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Author: search.filters.author.Giray, SemihSubject: search.filters.subject.malnutrition

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    Effects of Enteral Protein Supplements on Nutritional Status and Clinical Outcome in Unconscious Elderly Malnourished Patients
    (2014) Gulsen Atalay, Betul; Yagmur, Cahide; Nursal, Tarik; Atalay, Hakan; Sezgin, Nurzen; Giray, Semih; Selcuk, Haldun; https://orcid.org/0000-0002-0722-3181; https://orcid.org/0000-0002-8445-6413; IQV-1169-2023; AAH-1091-2020; AAJ-6976-2021
    Aim: Unconscious malnourished patients have reduced serum proteins. Enteral protein supplements may improve their nutritional status and clinical outcome. Our aim for the present study was to determine the effect on nutritional status and patient prognosis of enteral protein supplementation in tube-fed hospitalised unconscious elderly malnourished patients. Methods: In total, 20 patients were fed a standard enteral nutrition formula during the four-day adaptation period. The study group (n = 10) received an enteral protein supplement (2 g/kg/day protein) and the control group (n = 10) received only standard enteral nutrition (1 g/kg/day protein) during the 12-day study period. Nutritional status and clinical outcome were assessed. Results: No difference was observed between the groups with regard to biochemical, inflammatory parameters, anthropometric measurements or nitrogen balance (P > 0.05). Triceps and subscapular skinfold thickness mean levels were elevated in the study group at the end of the study compared with the beginning of the study (P < 0.05). No significant difference was observed between the groups with regard to complications or mortality rate (P > 0.05). Conclusions: In the present study, the use of enteral protein support (EPS) in unconscious malnourished patients provided some advantages in the early stages of medical treatment. Triceps skinfold thickness and subscapular skinfold thickness mean levels were increased significantly in our study group. Although there was no significant difference, serum insulin-growth factor, retinol-binding protein and prealbumin mean values showed a tendency to increase in the study group at the end of the study. We believe that further research is required to determine the effects of EPS on these values in malnourished elderly patients.
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    Real World Data Estimation: Management and Cost-analysis of Stroke in Tertiary Hospitals in Turkey and the Impact of Co-morbid Malnutrition
    (2016) Arsava, Ethem Murat; Ozcagli, Tahsin Gokcem; Berktas, Mehmet; Giray, Semih; Guler, Ayse; Gungor, Levent; Ozdemir, Ozcan; Uluc, Kayihan; Yaka, Erdem; Yesilot, Nilufer; https://orcid.org/0000-0002-0722-3181; AAH-1091-2020
    Objective: To evaluate the management and cost analysis of first-ever stroke patients in Turkey and determine the impact of comorbid malnutrition. Methods: This study was based on expert's view on the management and cost analysis of stroke patients with or without malnutrition via standardized questionnaire forms filled by experts according to their daily clinical practice. Cost items were related to medical treatment, healthcare resources utilization, tests, consultations and complications. Per admission and total annual direct medical costs were calculated with respect to co-morbid malnutrition. Results: Malnutrition was evident in 7.8(3.6)% [mean(standard error of mean; SEM)] of patients at admission; an additional 7.1(4.8)% and 0.9(0.6)% patients developed malnutrition during Neuro-ICU and stroke unit hospitalization, respectively. Length of hospital stay (LOS) was almost 2-fold in patients with malnutrition (P<0.01 for all hospital units). During the 1-year follow-up period a mean(SEM) of 93.8(15.4)% with and 43.3(3.7)% without malnutrition were expected to experience at least 1 complication. The mean (SEM) per patient annual cost of stroke was US$5201(740) in patients with malnutrition and US$3619(614) in patients without malnutrition, while the corresponding figures for per admission were US$3061(513) and US$1958(372), respectively. Conclusions: In conclusion, our findings revealed that management of stroke and its complications have a relatively high burden on the Turkish health reimbursement system. Furthermore, co-morbid malnutrition, being not uncommonly encountered, increased the overall costs and was associated with longer LOS and higher rate of expected complications during 1-year follow up.