Does the presence of anemia and its severity in nursing home and community residents affect the rate of hospitalization and hospital length of stay (LOS)?

internal validity such as drop-outs and the external validity of the trial such as the inclusion criteria were assessed. Chi-square and Mann-Whitney tests were used to analyze categorical and continuous measurements respectively. P ⬍ 0.05 of a two-tail test was chosen as significant. Data was analyzed with SPSS. Results: More than half (19/34) drug and nutritional supplement trials were sponsored by industry. 38% (13 of 34) of them were purely sponsored by industry. 18% (6 of 34) were partially sponsored by industry. Solely industrysponsored drug trials reported more statistically significant findings than that sponsored by non-industry (11/13 versus 9/21, P ⫽ 0.03). Combining solely and partially industry-sponsored drug and nutritional supplement trials also showed a trend of reporting more statistically significant findings than that sponsored by others (13/19 versus 7/15, P ⫽ 0.30). However, Both the quality of internal and external validity of trials were similar. Although solely industry-sponsored randomized, controlled drug and nutritional supplement trials had larger sample size than that sponsored by others (157 versus 38, P ⫽ 0.005), there was no difference of sample size between combining solely and partially industry-sponsored drug and nutritional supplement trials and others (116 versus 107, P ⬎ 0.05). Conclusion/Discussion: Industry-sponsored drug and nutritional supplement trials done in NH tend to report more statistically significant findings than that sponsored by non-industry. However, the sponsorship was not associated with better quality of trials. Disclosures: Huai Y. Cheng, MD has no disclosures to be made that are pertinent to this abstract.

Does the presence of anemia and its severity in nursing home and community residents affect the rate of hospitalization and hospital length of stay (LOS)? Presenting Author(s): Thiruvinva S. Dharmarajan, MD, FACP, AGSF, Our Lady of Mercy Medical Center Author(s): Thiruvinva S. Dharmarajan, MD, FACP, AGSF; Anna Pankratov, MD; Evelyn Morris, MD; Saima Qurashi, MD; Praveen Jaspal, MD; Sunila Phillips, MD; Edward P. Norkus Introduction/Objective: Anemia in older adults appears often overlooked and under-treated. This study examined if anemia severity was related to hospitalizations and length of hospitalization over 16-months among Bronx residents. Design/Methodology: Nursing home (NH) and community (C) residents were screened during routine medical examinations; those with laboratory data including hemoglobin (Hb) (within 14 days) were enrolled. Age, sex, place of residence, past hospitalizations (⬎01/01/05), LOS/hospitalization and Hb during hospitalization were recorded. Data on comorbidity and hospitalization diagnoses were collected. WHO criteria defined anemia (Hb ⬍12.0 g/dL in F & ⬍13.0 g/dL in M). Results: Data from 303 subjects (78 ⫾ 13(sd) years; 59% female and 69% from NH) were obtained. NH subjects were older (80 ⫾ 12 yrs vs. 73 ⫾ 14 yrs; P ⫽ .0001) but had similar sex ratios as C patients (P ⫽ .402). Anemia was present in 58% and 77% had a history of previous hospitalization. Anemic and non-anemic patients had similar demographics and similar comorbidity (age, sex, residence, HTN, CVA, CAD, afib, DM, depression, hypoT, hypertT, Parkinson’s, neuropathy, dementia, arthritis, osteoporosis, pressure ulcers; all P ⬎ .05). Anemic patients had significantly ⬎ LOS (10 ⫾ 8 d vs. 6 ⫾ 4 d; P ⫽ 0.0005) than non-anemic patients. Severity of anemia also increased the likelihood of longer LOS (ex. anemic patients with Hb ⬍11.0 g/dL, ⬍10.0 g/dL and ⬍9.0 g/dL were 4-, 6- & 7-fold, respectively, more likely to have longer LOS than anemic patients with higher Hb; all P ⬍ .0005). Severity of anemia also increased the likelihood of hospitalization (ex. anemic patients with Hb ⬍11.0 g/dL, ⬍10.0 g/dL and ⬍9.0 g/dL were 50%, 70% and 75%, respectively, more likely to experience hospitalization than anemic patients with higher Hb; all P ⬍ .0005). Age, sex, place of residence and CrCl level did not influence hospitalization or LOS. Anemic African Americans were 2- to 5-fold more likely to have a longer LOS (P ⫽ .004) and 25% to 60% more likely to have hospitalization (P ⫽ .008) than Hispanic, White or Asian/Oriental patients at all Hb levels. Conclusion/Discussion: These findings suggest that 1) severity of anemia is a significant risk factor for hospitalization, 2) once hospitalized, anemia increased the LOS, 3) both hospitalization and longer LOS increase healthPOSTER ABSTRACTS

