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SUN-P199: Frailty Syndrome Among Patients Undergoing Nutrition Support Therapy in a Brazilian Tertiary Hospital
Nutritional assessment 1
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Patients were included if BMI was documented, as well as one CT scan. The cut-point for sarcopenia was established in men <50 mm2 and <40 mm2 for women at the L3 level. Results: A total of 45 patients (56%men 66 ± years old) were included in the study. According to BMI related to sarcopenia see Table 1. Table 1: BMI # Patients Sarcopenia %
<18 4 2 50.00
18.1–24.9 23 4 17.39
25–29.9 14 2 14.29
>30 4 0 0
Conclusion: BMI assessment may not be suitable for the assessment of nutritional status in cancer patients as it may underestimate patients that have sarcopenia. Other assessments, such as CT scans may provide more information regarding body composition, especially lean body mass, which is a predictor of mortality in cancer patients. Disclosure of Interest: None declared.
SUN-P198 NUTRITIONAL RISK ASSESSMENT IN PATIENTS UNDERGOING GASTROINTESTINAL SURGERY: CAN NRS 2002 SCORE BE SIMPLIFIED? ́ , I. Palibrk1,2 *, M. Žnidaršič2, S. Zec2, J. Veličkovic1,2 2 M. Marnić , M. Đukanovic1́ . 1Center for Anesthesiology, Clinical Center of Serbia, 2School of Medicine, University of Belgrade, Belgrade, Serbia Rationale: The NRS 2002 score is a tool for identification of patients at nutritional risk who may benefit from nutritional support. The aim of our study was to determine the prevalence of nutritional risk and its impact on postoperative complications (POC) and length of hospital stay(LOS) following gastrointestinal surgery in a Serbian teaching hospital. We also aimed to establish which components of NRS 2002 score show the strongest association with postoperative outcomes. Methods: We evaluated 132 unselected patients in a crosssectional study during the Nutrition Day (ND) 2016. Data regarding nutritional intake and health status were collected from questionnaires prepared by ND organization. For each patient NRS 2002 score was calculated. Patients were followed for complications until hospital discharge or readmission. Results: The overall prevalence of nutritional risk (NRS ≥ 3) was 37.1%. Median LOS was significantly longer in patients at nutritional risk (24 vs 14 days, p < 0.001). Patients with NRS ≥ 3 had a significantly higher complication rate of 57.1% (28/49) compared to 13.3% (11/83) in patients with a normal score ( p < 0.001). Postoperative morbidity was increased 3.84 times for each positive response to the initial four screening questions (OR 3.84; 95% CI 2.31–6.39). Positive answer to the question regarding weight loss in the last 3 months increased the risk for POC by 88.21 (95% CI 11.53–674.42). AUROC for discrimination between patients with and without POCs with this question was 0.84 (0.77–0.90) as compared to 0.75 (0.65– 0.81) with the entire score. Conclusion: The prevalence of nutritional risk in patients undergoing gastrointestinal surgery in Serbia is high. The initial screening questions of NRS2002 were strong predictors of POC and LOS. Weight loss in the last three months was stronger
predictor of poor outcome than the whole score which might simplify nutritional risk screening. Disclosure of Interest: None declared.
