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Effect of Early Nutritional Therapy on Frailty, Functional Outcomes and Recovery of Undernourished Medical Inpatients Trial: The EFFORT Project

English title Effect of Early Nutritional Therapy on Frailty, Functional Outcomes and Recovery of Undernourished Medical Inpatients Trial: The EFFORT Project
Applicant Schuetz Philipp
Number 150531
Funding scheme SNSF Professorships
Research institution
Universitätsspital Basel Neurologie
Kantonsspital Aarau
Institution of higher education University of Basel - BS
Main discipline Clinical Nutritional Research
Start/End 01.03.2014 - 28.02.2018
Approved amount 1'196'640.00
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Keywords (7)

physio-pathological; Medical patients; randomised-controlled trial; Nutrition; nutritional target; metaanalysis; intervention

Lay Summary (German)

Lead
Effekt der Ernährungstherapie bei hospitalisierten, akut kranken medizinischen Patienten: die EFFORT Studie
Lay summary
Hospitalisierte medizinische Patienten haben in 30-50% ein Risiko für Mangelernährung, was eng mit Komplikationen und hoher Sterblichkeit assoziiert ist. Ob ein systematisches Screening von Patienten für Mangelernährung und eine Ernährungstherapie einen positiven Effekt auf den Verlauf der Erkrankung haben ist unklar. Neue Studien aus der Intensivstation haben gezeigt, dass eine übermässige Ernährung negative Effekte haben kann.
  
Die EFFORT Studie möchte deshalb den Effekt einer individuellen Ernährungstherapie - im Vergleich zu einer Kontrollgruppe ohne Ernährungstherapie - bei akut kranken medizinischen Patienten testen. Es sollen 3000 Patienten in verschiedenen Schweizer Spitäler eingeschlossen werden und per Zufall einer Gruppe zugeteilt werden (Randomisierung). In einer ersten Phase wird deshalb eine Metaanalyse durchgeführt und ein Behandlungsalgorithmus erstellt, der dann geprüft wird. Der Hauptendpunkt ist Therapieversagen nach 30 Tagen. Es werden aber auch andere Endpunkte wie Lebensqualität, Sterblichkeit, Rehospitalisation, Funktioneller Status, verschiedene Ernährungsmarker, Kosten und andere angeschaut. 

Diese Studie hat das Ziel, als erste gross-angelegte multizentrische Untersuchung, den Nutzen der Ernährungstherapie bei akut kranken medizinischen Patienten zu beweisen. Sie wird auch in Subgruppen anschauen, welche Patienten besonderst von der Ernährungstherapie profitieren, und welche eher keinen Benefit haben. Dies wird es uns in der Zukunft erlauben Patienten individuell bezüglich der Ernährung zu beraten. 
Direct link to Lay Summary Last update: 26.02.2014