care costs, while treatment of anemia is achievable at low cost, and 4) there is a need for increased efforts to recognize and treat anemia, as they have the potential to improve outcome and lower health care costs. Disclosures: All authors have stated that there are no disclosures to be made that are pertinent to this abstract.

Enhancement of select breakfast and lunch foods to systematically increase energy intake in LTC residents Presenting Author(s): Victoria H. Castellanos, PhD, RD, Florida International University Author(s): Victoria H. Castellanos, PhD, RD; Melissa Ventura-Marra, PhD, RD Introduction/Objective: Based on the high prevalence of unintended weight loss in the long term care (LTC) setting, (up to 65% of residents), we know that calorie and protein intakes are frequently inadequate in this population. Protein energy malnutrition is associated with increased incidence of unintended weight loss, increased risk of wounds and poor wound healing, muscle weakness and falls, and increased infections concomitant with an impaired immune response. Significant weight loss has been identified by the Centers for Medicare and Medicaid Services (CMS) as one of the 15 Quality Measures, the prevalence of which is reported nationally on the Nursing Home Compare web site.This study was designed to evaluate whether energy and/or protein enhancement of selected food items would result in increased total 24-hour calorie and protein intakes in the LTC setting. Design/Methodology: A total of 35 older adults were enrolled in this study (10 males and 25 females). A within-subjects repeated measures design was utilized. Each subject was tested under 3 menu conditions: 1) regular breakfast and regular lunch; 2) regular breakfast and enhanced lunch; and 3) enhanced breakfast and enhanced lunch. Thus, subjects served as their own controls. Each of the 3 conditions was tested on 2 different non-sequential menu days (Tuesday and Thursday). Treatment order was assigned using a 3 ⫻ 3 Latin square. Two breakfast foods (juice and hot cereal) and two lunch foods (soup and potato side dish) were enhanced each day. These foods were chosen because it was determined that a relatively large amount of these foods was consumed by most residents. Food intake was measured at breakfast, lunch and dinner meals. Results: Residents ate the same amount of the enhanced foods as they did the regular foods, thus there was no evidence of compensation for the extra calorie content. There was a statistically significant incremental increase in calorie intake for each meal that was enhanced. When both breakfast and lunch were enhanced, there was a total daily kcal increase of 258 kcal (Tues) to 277 kcal (Thurs)(P ⬍ 0.05) and a non-significant 7–9% increase in daily protein intake. Conclusion/Discussion: Enhancing the juice and cereal offerings at breakfast for all residents and serving high-calorie soups and side dishes at lunch to all residents represents a simple yet effective strategy to significantly increase energy intake across the resident population in the LTC setting. In particular, serving enhanced breakfast menu items has the potential for increasing overall energy intake. Disclosures: Victoria H. Castellanos, PhD, RD received salary from Nivartis Nutrition for authoring a manuscript.

Predicting six-month mortality in the nursing home: A case-controlled pilot study Presenting Author(s): Tracy Marx, DO, CMD, OUCOM Author(s): Tracy Marx, DO, CMD Introduction/Objective: Increasing numbers of Americans will die in nursing homes. Many will die without the benefit of hospice, which has been shown to improve pain and symptom management as well as patient and family satisfaction with care at the end-of-life. As accurate prognostication of hospice eligibility is clinically quite difficult, we designed this study to determine if the Minimum Data Set Mortality Risk Index (MMRI) accurately predicts six-month mortality in Ohio nursing home residents. Design/Methodology: This pilot study is a retrospective case-controlled study to test data extraction from the Minimum Data Set (MDS) and apply the MMRI algorithm prior to examining the statewide database. Forty nursing B19