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LB008-MON ORAL REFEEDING AFTER DYSPHAGIA ASSESSMENT AND REHABILITATION BY NUTRITION SUPPORT TEAM
218 percentile for age and sex. Results are presented as means±SD. Results: Fourteen paediatric units participated in the study all over France. On 1063 data collected, 952 were analysed. Only children aged under 16 with specified weight and height were selected. Mean age was 6.5±5.5 y (1 day to 16 y). BBMI <3rd percentile for age and sex was found in 14.2% of the whole population, and was associated with clinical signs of malnutrition in 9.0%. Within 625 children with documented diagnostic, 52% were hospitalized for chronic diseases. Malnutrition was more frequent in children with chronic diseases (21% vs 8%, p < 0.01). Highest prevalences of low BMI were observed in children with neurological (25%), metabolic, immune and endocrine (23%), cardiac (22%) or surgical (18%) diseases. BMI >97th percentile was found in 14% of hospitalized children. Loss of muscle mass and handicap were best predictors of confirmed malnutrition. Conclusion: This is the first french large scale multicenter study estimating malnutrition in hospitalized children. Next step will be to set up an European paediatric DDAY in order to promote nutritional care in children over EEC and compare participating countries with same tools and diagnostic procedures. Disclosure of Interest: S. Sissaoui: None Declared, H. Piloquet: None Declared, A. De Luca: None Declared, D. Guimber: None Declared, N. Peretti: None Declared, M. Coste: None Declared, A. Turquet: None Declared, D. Djeddi: None Declared, A. Leke: None Declared, A. Vanrenterghem: None Declared, V. Triolo: None Declared, E. Mas: None Declared, A. Breton: None Declared, C. Lambe: None Declared, V. Colomb: None Declared, O. Goulet: None Declared, N. Thomassin: None Declared, J. Chouraqui: None Declared, P. Renard: None Declared, P. Massicot: None Declared, A. Bougnol: None Declared, S. Leprince: None Declared, B. Dorigny: None Declared, M. Fischbach: None Declared, P. Ingrand: None Declared, R. Hankard Grant/Research Support from: Nutricia, Advanced Medical Nutrition
LB008-MON ORAL REFEEDING AFTER DYSPHAGIA ASSESSMENT AND REHABILITATION BY NUTRITION SUPPORT TEAM A. Kaneoka1 , K. Yokota1 , K. Fukatsu2 , T. Nito3 , N. Haga4 . 1 Central Rehabilitation Service, 2 Surgical Center, The University of Tokyo Hospital, 3 Department of Otolaryngology, Faculty of Medicine, The University of Tokyo, 4 Department of Rehabilitation Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan Rationale: Deciding whether or not patients can restart oral feeding (OF) is an important part of nutritional management. Our nutrition support team (NST) proposed a simple evaluation and rehabilitation procedure for dysphagia to medical staff members in our hospital. Herein, we review the clinical benefits of this procedure. Methods: The evaluation procedure includes a preliminary questionnaire (PQ), screening test (modified water swallowing test: MWST) and videofluorography (VF). Swallowing rehabilitation is implemented according to the evaluation results. From Jan 2010 to Mar 2011, 38 patients (27 males, 11 females) were assessed for the presence of dysphagia. We retrospectively reviewed medical charts to ascertain patient’s characteristics, changes
Late Breaking Abstracts in nutritional management and nutritional status, and the occurrence of aspiration pneumonia. Results: Data are expressed as mean±SD. The average age was 70.8±16.6 years. Twenty-seven patients were appropriate candidates for oral feeding, while 11 were not. Both groups had been given OF (n = 5, 0), enteral nutrition (EN, n = 13, 9) or parenteral nutrition (PN, n = 9, 2) before assessment. After training, more patients received OF (n = 22, 3), fewer EN (n = 1, 6) or PN (n = 4, 2). Thus, our procedure increased numbers of patients receiving OF from five (13%) to 25 (66%) (p < 0.001, Fisher’s exact probability test). Plasma albumin levels of the 20 patients on OF with blood biochemical examinations were higher at discharge than before assessment (2.9±0.6 vs 3.2±0.6 g/dL, p < 0.05, paired t-test). Aspiration pneumonia occurred in three patients in the non-OF group at discharge receiving direct training with jelly feeding or only indirect training. Conclusion: Our evaluation procedure and rehabilitation are useful for nutritional management of patients with suspected dysphagia. Aspiration pneumonia does not appear to be a major risk in patients receiving OF at discharge. Disclosure of Interest: None Declared
LB009-MON GENDER-SPECIFIC IMPACT ON MUSCLE DYSFUNCTION IN DISEASE-RELATED MALNUTRITION K. Norman1 , N. Stob¨ aus2 , J. Schulzke2 , L. Valentini1 , 1 1 M. Pirlich . Dept. of Gastroenterology, 2 Dept of General Medicine, Charit´ e University Medicine, Berlin, Germany Rationale: Reduced muscle strength is a cardinal feature in disease-related malnutrition. Objective: We investigated whether malnutrition impacts muscle strength differently in men and women. Methods: 1500 hospitalized patients (57.6±16.0 yrs, BMI 24.6±4.8 kg/m2 , 47.9% men, 47.4% malnutrition) were included in a pooled analysis. Nutritional status was determined with Subjective Global Assessment (SGA), muscle function by grip strength. Mid upper arm circumference and triceps skinfold were used to calculate arm muscle area (AMA). Interrelationship between gender and disease-related malnutrition was evaluated by regression analysis performed with General Linear Model (GLM) allowing adjustment for continuous and categorical variables and corrected for age, AMA, BMI and diagnosis category (benign/malignant) as covariates. Results: Both men and women exhibited a significant stepwise decrease of grip strength when moderately or severely malnourished. Age, gender, SGA categories B and C (moderate and severe malnutrition), BMI and AMA were significant predictors of grip strength. The GLM revealed a significant gender × malnutrition effect, since grip strength was similarly decreased in moderate malnutrition in men and women when compared to good nutritional status (8.5% in men and 10.5% in women, n.s.), but the further reduction of grip strength in severe malnutrition was significantly different between men and women (10.6% vs. 4.1%, P = 0.033). (SGA C compared to SGA B in men vs. women: b: 2.732, p = 0.033).