Responsible applicant and co-applicants

Employees

Publications

Publication
Excess Mortality Among Hospitalized Patients With Hypopituitarism—A Population-Based, Matched-Cohort Study
Ebrahimi Fahim, Kutz Alexander, Wagner Ulrich, Illigens Ben, Siepmann Timo, Schuetz Philipp, Christ-Crain Mirjam, Mueller Beat, Christ Emanuel R (2020), Excess Mortality Among Hospitalized Patients With Hypopituitarism—A Population-Based, Matched-Cohort Study, in The Journal of Clinical Endocrinology & Metabolism, 105(11), 12-14.
Six-month outcomes after individualized nutritional support during the hospital stay in medical patients at nutritional risk: Secondary analysis of a prospective randomized trial
Kaegi-Braun Nina, Tribolet Pascal, Gomes Filomena, Fehr Rebecca, Baechli Valerie, Geiser Martina, Deiss Manuela, Kutz Alexander, Bregenzer Thomas, Hoess Claus, Pavlicek Vojtech, Schmid Sarah, Bilz Stefan, Sigrist Sarah, Brändle Michael, Benz Carmen, Henzen Christoph, Mattmann Silvia, Thomann Robert, Rutishauser Jonas, Aujesky Drahomir, Rodondi Nicolas, Donzé Jacques, Stanga Zeno, et al. (2020), Six-month outcomes after individualized nutritional support during the hospital stay in medical patients at nutritional risk: Secondary analysis of a prospective randomized trial, in Clinical Nutrition, 44-49.
Individualised nutritional support in medical inpatients – a practical guideline
Baumgartner Annic, Kgi-Braun Nina, Tribolet Pascal, Gomes Filomena, Stanga Zeno, Schuetz Philippp (2020), Individualised nutritional support in medical inpatients – a practical guideline, in Swiss Medical Weekly, 22-27.
Association of Baseline Inflammation With Effectiveness of Nutritional Support Among Patients With Disease-Related MalnutritionA Secondary Analysis of a Randomized Clinical Trial
Merker Meret, Felder Martina, Gueissaz Louise, Bolliger Rebekka, Tribolet Pascal, Kägi-Braun Nina, Gomes Filomena, Hoess Claus, Pavlicek Vojtech, Bilz Stefan, Sigrist Sarah, Brändle Michael, Henzen Christoph, Thomann Robert, Rutishauser Jonas, Aujesky Drahomir, Rodondi Nicolas, Donzé Jaques, Stanga Zeno, Mueller Beat, Schuetz Philipp (2020), Association of Baseline Inflammation With Effectiveness of Nutritional Support Among Patients With Disease-Related MalnutritionA Secondary Analysis of a Randomized Clinical Trial, in JAMA Network Open, 3(3), e200663-e200663.
Risk of Adverse Clinical Outcomes in Hyponatremic Adult Patients Hospitalized for Acute Medical Conditions: A Population-Based Cohort Study
Kutz Alexander, Ebrahimi Fahim, Aghlmandi Soheila, Wagner Ulrich, Bromley Miluska, Illigens Ben, Siepmann Timo, Schuetz Philipp, Mueller Beat, Christ-Crain Mirjam (2020), Risk of Adverse Clinical Outcomes in Hyponatremic Adult Patients Hospitalized for Acute Medical Conditions: A Population-Based Cohort Study, in The Journal of Clinical Endocrinology {&} Metabolism, 105(11), 1.
Seasonality of Hypoosmolar Hyponatremia in Medical Inpatients – Data from a Nationwide Cohort Study
Kutz Alexander, Ebrahimi Fahim, Sailer Clara O, Wagner Ulrich, Schuetz Philipp, Mueller Beat, Christ-Crain Mirjam (2020), Seasonality of Hypoosmolar Hyponatremia in Medical Inpatients – Data from a Nationwide Cohort Study, in The Journal of Clinical Endocrinology {&} Metabolism, 105(4), 947-954.
Performance of clinical risk scores to predict mortality and neurological outcome in cardiac arrest patients
Isenschmid Cyril, Luescher Tanja, Rasiah Roshaani, Kalt Jeanice, Tondorf Theresa, Gamp Martina, Becker Christoph, Tisljar Kai, Sutter Raoul, Schuetz Philipp, Hochstrasser Seraina, Metzger Kerstin, Marsch Stephan, Hunziker Sabina (2019), Performance of clinical risk scores to predict mortality and neurological outcome in cardiac arrest patients, in Resuscitation, 136, 21-29.
Biological pathways underlying the association of red cell distribution width and adverse clinical outcome: Results of a prospective cohort study
Zurauskaite G., Meier M., Voegeli A., Koch D., Haubitz S., Kutz A., Bernasconi L., Huber A., Bargetzi M., Mueller B., Schuetz P. (2018), Biological pathways underlying the association of red cell distribution width and adverse clinical outcome: Results of a prospective cohort study, in PLoS One, 13, 0191280-0191280.
Efficacy and Safety of Procalcitonin Guidance in Patients With Suspected or Confirmed Sepsis: A Systematic Review and Meta-Analysis
Iankova I., Thompson-Leduc P., Kirson N. Y., Rice B., Hey J., Krause A., Schonfeld S. A., DeBrase C. R., Bozzette S., Schuetz P. (2018), Efficacy and Safety of Procalcitonin Guidance in Patients With Suspected or Confirmed Sepsis: A Systematic Review and Meta-Analysis, in Crit Care Med, 100-102.
Management and prevention of refeeding syndrome in medical inpatients: An evidence-based and consensus-supported algorithm
Friedli Natalie, Stanga Zeno, Culkin Alison, Crook Martin, Laviano Alessandro, Sobotka Lubos, Kressig Reto W., Kondrup Jens, Mueller Beat, Schuetz Philipp (2018), Management and prevention of refeeding syndrome in medical inpatients: An evidence-based and consensus-supported algorithm, in Nutrition, 47, 13-20.
Routine blood markers from different biological pathways improve early risk stratification in cardiac arrest patients: Results from the prospective, observational COMMUNICATE study
Isenschmid Cyril, Kalt Jeanice, Gamp Martina, Tondorf Theresa, Becker Christoph, Tisljar Kai, Locher Stefan, Schuetz Philipp, Marsch Stephan, Hunziker Sabina (2018), Routine blood markers from different biological pathways improve early risk stratification in cardiac arrest patients: Results from the prospective, observational COMMUNICATE study, in Resuscitation, 130, 138-145.
Additional Real-World Evidence Supporting Procalcitonin as an Effective Tool to Improve Antibiotic Management and Cost of the Critically Ill Patient
Schuetz P., Wahl P. M. (2017), Additional Real-World Evidence Supporting Procalcitonin as an Effective Tool to Improve Antibiotic Management and Cost of the Critically Ill Patient, in Chest, 151, 6-8.
Copeptin for risk stratification in non-traumatic headache in the emergency setting: a prospective multicenter observational cohort study
Blum C. A., Winzeler B., Nigro N., Schuetz P., Biethahn S., Kahles T., Mueller C., Timper K., Haaf K., Tepperberg J., Amort M., Huber A., Bingisser R., Sandor P. S., Nedeltchev K., Muller B., Katan M., Christ-Crain M. (2017), Copeptin for risk stratification in non-traumatic headache in the emergency setting: a prospective multicenter observational cohort study, in J Headache Pain, 18, 21-21.