SUN-P199 FRAILTY SYNDROME AMONG PATIENTS UNDERGOING NUTRITION SUPPORT THERAPY IN A BRAZILIAN TERTIARY HOSPITAL I. A. O. Souza1 *, T. S. Vieira2, P. C. Ribeiro3, L. U. Taniguchi1, on behalf of Nutrition Support Team Hospital Sirio-Libanes. 1 Intensive Care Unit, Hospital Sirio-Libanes, 2Intensive Care Unit, Hospital Beneficência Portuguesa Mirante, 3Nutrition Support Team, Hospital Sirio-Libanes, Sao Paulo, Brazil Rationale: Frailty is a multidimensional syndrome characterized by loss of physiologic and cognitive reserves that confers vulnerability to adverse outcomes during hospitalization, with higher morbidity and mortality rates. We aimed to describe the prevalence and outcomes associated with frailty among patients who required nutrition support therapy in a Brazilian tertiary hospital. Methods: We conducted a prospective single-center cohort study of patients admitted to Hospital Sirio-Libanes (Sao Paulo, Brazil), between October 2015 and March 2017. Frailty syndrome was classified using the Canadian Study on Health and Aging Clinical Frailty Scale (CFS). Patients were divided in three sub-groups according to the CFS: CFS 1–3, CFS 4–6, CFS 7– 9. Multivariable analyses were used to evaluate the independent association between frailty and hospital mortality. Results: We studied 848 patients during the study period (mean age was 72.2 years, 73.0% were admitted for non-surgical reasons, 45.2% had cancer and 64.6% required ICU admission). 602 (71.0%) patients undergone enteral nutrition, 178 (21.0%) parenteral nutrition and 68 (8%) required enteral and parenteral nutrition. The distribution of patients between the three groups was: 220 (25.9%) CFS 1–3, 358 (42.2%) CFS 4–6 and 270 (31.8%) CFS 7–9. The mortality rates were 9.5% in the CFS 1–3 group, 24.9% in the CFS 4–6 group and 24.4% in the CFS 7–9 group. After controlling for baseline differences, adjusted odds ratios for hospital death were 2.68 (95% CI 1.53–4.70) and 2.00 (95%CI 1.10–3.63), for sub-groups CFS 4–6 and CFS 7–9 compared to CFS 1–3, respectively. Conclusion: Frailty is very common among patients undergoing nutrition support therapy, and it was associated with higher adjusted odds ratio for hospital mortality. Disclosure of Interest: None declared.
SUN-P200 VALIDITY OF EQUATIONS USING KNEE HEIGHT TO PREDICT OVERALL HEIGHT AMONG OLDER PEOPLE IN BENIN P. Jésus1,2,3, P. Fayemendy1,2,3, C. Mizéhoun-Adissoda4,5, D. Houinato2,3,5, P. M. Preux2,3, J. C. Desport1,2,3 *. 1Nutrition Unit, University Hospital of Limoges, 2INSERM UMR1094, Tropical Neuroepidemiology, School of Medicine, 3UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France, 4School of Nutrition and Dietetic, 5 Laboratory of Non-communicable and Neurologic Diseases Epidemiology (LEMACEN), Faculty of Health Science, University of Abomey-Calavi, Cotonou, Benin Rationale: Chumlea’s formulas are a validated means of predicting overall height from knee height (KH) among
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Patients were included if BMI was documented, as well as one CT scan. The cut-point for sarcopenia was established in men <50 mm2 and <40 mm2 for women at the L3 level. Results: A total of 45 patients (56%men 66 ± years old) were included in the study. According to BMI related to sarcopenia see Table 1. Table 1: BMI # Patients Sarcopenia %
<18 4 2 50.00
18.1–24.9 23 4 17.39
25–29.9 14 2 14.29
>30 4 0 0
Conclusion: BMI assessment may not be suitable for the assessment of nutritional status in cancer patients as it may underestimate patients that have sarcopenia. Other assessments, such as CT scans may provide more information regarding body composition, especially lean body mass, which is a predictor of mortality in cancer patients. Disclosure of Interest: None declared.
SUN-P198 NUTRITIONAL RISK ASSESSMENT IN PATIENTS UNDERGOING GASTROINTESTINAL SURGERY: CAN NRS 2002 SCORE BE SIMPLIFIED? ́ , I. Palibrk1,2 *, M. Žnidaršič2, S. Zec2, J. Veličkovic1,2 2 M. Marnić , M. Đukanovic1́ . 1Center for Anesthesiology, Clinical Center of Serbia, 2School of Medicine, University of Belgrade, Belgrade, Serbia Rationale: The NRS 2002 score is a tool for identification of patients at nutritional risk who may benefit from nutritional support. The aim of our study was to determine the prevalence of nutritional risk and its impact on postoperative complications (POC) and length of hospital stay(LOS) following gastrointestinal surgery in a Serbian teaching hospital. We also aimed to establish which components of NRS 2002 score show the strongest association with postoperative outcomes. Methods: We evaluated 132 unselected patients in a crosssectional study during the Nutrition Day (ND) 2016. Data regarding nutritional intake and health status were collected from questionnaires prepared by ND organization. For each patient NRS 2002 score was calculated. Patients were followed for complications until hospital discharge or readmission. Results: The overall prevalence of nutritional risk (NRS ≥ 3) was 37.1%. Median LOS was significantly longer in patients at nutritional risk (24 vs 14 days, p < 0.001). Patients with NRS ≥ 3 had a significantly higher complication rate of 57.1% (28/49) compared to 13.3% (11/83) in patients with a normal score ( p < 0.001). Postoperative morbidity was increased 3.84 times for each positive response to the initial four screening questions (OR 3.84; 95% CI 2.31–6.39). Positive answer to the question regarding weight loss in the last 3 months increased the risk for POC by 88.21 (95% CI 11.53–674.42). AUROC for discrimination between patients with and without POCs with this question was 0.84 (0.77–0.90) as compared to 0.75 (0.65– 0.81) with the entire score. Conclusion: The prevalence of nutritional risk in patients undergoing gastrointestinal surgery in Serbia is high. The initial screening questions of NRS2002 were strong predictors of POC and LOS. Weight loss in the last three months was stronger
predictor of poor outcome than the whole score which might simplify nutritional risk screening. Disclosure of Interest: None declared.
