About this trial

Malnutrition among hospitalized patients is a critical, yet often overlooked, public health issue associated with increased complications, longer hospital stays, higher mortality, and greater healthcare costs. In Iraq, factors such as dietary patterns, the burden of chronic diseases, and healthcare constraints may increase the risk of hospital-acquired malnutrition. Current standard care may not include systematic nutritional screening or protocol-driven support. This trial aims to test whether implementing an individualized nutritional support program can improve clinical outcomes for at-risk medical inpatients in Iraqi hospitals, building upon evidence from international studies

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Age: Adult patients aged $\ge$ 18 years.Setting: Patients admitted to the Medicine, Surgery, or Neurology Intensive Care Unit (ICU) wards at Al-Basrah Teaching Hospital or Al-Fayhaa General Hospital.Duration of Stay: Patients who have been hospitalized for a minimum of 48 hours (to ensure a baseline for malnutrition screening and medication review).Clinical Conditions: Patients with various primary diagnoses, including specific subgroups with Chronic Obstructive Pulmonary Disease (COPD) and Alzheimer's Disease.Informed Consent: Patients or their legal guardians (especially for those in the ICU or with cognitive impairment) who provide written or verbal informed consent.

Disqualifiers

Maternity/Obstetrics: Pregnant or lactating women, as nutritional requirements and physiological BMI changes differ from the general adult population.

Trial population

The study population consists of hospitalized adult patients admitted to Al-Basrah Teaching Hospital and Al-Fayhaa General Hospital in Basra, Iraq. The cohort primarily includes individuals admitted to the Medical wards, Surgical wards, and the Neurology Intensive Care Unit (ICU). This population represents a diverse clinical spectrum, with a particular focus on patients suffering from chronic inflammatory conditions and neurodegenerative disorders, specifically Chronic Obstructive Pulmonary Disease (COPD) and Alzheimer's Disease. The population is characterized by varying levels of nutritional risk and complex pharmacotherapy regimens (polypharmacy). Participants are recruited within the first 48 hours of admission to capture point-prevalence data. The demographic includes both males and females aged 18 years and older, representing the urban and suburban population served by the Basra Health Directorate.

Trial design

Design model

Cohort

Time perspective

Cross-sectional

Treatments tested in this trial

Nutritional Assessment and Medication Review
Other intervention
Intervention Description"This observational intervention consists of a multi-disciplinary clinical assessment conducted in three distinct phases for each enrolled participant:Validated Two-Step Nutritional Evaluation: Unlike standard hospital screening, this study uses the Nutritional Risk Screening (NRS-2002) as an initial filter. Patients identified as 'at risk' (score $\\ge$ 3) are immediately subjected to the Global Leadership Initiative on Malnutrition (GLIM) criteria. This provides a definitive diagnosis by combining phenotypic criteria (non-volitional weight loss, low BMI, or reduced muscle mass) with etiologic criteria (reduced food intake/malabsorption or disease-related inflammation/chronic illness).Specialized Comorbidity Analysis: The assessment specifically targets the impact of Chronic Obstructive Pulmonary Disease (COPD) and Alzheimer's Disease on nutritional status, evaluating how respiratory hypermetabolism and cognitive impairment act as independent drivers of malnutri
Nutritional Assessment and Medication Review
Other intervention
To distinguish your research from a standard hospital audit or a basic nutritional survey, your description must highlight the systematic, two-step diagnostic workflow and the integration of clinical pharmacy oversight.Use the following detailed description for your entry:Intervention Description"This observational intervention consists of a multi-dimensional clinical assessment conducted in three specific phases for each participant:Validated Two-Step Nutritional Protocol: Unlike standard care, which may lack formal screening, this intervention applies the Nutritional Risk Screening (NRS-2002) within 48 hours of admission. Participants identified as 'at risk' (score $\\ge$ 3) are immediately subjected to the Global Leadership Initiative on Malnutrition (GLIM) criteria. This provides a definitive diagnosis by combining phenotypic criteria (non-volitional weight loss, low BMI, or reduced muscle mass) with etiologic criteria (reduced food intake/malabsorption or disease-related inflammati

Treatment groups

300 Participants

are divided into 1 treatment group

Group A: Hospitalized Adults in Basrah1 intervention

Trial outcomes

Primary outcomes

1

oint Prevalence of Malnutrition using GLIM Criteria and NRS-2002

The primary goal is to determine the prevalence of malnutrition among hospitalized adult patients in Al-Basrah Teaching Hospital and Al-Fayhaa General Hospital. All participants are first screened using the Nutritional Risk Screening (NRS-2002). For those identified as "at risk" (score $\\ge$ 3), a definitive diagnosis is made using the Global Leadership Initiative on Malnutrition (GLIM) criteria. Diagnosis requires at least one phenotypic criterion (non-volitional weight loss, low BMI, or reduced muscle mass) and one etiologic criterion (reduced food intake/malabsorption or disease-related inflammation/chronic illness, such as COPD or critical illness in the Neurology ICU). The prevalence will be reported as the percentage of the total cohort meeting the GLIM diagnostic threshold.

Time frame

Within 48 hours of hospital admission

2

Point Prevalence of Malnutrition using GLIM Criteria , NRS2002

The primary goal is to determine the prevalence of malnutrition among hospitalized adult patients in Al-Basrah Teaching Hospital and Al-Fayhaa General Hospital. All participants are first screened using the Nutritional Risk Screening (NRS-2002). For those identified as "at risk" (score $\\ge$ 3), a definitive diagnosis is made using the Global Leadership Initiative on Malnutrition (GLIM) criteria. Diagnosis requires at least one phenotypic criterion (non-volitional weight loss, low BMI, or reduced muscle mass) and one etiologic criterion (reduced food intake/malabsorption or disease-related inflammation/chronic illness, such as COPD or critical illness in the Neurology ICU). The prevalence will be reported as the percentage of the total cohort meeting the GLIM diagnostic threshold.

Time frame

Within 48 hours of hospital admission.

Locations

This trial has no locations.

Assessment of Malnutrition in Hospitalized Patients: a Quasi Study