Economic evaluation of procalcitonin-guided antibiotic therapy in acute respiratory infections: a Chinese hospital system perspective
Stojanovic I., Schneider J. E., Wei L., Hong Z., Keane C., Schuetz P. (2017), Economic evaluation of procalcitonin-guided antibiotic therapy in acute respiratory infections: a Chinese hospital system perspective, in Clin Chem Lab Med, 55, 561-570.
Economic evaluation of procalcitonin-guided antibiotic therapy in acute respiratory infections: a Chinese hospital system perspective
Stojanovic I., Schneider J. E., Wei L., Hong Z., Keane C., Schuetz P. (2017), Economic evaluation of procalcitonin-guided antibiotic therapy in acute respiratory infections: a Chinese hospital system perspective, in Clin Chem Lab Med, 55, 561-570.
Food for thought: why does the medical community struggle with research about nutritional therapy in the acute care setting?
Schuetz P. (2017), Food for thought: why does the medical community struggle with research about nutritional therapy in the acute care setting?, in BMC Med, 15, 38-38.
Industry sponsorship and outcomes of nutrition studies: Is there an association when looking at the trial level?
Schuetz P., Meier M. A., Bally M. R., Gomes F., Mueller B. (2017), Industry sponsorship and outcomes of nutrition studies: Is there an association when looking at the trial level?, in Clin Nutr, 1-2.
Metformin prevents metabolic side effects during systemic glucocorticoid treatment
Seelig E., Meyer S., Timper K., Nigro N., Bally M., Pernicova I., Schuetz P., Muller B., Korbonits M., Christ-Crain M. (2017), Metformin prevents metabolic side effects during systemic glucocorticoid treatment, in Eur J Endocrinol, 176, 349-358.
Metformin prevents metabolic side effects during systemic glucocorticoid treatment
Seelig E., Meyer S., Timper K., Nigro N., Bally M., Pernicova I., Schuetz P., Muller B., Korbonits M., Christ-Crain M. (2017), Metformin prevents metabolic side effects during systemic glucocorticoid treatment, in Eur J Endocrinol, 176, 349-358.
Nutritional support practices in hematopoietic stem cell transplantation centers: A nationwide comparison
Baumgartner A., Bargetzi M., Bargetzi A., Zueger N., Medinger M., Passweg J., Schanz U., Samaras P., Chalandon Y., Pichard C., Limonta A., Wannesson L., Pabst T., Duchosal M. A., Hess U., Stanga Z., Mueller B., Schuetz P. (2017), Nutritional support practices in hematopoietic stem cell transplantation centers: A nationwide comparison, in Nutrition, 35, 43-50.
Nutritional support practices in hematopoietic stem cell transplantation centers: A nationwide comparison
Baumgartner A., Bargetzi M., Bargetzi A., Zueger N., Medinger M., Passweg J., Schanz U., Samaras P., Chalandon Y., Pichard C., Limonta A., Wannesson L., Pabst T., Duchosal M. A., Hess U., Stanga Z., Mueller B., Schuetz P. (2017), Nutritional support practices in hematopoietic stem cell transplantation centers: A nationwide comparison, in Nutrition, 35, 43-50.
Nutritional support practices in hematopoietic stem cell transplantation centers: A nationwide comparison.
Baumgartner Annic, Bargetzi Mario, Bargetzi Annika, Zueger Noemi, Medinger Micheal, Passweg Jakob, Schanz Urs, Samaras Panagiotis, Chalandon Yves, Pichard Claude, Limonta Alessandro, Wannesson Luciano, Pabst Thomas, Duchosal Michel A, Hess Urs, Stanga Zeno, Mueller Beat, Schuetz Philipp (2017), Nutritional support practices in hematopoietic stem cell transplantation centers: A nationwide comparison., in Nutrition (Burbank, Los Angeles County, Calif.), 35, 43-50.
Obesity paradox in patients with community-acquired pneumonia: Is inflammation the missing link?
Braun N., Hoess C., Kutz A., Christ-Crain M., Thomann R., Henzen C., Zimmerli W., Mueller B., Schuetz P. (2017), Obesity paradox in patients with community-acquired pneumonia: Is inflammation the missing link?, in Nutrition, 33, 304-310.
Procalcitonin-guided diagnosis and antibiotic stewardship revisited
Sager R., Kutz A., Mueller B., Schuetz P. (2017), Procalcitonin-guided diagnosis and antibiotic stewardship revisited, in BMC Med, 15, 15-15.
Revisiting nutritional support for allogeneic hematologic stem cell transplantation-a systematic review
Baumgartner A., Bargetzi A., Zueger N., Bargetzi M., Medinger M., Bounoure L., Gomes F., Stanga Z., Mueller B., Schuetz P. (2017), Revisiting nutritional support for allogeneic hematologic stem cell transplantation-a systematic review, in Bone Marrow Transplant, 1-2.
Revisiting nutritional support for allogeneic hematologic stem cell transplantation-a systematic review
Baumgartner A., Bargetzi A., Zueger N., Bargetzi M., Medinger M., Bounoure L., Gomes F., Stanga Z., Mueller B., Schuetz P. (2017), Revisiting nutritional support for allogeneic hematologic stem cell transplantation-a systematic review, in Bone Marrow Transplant, 52, 506-513.
Revisiting the refeeding syndrome: Results of a systematic review
Friedli N., Stanga Z., Sobotka L., Culkin A., Kondrup J., Laviano A., Mueller B., Schuetz P. (2017), Revisiting the refeeding syndrome: Results of a systematic review, in Nutrition, 35, 151-160.
Revisiting the refeeding syndrome: Results of a systematic review
Friedli N., Stanga Z., Sobotka L., Culkin A., Kondrup J., Laviano A., Mueller B., Schuetz P. (2017), Revisiting the refeeding syndrome: Results of a systematic review, in Nutrition, 1-2.
Revisiting the refeeding syndrome: Results of a systematic review
Friedli N., Stanga Z., Sobotka L., Culkin A., Kondrup J., Laviano A., Mueller B., Schuetz P. (2017), Revisiting the refeeding syndrome: Results of a systematic review, in Nutrition, 35, 151-160.
Serial Procalcitonin Predicts Mortality in Severe Sepsis Patients: Results From the Multicenter Procalcitonin MOnitoring SEpsis (MOSES) Study
Schuetz P., Birkhahn R., Sherwin R., Jones A. E., Singer A., Kline J. A., Runyon M. S., Self W. H., Courtney D. M., Nowak R. M., Gaieski D. F., Ebmeyer S., Johannes S., Wiemer J. C., Schwabe A., Shapiro N. I. (2017), Serial Procalcitonin Predicts Mortality in Severe Sepsis Patients: Results From the Multicenter Procalcitonin MOnitoring SEpsis (MOSES) Study, in Crit Care Med, 1-2.
The role of metabolomic markers for patients with infectious diseases: implications for risk stratification and therapeutic modulation
