine ward during the period January to June 2016. The data relating to social and demographic profile, the presence of comorbidities, use of medicines and nutritional assessment will be collected within 24 hours of admission of the patient and every 7 days we will repeat the assessment of nutritional status (subjective global assessment produced by the patient, bioelectrical impedance analysis, grip strength and calf circumference). In the seven and thirty days after discharge, the patient will receive a phone call to verify the occurrence of and readmission or need for consultation in the health service. Expected results: it is expected that a lower socioeconomic status, patients with more comorbidity, longer hospital stays, polypharmacy and worse nutritional status exhibit higher readmission rates. Keywords: hospital readmissions, assessment of nutritional status, risk factors, internal medicine