Preliminary evidence in the literature suggests a high prevalence of malnutrition (undernutrition) in patients with severe acquired brain injuries (sABI), with an expected negative impact on clinical outcomes and pressure ulcers (PUs) in particular. In a retrospective cohort study on patients discharged from intensive care units (ICU) and admitted to an intensive rehabilitation unit (IRU), the risk of malnutrition was systematically assessed, in addition to standard clinical procedures (including PUs evaluation), using two different tools: the Malnutrition Universal Screening Tool (MUST) and the Controlling Nutritional Status (CONUT) tool. Eighty-eight patients were included in the analysis. A high proportion (79.5%) of patients with sABI suffered from PUs, being older and more frequently men, with a longer ICU stay between the event and admission to IRU, and a greater MUST score. At discharge, when compared to patients whose PUs had healed, those with persisting PUs were more often men and had the worst cognitive performance at admission. As for nutritional risk, the baseline CONUT score was identified as an independent negative predictor of PUs at discharge by the logistic regression model. In conclusion, the assessment of nutritional risk using simple standard tools may be useful in the clinical evaluation of sABI patients with PUs.

Aim: Malnutrition is an often underestimated, worldwide, frequent problem with a high prevalence among inpatients, especially the elderly ones. Undernourished patients have an increased risk of comorbidities, complications and a decreased quality of life. Malnutrition is associated with longer hospital stay, increased care needs and costs for the National Health Service (NHS). We describe the protocol of a study conducted to evaluate the impact of specialized nutritional care on 3-month outcomes of patients at high risk of malnutrition at admission and to describe the actual nutritional practice in a rehabilitation setting. Methods: In this single-center, prospective, observational study patients at high risk of malnutrition who received standard nutritional care (Group 1) were compared with patients at high risk of malnutrition who received a specialized nutritional care (Group 2). Three months after discharge (follow-up), patients of both groups were interviewed by telephone to collect data regarding number of hospital readmission, emergency department admission, general practitioner (GP) and outpatient visits, diagnostic tests, daily medication use and survival. Conclusion: Our study could help to support clinical choices for personalized nutritional interventions to improve rehabilitation outcomes and to decrease the costs for the NHS. This protocol is registered at ClinicalTrials.gov (NCT07183098) under the title “A Prospective Observational Study on the Prevalence of Malnutrition and Clinical-Economic Aspects of the Impact of Specialized Nutritional care on the 3-month Outcomes of Patients at high Risk of malnutrition Admitted to a Rehabilitation Hospital”.

Whey protein (WP) supplementation could affect low-grade inflammation (inflammaging) and gut microbiome dysbiosis, both of which play key roles in non-communicable diseases (NCDs). Twenty-seven cardiac rehabilitation patients were randomly allocated to two groups: the case group (CA) (n = 14) received 80 g/die vitamin D and leucine-enriched WP supplement, combined with a standard hospital diet, while the control group (CO, n = 13) received the standard hospital diet alone. Blood and stool samples were collected at baseline (T0) and after two weeks (T1). At T1, serum levels of interleukin 6 (IL-6) and C-reactive protein (CRP) significantly decreased in the CA group. Ferritin levels significantly decreased within both groups and between the two groups. No significant differences were observed for IL-1β, tumor necrosis factor-α (TNF-α), or IL-10. A clear difference in the bacterial intestinal microbiome composition between the case group at T1 (CAT1) and at T0 (CAT0), and control group at T0 (COT0) and at T1 (COT1), was observed. The eubacterial rpoB copy number, which was quantified by qPCR, significantly increased between CAT0 and CAT1, in contrast to the Lactobacillus spp. rpoB copy number. Our exploratory results showed that vitamin D and leucine-enriched WP supplementation could have a potential effect on chronic inflammation and gut microbiota composition in cardiac rehabilitation patients.