Zurfluh S., Baumgartner T., Meier M. A., Ottiger M., Voegeli A., Bernasconi L., Neyer P., Mueller B., Schuetz P. (2017), The role of metabolomic markers for patients with infectious diseases: implications for risk stratification and therapeutic modulation, in Expert Rev Anti Infect Ther, 16, 133-142.
Psychological distress in medical patients 30 days following an emergency department admission: results from a prospective, observational study
Faessler Lukas, Kutz Alexander, Haubitz Sebastian, Mueller Beat, Perrig-Chiello Pasqualina, Schuetz Philipp (2016), Psychological distress in medical patients 30 days following an emergency department admission: results from a prospective, observational study, in BMC Emergency Medicine, 16(1), 33-33.
"The obesity paradox" in disease - is the protective effect of obesity true?
Braun N., Gomes F., Schutz P. (2016), "The obesity paradox" in disease - is the protective effect of obesity true?, in Swiss Med Wkly, 145, 14265-14265.
Activation of the tryptophan/serotonin pathway is associated with severity and predicts outcomes in pneumonia: results of a long-term cohort study
Meier M. A., Ottiger M., Vogeli A., Steuer C., Bernasconi L., Thomann R., Christ-Crain M., Henzen C., Hoess C., Zimmerli W., Huber A., Mueller B., Schuetz P. (2016), Activation of the tryptophan/serotonin pathway is associated with severity and predicts outcomes in pneumonia: results of a long-term cohort study, in Clin Chem Lab Med, 1-2.
Admission levels of asymmetric and symmetric dimethylarginine predict long-term outcome in patients with community-acquired pneumonia
Vogeli A., Ottiger M., Meier M. A., Steuer C., Bernasconi L., Kulkarni P., Huber A., Christ-Crain M., Henzen C., Hoess C., Thomann R., Zimmerli W., Mueller B., Schuetz P. (2016), Admission levels of asymmetric and symmetric dimethylarginine predict long-term outcome in patients with community-acquired pneumonia, in Respir Res, 18, 25-25.
Benefit of adjunct corticosteroids for community-acquired pneumonia in diabetic patients
Popovic M., Blum C. A., Nigro N., Mueller B., Schuetz P., Christ-Crain M. (2016), Benefit of adjunct corticosteroids for community-acquired pneumonia in diabetic patients, in Diabetologia, 59, 2552-2560.
Can we predict relapse in Graves' disease? Results from a systematic review and meta-analysis
Struja T., Fehlberg H., Kutz A., Guebelin L., Degen C., Mueller B., Schuetz P. (2016), Can we predict relapse in Graves' disease? Results from a systematic review and meta-analysis, in Eur J Endocrinol, 176, 87-97.
Comparison between B.R.A.H.M.S PCT direct, a new sensitive point-of-care testing device for rapid quantification of procalcitonin in emergency department patients and established reference methods - a prospective multinational trial
Kutz A., Hausfater P., Oppert M., Alan M., Grolimund E., Gast C., Alonso C., Wissmann C., Kuehn C., Bernard M., Huber A., Mueller B., Schuetz P. (2016), Comparison between B.R.A.H.M.S PCT direct, a new sensitive point-of-care testing device for rapid quantification of procalcitonin in emergency department patients and established reference methods - a prospective multinational trial, in Clin Chem Lab Med, 54, 577-84.
Copeptin predicts 10-year all-cause mortality in community patients: a 10-year prospective cohort study
Odermatt J., Bolliger R., Hersberger L., Ottiger M., Christ-Crain M., Briel M., Bucher H. C., Mueller B., Schuetz P. (2016), Copeptin predicts 10-year all-cause mortality in community patients: a 10-year prospective cohort study, in Clin Chem Lab Med, 54, 1681-90.
Detection and treatment of medical inpatients with or at-risk of malnutrition: suggested procedures based on validated guidelines
Bounoure L., Gomes F., Stanga Z., Keller U., Meier R., Ballmer P., Fehr R., Mueller B., Genton L., Norman K., Henzen C., Laviano A., Bischoff S., Schneider SM., Kondrup J., Schuetz P. (2016), Detection and treatment of medical inpatients with or at-risk of malnutrition: suggested procedures based on validated guidelines, in Nutrition, 1(11), 1.
Does Immunosuppressive Therapy Improve Outcomes in Graves' Disease? A Systematic Review and Meta-Analysis
Struja T., Guebelin L., Kutz A., Fehlberg H., Mueller B., Schuetz P. (2016), Does Immunosuppressive Therapy Improve Outcomes in Graves' Disease? A Systematic Review and Meta-Analysis, in Thyroid, 26, 634-40.
Economic evaluation of procalcitonin-guided antibiotic therapy in acute respiratory infections: a Chinese hospital system perspective
Stojanovic I., Schneider J. E., Wei L., Hong Z., Keane C., Schuetz P. (2016), Economic evaluation of procalcitonin-guided antibiotic therapy in acute respiratory infections: a Chinese hospital system perspective, in Clin Chem Lab Med, 1-2.
Economic evaluation of procalcitonin-guided antibiotic therapy in acute respiratory infections: a US health system perspective
Schuetz P., Balk R., Briel M., Kutz A., Christ-Crain M., Stolz D., Bouadma L., Wolff M., Kristoffersen K. B., Wei L., Burkhardt O., Welte T., Schroeder S., Nobre V., Tamm M., Bhatnagar N., Bucher H. C., Luyt C. E., Chastre J., Tubach F., Mueller B., Lacey M. J., Ohsfeldt R. L., Scheibling C. M., Schneider J. E. (2016), Economic evaluation of procalcitonin-guided antibiotic therapy in acute respiratory infections: a US health system perspective, in Clin Chem Lab Med, 53, 583-92.
Evaluation of copeptin and commonly used laboratory parameters for the differential diagnosis of profound hyponatraemia in hospitalized patients: 'The Co-MED Study'
Nigro N., Winzeler B., Suter-Widmer I., Schuetz P., Arici B., Bally M., Blum C. A., Nickel C. H., Bingisser R., Bock A., Huber A., Muller B., Christ-Crain M. (2016), Evaluation of copeptin and commonly used laboratory parameters for the differential diagnosis of profound hyponatraemia in hospitalized patients: 'The Co-MED Study', in Clin Endocrinol (Oxf), 86, 456-462.
Evaluation of copeptin and commonly used laboratory parameters for the differential diagnosis of profound hyponatraemia in hospitalized patients: 'The Co-MED Study'
Nigro N., Winzeler B., Suter-Widmer I., Schuetz P., Arici B., Bally M., Blum C. A., Nickel C. H., Bingisser R., Bock A., Huber A., Muller B., Christ-Crain M. (2016), Evaluation of copeptin and commonly used laboratory parameters for the differential diagnosis of profound hyponatraemia in hospitalized patients: 'The Co-MED Study', in Clin Endocrinol (Oxf), 1-2.
External validation of the GREAT score to predict relapse risk in Graves' disease Results from a multicenter, retrospective study with 741 patients