SUN-P199 FRAILTY SYNDROME AMONG PATIENTS UNDERGOING NUTRITION SUPPORT THERAPY IN A BRAZILIAN TERTIARY HOSPITAL I. A. O. Souza1 *, T. S. Vieira2, P. C. Ribeiro3, L. U. Taniguchi1, on behalf of Nutrition Support Team Hospital Sirio-Libanes. 1 Intensive Care Unit, Hospital Sirio-Libanes, 2Intensive Care Unit, Hospital Beneficência Portuguesa Mirante, 3Nutrition Support Team, Hospital Sirio-Libanes, Sao Paulo, Brazil Rationale: Frailty is a multidimensional syndrome characterized by loss of physiologic and cognitive reserves that confers vulnerability to adverse outcomes during hospitalization, with higher morbidity and mortality rates. We aimed to describe the prevalence and outcomes associated with frailty among patients who required nutrition support therapy in a Brazilian tertiary hospital. Methods: We conducted a prospective single-center cohort study of patients admitted to Hospital Sirio-Libanes (Sao Paulo, Brazil), between October 2015 and March 2017. Frailty syndrome was classified using the Canadian Study on Health and Aging Clinical Frailty Scale (CFS). Patients were divided in three sub-groups according to the CFS: CFS 1–3, CFS 4–6, CFS 7– 9. Multivariable analyses were used to evaluate the independent association between frailty and hospital mortality. Results: We studied 848 patients during the study period (mean age was 72.2 years, 73.0% were admitted for non-surgical reasons, 45.2% had cancer and 64.6% required ICU admission). 602 (71.0%) patients undergone enteral nutrition, 178 (21.0%) parenteral nutrition and 68 (8%) required enteral and parenteral nutrition. The distribution of patients between the three groups was: 220 (25.9%) CFS 1–3, 358 (42.2%) CFS 4–6 and 270 (31.8%) CFS 7–9. The mortality rates were 9.5% in the CFS 1–3 group, 24.9% in the CFS 4–6 group and 24.4% in the CFS 7–9 group. After controlling for baseline differences, adjusted odds ratios for hospital death were 2.68 (95% CI 1.53–4.70) and 2.00 (95%CI 1.10–3.63), for sub-groups CFS 4–6 and CFS 7–9 compared to CFS 1–3, respectively. Conclusion: Frailty is very common among patients undergoing nutrition support therapy, and it was associated with higher adjusted odds ratio for hospital mortality. Disclosure of Interest: None declared.
SUN-P200 VALIDITY OF EQUATIONS USING KNEE HEIGHT TO PREDICT OVERALL HEIGHT AMONG OLDER PEOPLE IN BENIN P. Jésus1,2,3, P. Fayemendy1,2,3, C. Mizéhoun-Adissoda4,5, D. Houinato2,3,5, P. M. Preux2,3, J. C. Desport1,2,3 *. 1Nutrition Unit, University Hospital of Limoges, 2INSERM UMR1094, Tropical Neuroepidemiology, School of Medicine, 3UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France, 4School of Nutrition and Dietetic, 5 Laboratory of Non-communicable and Neurologic Diseases Epidemiology (LEMACEN), Faculty of Health Science, University of Abomey-Calavi, Cotonou, Benin Rationale: Chumlea’s formulas are a validated means of predicting overall height from knee height (KH) among