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Multidisciplinary nutritional support team and survival outcomes in patients with sepsis: a nationwide population-based cohort study in South Korea

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Abstract

Background

The South Korean government implemented a multidisciplinary nutritional support team (NST) system to focus on the proper evaluation and supply of nutritional status in hospitalized patients who are at a higher risk of malnutrition.

Methods

This nationwide population-based cohort study included patients diagnosed with sepsis who were admitted to hospitals from 2016 to 2020. The NST should consist of four professional personnel (physicians, full-time nurses, full-time pharmacists, and full-time clinical dietitians). The NST group included patients with sepsis admitted to a hospital with an NST system, whereas the non-NST group included patients with sepsis admitted to a hospital without an NST system.

Results

A total of 323,841 patients with sepsis were included in the final analysis, and 120,274 (37.1%) admitted to a hospital with an NST system were included in the NST group. In the multivariable Cox regression analysis, the NST group showed a 15% lower 90-day mortality than the non-NST group (hazard ratio [HR]:0.85, 95% confidence interval [CI]:0.83, 0.86; P < 0.001). The NST group shows 11% lower 1-year all-cause mortality than the non-NST group (HR:0.89, 95% CI:0.87, 0.90; P < 0.001). In subgroup analyses, a more evident association of the NST group with lower 90-day mortality was shown in the intensive care unit admission group and age ≥65 years old group.

Conclusions

Multidisciplinary NST intervention is associated with improved survival outcomes in patients with sepsis. Moreover, this association was more evident in patients with sepsis aged ≥65 years old who were admitted to the ICU.

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Fig. 1: Patient with sepsis selection process.

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Data availability

All data are available upon reasonable request from the corresponding author.

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Author notes

  1. These authors contributed equally: Kyunghwa Lee, In-Ae Song.

Authors and Affiliations

  1. Department of Pharmacy, Seoul National University Bundang Hospital, Seongnam-si, South Korea

    Kyunghwa Lee, Sunghee Lee & Keonhee Kim

  2. Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam-si, South Korea

    In-Ae Song & Tak Kyu Oh

  3. Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul, South Korea

    In-Ae Song & Tak Kyu Oh

Authors
  1. Kyunghwa Lee
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  2. In-Ae Song
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  3. Sunghee Lee
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  4. Keonhee Kim
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  5. Tak Kyu Oh
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Contributions

Tak Kyu Oh designed the study, analysed the data, interpreted the data, and drafted the manuscript; Sunghee Lee, and Keonhee Kim collected the data; Kyunghwa Lee and, In-Ae Song contributed to the study conceptualization, acquisition of data, and review of manuscript.; All authors have given final approval for the final version of the manuscript.

Corresponding author

Correspondence to Tak Kyu Oh.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

This study was approved by the Institutional Review Boards (approval date: 5 January 2022, approval number: X-2201-735-902; study title: Associated factor for prognosis of patient with sepsis in South Korea) and the National Health Insurance Service (NHIS) (NHIS-2022-1-337). The requirement for informed consent was waived due to the retrospective design and use of anonymous data extracted from the NHIS database of the Republic of Korea.

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Lee, K., Song, IA., Lee, S. et al. Multidisciplinary nutritional support team and survival outcomes in patients with sepsis: a nationwide population-based cohort study in South Korea. Eur J Clin Nutr (2024). https://doi.org/10.1038/s41430-024-01463-3

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