Struja T., Kaeslin M., Boesiger F., Jutzi R., Imahorn N., Kutz A., Bernasconi L., Mundwiler E., Mueller B., Christ-Crain M., Meienberg F., Ebrahimi F., Henzen C., Fischli S., Kraenzlin M., Meier C., Schuetz P. (2016), External validation of the GREAT score to predict relapse risk in Graves' disease Results from a multicenter, retrospective study with 741 patients, in Eur J Endocrinol, 413-419.
Infection biomarkers in primary care patients with acute respiratory tract infections-comparison of Procalcitonin and C-reactive protein
Meili M., Kutz A., Briel M., Christ-Crain M., Bucher H. C., Mueller B., Schuetz P. (2016), Infection biomarkers in primary care patients with acute respiratory tract infections-comparison of Procalcitonin and C-reactive protein, in BMC Pulm Med, 16, 43-43.
Influence of hospital characteristics on quality of care in patients with community-acquired pneumonia
Straubhaar K., Schuetz P., Blum C. A., Nigro N., Matthias B., Christ-Crain M., Mueller B., Step Study Group (2016), Influence of hospital characteristics on quality of care in patients with community-acquired pneumonia, in Swiss Med Wkly, 146, 14337-14337.
Long-term outcome of profound hyponatremia: a prospective 12 months follow-up study
Winzeler B., Jeanloz N., Nigro N., Suter-Widmer I., Schuetz P., Arici B., Bally M., Blum C., Bock A., Huber A., Mueller B., Christ-Crain M. (2016), Long-term outcome of profound hyponatremia: a prospective 12 months follow-up study, in Eur J Endocrinol, 175, 499-507.
Metformin prevents metabolic side effects during systemic glucocorticoid treatment
Seelig E., Meyer S., Timper K., Nigro N., Bally M., Pernicova I., Schuetz P., Muller B., Korbonits M., Christ-Crain M. (2016), Metformin prevents metabolic side effects during systemic glucocorticoid treatment, in Eur J Endocrinol, 176, 349-358.
Nutritional Support and Outcomes in Malnourished Medical Inpatients A Systematic Review and Meta-analysis
Bally Martina R., Yildirim Prisca Z. Blaser, Bounoure Lisa, Gloy Viktoria L., Mueller Beat, Briel Matthias, Schuetz Philipp (2016), Nutritional Support and Outcomes in Malnourished Medical Inpatients A Systematic Review and Meta-analysis, in JAMA INTERNAL MEDICINE, 176(1), 43-53.
Obesity paradox in patients with community-acquired pneumonia: Is inflammation the missing link?
Braun N., Hoess C., Kutz A., Christ-Crain M., Thomann R., Henzen C., Zimmerli W., Mueller B., Schuetz P. (2016), Obesity paradox in patients with community-acquired pneumonia: Is inflammation the missing link?, in Nutrition, 33, 304-310.
Pathogen- and antibiotic-specific effects of prednisone in community-acquired pneumonia
Wirz S. A., Blum C. A., Schuetz P., Albrich W. C., Noppen C., Mueller B., Christ-Crain M., Tarr P. E., for the Step Study Group (2016), Pathogen- and antibiotic-specific effects of prednisone in community-acquired pneumonia, in Eur Respir J, 48, 1150-1159.
Performance of the Manchester Triage System in Adult Medical Emergency Patients: A Prospective Cohort Study
Steiner D., Renetseder F., Kutz A., Haubitz S., Faessler L., Anderson J. B., Laukemann S., Rast A. C., Felder S., Conca A., Reutlinger B., Batschwaroff M., Tobias P., Buergi U., Mueller B., Schuetz P. (2016), Performance of the Manchester Triage System in Adult Medical Emergency Patients: A Prospective Cohort Study, in J Emerg Med, 50, 678-89.
Predictors for Delayed Emergency Department Care in Medical Patients with Acute Infections - An International Prospective Observational Study
Kutz A., Florin J., Hausfater P., Amin D., Amin A., Haubitz S., Conca A., Reutlinger B., Canavaggio P., Sauvin G., Bernard M., Huber A., Mueller B., Schuetz P., Triage Study group (2016), Predictors for Delayed Emergency Department Care in Medical Patients with Acute Infections - An International Prospective Observational Study, in PLoS One, 11, 0155363-0155363.
Procalcitonin (PCT) levels for ruling-out bacterial coinfection in ICU patients with influenza: A CHAID decision-tree analysis
Rodriguez A. H., Aviles-Jurado F. X., Diaz E., Schuetz P., Trefler S. I., Sole-Violan J., Cordero L., Vidaur L., Estella A., Pozo Laderas J. C., Socias L., Vergara J. C., Zaragoza R., Bonastre J., Guerrero J. E., Suberviola B., Cilloniz C., Restrepo M. I., Martin-Loeches I., Semicyuc Getgag Working Group (2016), Procalcitonin (PCT) levels for ruling-out bacterial coinfection in ICU patients with influenza: A CHAID decision-tree analysis, in J Infect, 72, 143-51.
Procalcitonin in critically ill patients: time to change guidelines and antibiotic use in practice
Schuetz P., Mueller B. (2016), Procalcitonin in critically ill patients: time to change guidelines and antibiotic use in practice, in Lancet Infect Dis, 16, 758-60.
Procalcitonin: A new biomarker for the cardiologist
Schuetz P., Daniels L. B., Kulkarni P., Anker S. D., Mueller B. (2016), Procalcitonin: A new biomarker for the cardiologist, in Int J Cardiol, 223, 390-397.
Prospective evaluation of biomarkers for prediction of quality of life in community-acquired pneumonia
Nickler M., Schaffner D., Christ-Crain M., Ottiger M., Thomann R., Hoess C., Henzen C., Mueller B., Schuetz P. (2016), Prospective evaluation of biomarkers for prediction of quality of life in community-acquired pneumonia, in Clin Chem Lab Med, 54, 1831-1846.
Screening and Treatment of Vitamin D Deficiency on Hospital Admission: Is There a Benefit for Medical Inpatients?
Gradel L., Merker M., Mueller B., Schuetz P. (2016), Screening and Treatment of Vitamin D Deficiency on Hospital Admission: Is There a Benefit for Medical Inpatients?, in Am J Med, 129, 1-2.
Screening and Treatment of Vitamin D Deficiency on Hospital Admission: Is There a Benefit for Medical Inpatients?
Graedel Lena, Merker Meret, Mueller Beat, Schuetz Philipp (2016), Screening and Treatment of Vitamin D Deficiency on Hospital Admission: Is There a Benefit for Medical Inpatients?, in AMERICAN JOURNAL OF MEDICINE, 129(1), 116.
Systematic review regarding metabolic profiling for improved pathophysiological understanding of disease and outcome prediction in respiratory infections
Nickler M., Ottiger M., Steuer C., Huber A., Anderson J. B., Muller B., Schuetz P. (2016), Systematic review regarding metabolic profiling for improved pathophysiological understanding of disease and outcome prediction in respiratory infections, in Respir Res, 16, 125-125.
The association of admission hyperglycaemia and adverse clinical outcome in medical emergencies: the multinational, prospective, observational TRIAGE study
Kutz A., Struja T., Hausfater P., Amin D., Amin A., Haubitz S., Bernard M., Huber A., Mueller B., Schuetz P., Triage study group (2016), The association of admission hyperglycaemia and adverse clinical outcome in medical emergencies: the multinational, prospective, observational TRIAGE study, in Diabet Med, 1-2.
The National Early Warning Score (NEWS) for outcome prediction in emergency department patients with community-acquired pneumonia: results from a 6-year prospective cohort study
Sbiti-Rohr D., Kutz A., Christ-Crain M., Thomann R., Zimmerli W., Hoess C., Henzen C., Mueller B., Schuetz P., Pro Hosp Study Group (2016), The National Early Warning Score (NEWS) for outcome prediction in emergency department patients with community-acquired pneumonia: results from a 6-year prospective cohort study, in BMJ Open, 6, 011021-011021.
The natriuretic peptide MR-proANP predicts all-cause mortality and adverse outcome in community patients: a 10-year follow-up study
Odermatt J., Hersberger L., Bolliger R., Graedel L., Christ-Crain M., Briel M., Bucher H. C., Mueller B., Schuetz P. (2016), The natriuretic peptide MR-proANP predicts all-cause mortality and adverse outcome in community patients: a 10-year follow-up study, in Clin Chem Lab Med, 1-2.
The TRIAGE-ProADM Score for an Early Risk Stratification of Medical Patients in the Emergency Department - Development Based on a Multi-National, Prospective, Observational Study
Kutz A., Hausfater P., Amin D., Amin A., Canavaggio P., Sauvin G., Bernard M., Conca A., Haubitz S., Struja T., Huber A., Mueller B., Schuetz P., Triage study group (2016), The TRIAGE-ProADM Score for an Early Risk Stratification of Medical Patients in the Emergency Department - Development Based on a Multi-National, Prospective, Observational Study, in PLoS One, 11, 0168076-0168076.
Trimethylamine-N-oxide (TMAO) predicts fatal outcomes in community-acquired pneumonia patients without evident coronary artery disease
Ottiger M., Nickler M., Steuer C., Odermatt J., Huber A., Christ-Crain M., Henzen C., Hoess C., Thomann R., Zimmerli W., Mueller B., Schuetz P. (2016), Trimethylamine-N-oxide (TMAO) predicts fatal outcomes in community-acquired pneumonia patients without evident coronary artery disease, in Eur J Intern Med, 36, 67-73.
Unraveling the Link between Malnutrition and Adverse Clinical Outcomes: Association of Acute and Chronic Malnutrition Measures with Blood Biomarkers from Different Pathophysiological States
Felder S., Braun N., Stanga Z., Kulkarni P., Faessler L., Kutz A., Steiner D., Laukemann S., Haubitz S., Huber A., Mueller B., Schuetz P. (2016), Unraveling the Link between Malnutrition and Adverse Clinical Outcomes: Association of Acute and Chronic Malnutrition Measures with Blood Biomarkers from Different Pathophysiological States, in Ann Nutr Metab, 68, 164-72.
Unraveling the Link between Malnutrition and Adverse Clinical Outcomes: Association of Acute and Chronic Malnutrition Measures with Blood Biomarkers from Different Pathophysiological States
Felder S., Braun N., Stanga Z., Kulkarni P., Faessler L., Kutz A., Steiner D., Laukemann S., Haubitz S., Huber A., Mueller B., Schuetz P. (2016), Unraveling the Link between Malnutrition and Adverse Clinical Outcomes: Association of Acute and Chronic Malnutrition Measures with Blood Biomarkers from Different Pathophysiological States, in Ann Nutr Metab, 68, 164-172.
Vitamin D Deficiency Strongly Predicts Adverse Medical Outcome Across Different Medical Inpatient Populations: Results From a Prospective Study
Graedel L., Merker M., Felder S., Kutz A., Haubitz S., Faessler L., Kaeslin M., Huber A., Mueller B., Schuetz P. (2016), Vitamin D Deficiency Strongly Predicts Adverse Medical Outcome Across Different Medical Inpatient Populations: Results From a Prospective Study, in Medicine (Baltimore), 95, 3533-3533.
"Eat your lunch!" - controversies in the nutrition of the acutely, non-critically ill medical inpatient
Schuetz P. (2015), "Eat your lunch!" - controversies in the nutrition of the acutely, non-critically ill medical inpatient, in Swiss Med Wkly, 145, 14132-14132.
Association of nutritional risk and adverse medical outcomes across different medical inpatient populations
Felder S., Lechtenboehmer C., Bally M., Fehr R., Deiss M., Faessler L., Kutz A., Steiner D., Rast A. C., Laukemann S., Kulkarni P., Stanga Z., Haubitz S., Huber A., Mueller B., Schuetz P. (2015), Association of nutritional risk and adverse medical outcomes across different medical inpatient populations, in Nutrition, 31, 1385-93.
Early nutritional therapy for malnourished or nutritionally at-risk adult medical inpatients
Schuetz Philipp, Blaser Yildirim Prisca Z., Gloy Viktoria L., Briel Matthias, Bally Martina R. (2015), Early nutritional therapy for malnourished or nutritionally at-risk adult medical inpatients, in Cochrane Metabolic and Endocrine Disorders Group, 1(1), 1.
Simultaneous determination of phosphatidylcholine-derived quaternary ammonium compounds by a LC-MS/MS method in human blood plasma, serum and urine samples
Steuer C., Schutz P., Bernasconi L., Huber A. R. (2015), Simultaneous determination of phosphatidylcholine-derived quaternary ammonium compounds by a LC-MS/MS method in human blood plasma, serum and urine samples, in J Chromatogr B Analyt Technol Biomed Life Sci, 1008, 206-11.
Effect of hyperglycaemia on inflammatory and stress responses and clinical outcome of pneumonia in non-critical-care inpatients: Results from an observational cohort study
Schuetz Philipp, Friedli Natalie, Grolimund Eva, Kutz Alexander, Haubitz Sebastian, Christ-Crain Mirjam, Thomann Robert, Zimmerli Werner H., Hoess Claus, Henzen Christoph M., Mueller Beat U. (2014), Effect of hyperglycaemia on inflammatory and stress responses and clinical outcome of pneumonia in non-critical-care inpatients: Results from an observational cohort study, in Diabetologia, 57(2), 275-284.
Loss of appetite in acutely ill medical inpatients: Physiological response or therapeutic target?
Schuetz Philipp, Bally Martina, Stanga Zeno, Keller Ulrich B. (2014), Loss of appetite in acutely ill medical inpatients: Physiological response or therapeutic target?, in Swiss Medical Weekly, 144, 13957.
The role of immune and metabolic biomarkers for improved management of sepsis patients
Schuetz Philipp, Mueller Beat U. (2014), The role of immune and metabolic biomarkers for improved management of sepsis patients, in Expert Review of Clinical Immunology, 10(9), 1255-1262.

Collaboration

Group / person Country
Types of collaboration
Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Kantonsspital St.Gallen Switzerland (Europe)
- Publication
- Research Infrastructure
Department of Internal Medicine, University Hospital Basel (Prof. Donath; Prof. M.Christ-Crain) Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Institute of Nursing Science, University of Basel (Prof. S. De Geest) Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Department of Psychology, University of Berne (Prof. P. Perrig-Chiello) Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Kantonsspital Münsterlignen (Dr.Hoess) Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
CHU Pitié-Salpêtrière, AP-HP et Université Pierre et Marie Curie Paris France (Europe)
- Publication
- Research Infrastructure
Medical University Clinic, Department of Gastroenterology, Kantonsspital Liestal (Prof. R.Meier) Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
Kantonsspital Baselland (Dr Rutishauser) Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
Spital Lachen (Dr. Bregenzer) Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
Department of Endocrinology, University of Fribourg (Prof. A. Lauber) Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
University Hospitals Leuven (UZ Leuven) (Prof. G. Van den Berghe, Prof. M. Casaer) Belgium (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Department of Internal Medicine, Spital Muri (Dr. A.Spillmann) Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
Buergerspital Solothurn (Dr Thomann) Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
Clinical Trial Unit, University of Basel Switzerland (Europe)
- Research Infrastructure
- Exchange of personnel
Internal Medicine und Ernährungsberatung, Spital Winterthur Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
Department of Internal Medicine, Spital Zofingen (Dr. T.Ehmann, Dr. B.Flueckiger) Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
Nutrition 2017, Montreux Poster malnutrition and outcomes in hematological patients 23.09.2016 Montreux, Switzerland Schuetz Philipp;
Deutsche Gesellschaft für Innere Medizin (DGIM) Talk given at a conference Können wir klinische Outcomes der Internistischen Patienten mit Ernährungstherapie verbessern? 12.04.2016 Mannheim, Germany Schuetz Philipp;
Society of Critical Care Medicine (SCCM) Talk given at a conference Monitoring of PCT in the ICU – results of the MOSES study 20.02.2016 Orlando (FL), United States of America Schuetz Philipp;
SGED (Schweizerische Gesellschaft für Endokrinologie und Diabetes) Poster Derivation of an algorithm for nutritional therapy of acutely ill medical inpatients based on the current evidence 28.11.2014 Bern, Switzerland Bounoure Lisa; Felder Susan; Pulvermüller Isabelle; Schuetz Philipp; Fehr Rebecca; Kutz Alexander;
SGED (Schweizerische Gesellschaft für Endokrinologieu und Diabetes Poster Early nutritional therapy for malnourished or nutritionally at-risk adult medical inpatients: a Meta-Analysis 28.11.2014 Bern, Switzerland Schuetz Philipp;


Knowledge transfer events

Active participation

Title Type of contribution Date Place Persons involved
EFFORT trial - how should we deal with malnourished medical inpatients? Talk 29.04.2014 CHUV (Lausanne), Switzerland Schuetz Philipp;


Communication with the public

Communication Title Media Place Year
Media relations: radio, television PULS Sendung "Mangelernährung" SRF1 German-speaking Switzerland 2014

Awards

Title Year
Beste Original Publikation der SGAIM 2019 2019
erster Posterpreis, Nutrition 2016 2016

Associated projects

Number Title Start Funding scheme
176972 Effect of Early Nutritional Therapy on Frailty, Functional Outcomes and Recovery of Undernourished Medical Inpatients Trial: The EFFORT Project 01.03.2018 SNSF Professorships

Abstract

Background: Illness is associated with appetite loss leading to relevant nutritional deficits, particularly in elderly, frail medical inpatients. Undernutrition is associated with morbidity, long hospital stays and costs. Despite these associations, benefit of providing early nutritional therapy to unselected medical inpatients at risk for undernutrition remains largely unproven due to lack of large-scale, high-quality randomized controlled trials (RCTs). Still, the current clinical approach is to provide nutritional therapy to reach nutritional targets. Recent, provocative data from critical care showed harmful effects of early feeding and glutamine supplementation. This also calls into question the current nutritional approach in acutely-ill medical inpatients. Therefore, a large conclusive RCT is urgently needed to answer the questions (a) whether or not appetite loss during acute illness is indeed a protective physiological response that should be tolerated; (b) which patients do or do not benefit from nutritional therapy; (c) how and why nutrition affects the course of disease from a mechanistic physio-pathological standpoint. The EFFORT project has 5 separate aims that will help to unravel these issues.Collaborators: This project is embedded in multiple research collaborations with nutritional experts. The RCT (Aim#3) will be conducted in multiple experienced Swiss centers and possibly international sites. The Clinical Trial Unit (CTU) of the University of Basel will provide logistical and statistical support. General Aim: To test the hypothesis that in medical inpatients at risk for undernutrition, early tailored nutritional therapy to reach nutritional targets based on individualized nutritional counseling is a cost-effective strategy to prevent frailty and improve patient outcomes. Towards this general Aim, 5 subsidiary aims will be accomplished.Aim#1: To perform in collaboration with COCHRANE an aggregate data meta-analysis on efficacy and safety of different nutritional therapy strategies in medical inpatients.Aim# 2: Through a consensus conference, to develop a “state-of-the-art” nutritional strategy for individualized management of medical inpatients based on the results of Aim#1 and current recommendations (ESPEN)Aim#3: To conduct a large, multicenter RCT to compare nutritional therapy based on an up-to-date nutritional strategy developed in Aim#2 (intervention group) with a control group. Patient population: unselected medical inpatients at risk of undernutrition [Nutritional Risk Score 3 points or more] and an expected hospital stay of =5 days. We will exclude patients (i) in critical care or post-operative state, (ii) unable to swallow, (iii) at long-term need for parenteral/enteral nutrition, (iv) in terminal condition, (v) pregnant, (vi) with acute pancreatitis or acute liver failure. Intervention: Patients in the intervention group will receive individualized nutritional therapy to reach nutritional targets (caloric, protein, micronutrients, other) based on the strategy developed in Aim#2. In control patients, according to patients` appetite, standard hospital nutrition will be served. All patients will be re-assessed daily during the hospital stay for actual energy intake and hospital outcomes, and after 30 and 180 days by blinded phone interviews. Endpoints: The primary endpoint is cmobined treatment failure at 30 days. Secondary endpoints include (a) short term nutritional and functional outcomes from inclusion to day 8 [actual energy/protein intake, improvement in muscle strengths [handgrip strength] and lean body mass [body impedance analysis], nutrition markers; (b) hospital outcomes [complications, hospital length-of-stay] (c) 30 and 180 days outcomes [quality-of-life, re-hospitalization, mortality]. Sample size and statistics: The inclusion of 3000 patients will provide >95% power to detect a difference in Barthel`s Index from (mean ±SD) 80 [±20] to 84 [±20] (two-sample t-test). Duration: After a 3 month pilot (feasibility), trial enrollment will be 2 years.Aim#4: To understand the physio-pathological mechanisms underlying the effects of nutritional therapy on specific patient populations, we will specifically look at how nutritional effects vary depending on age, gender, underlying disease and acute vs. chronic courses. We will focus on inflammatory and endocrine blood markers to identify patients who do or do not benefit from nutritional therapy. We will study effects of nutritional therapy on the course of inflammation and infection recovery, as reflected by serial measurements of biomarkers.Aim#5: To perform an incremental cost-effectiveness analysis of nutritional therapy using patient data previously generated in Aim#3 within the 30-day follow up period.Discussion: Important gaps in the literature and the controversy about nutritional therapy in critical illness call into question our current nutritional therapy approach in medical inpatients. Herein, integrating recognized international experts and generating novel data both from the current literature and state-of-the-art investigation involving thousands of patients, we aim to establish an evidence-based standard for nutritional strategy for acutely-ill medical inpatients. This strategy will be tested in the largest nutritional RCT yet outside critical care and will allow us to answer whether, why, how, and where nutritional therapy works. This “real-world” comparative effectiveness research project thus has the potential to provide conclusive evidence about nutritional therapy in unselected, acutely-ill hospitalized, often polymorbid and frail medical inpatients to facilitate informed decision-making by patients and healthcare professionals world-wide.
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