LB008-MON ORAL REFEEDING AFTER DYSPHAGIA ASSESSMENT AND REHABILITATION BY NUTRITION SUPPORT TEAM A. Kaneoka1 , K. Yokota1 , K. Fukatsu2 , T. Nito3 , N. Haga4 . 1 Central Rehabilitation Service, 2 Surgical Center, The University of Tokyo Hospital, 3 Department of Otolaryngology, Faculty of Medicine, The University of Tokyo, 4 Department of Rehabilitation Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan Rationale: Deciding whether or not patients can restart oral feeding (OF) is an important part of nutritional management. Our nutrition support team (NST) proposed a simple evaluation and rehabilitation procedure for dysphagia to medical staff members in our hospital. Herein, we review the clinical benefits of this procedure. Methods: The evaluation procedure includes a preliminary questionnaire (PQ), screening test (modified water swallowing test: MWST) and videofluorography (VF). Swallowing rehabilitation is implemented according to the evaluation results. From Jan 2010 to Mar 2011, 38 patients (27 males, 11 females) were assessed for the presence of dysphagia. We retrospectively reviewed medical charts to ascertain patient’s characteristics, changes
Late Breaking Abstracts in nutritional management and nutritional status, and the occurrence of aspiration pneumonia. Results: Data are expressed as mean±SD. The average age was 70.8±16.6 years. Twenty-seven patients were appropriate candidates for oral feeding, while 11 were not. Both groups had been given OF (n = 5, 0), enteral nutrition (EN, n = 13, 9) or parenteral nutrition (PN, n = 9, 2) before assessment. After training, more patients received OF (n = 22, 3), fewer EN (n = 1, 6) or PN (n = 4, 2). Thus, our procedure increased numbers of patients receiving OF from five (13%) to 25 (66%) (p < 0.001, Fisher’s exact probability test). Plasma albumin levels of the 20 patients on OF with blood biochemical examinations were higher at discharge than before assessment (2.9±0.6 vs 3.2±0.6 g/dL, p < 0.05, paired t-test). Aspiration pneumonia occurred in three patients in the non-OF group at discharge receiving direct training with jelly feeding or only indirect training. Conclusion: Our evaluation procedure and rehabilitation are useful for nutritional management of patients with suspected dysphagia. Aspiration pneumonia does not appear to be a major risk in patients receiving OF at discharge. Disclosure of Interest: None Declared
LB009-MON GENDER-SPECIFIC IMPACT ON MUSCLE DYSFUNCTION IN DISEASE-RELATED MALNUTRITION K. Norman1 , N. Stob¨ aus2 , J. Schulzke2 , L. Valentini1 , 1 1 M. Pirlich . Dept. of Gastroenterology, 2 Dept of General Medicine, Charit´ e University Medicine, Berlin, Germany Rationale: Reduced muscle strength is a cardinal feature in disease-related malnutrition. Objective: We investigated whether malnutrition impacts muscle strength differently in men and women. Methods: 1500 hospitalized patients (57.6±16.0 yrs, BMI 24.6±4.8 kg/m2 , 47.9% men, 47.4% malnutrition) were included in a pooled analysis. Nutritional status was determined with Subjective Global Assessment (SGA), muscle function by grip strength. Mid upper arm circumference and triceps skinfold were used to calculate arm muscle area (AMA). Interrelationship between gender and disease-related malnutrition was evaluated by regression analysis performed with General Linear Model (GLM) allowing adjustment for continuous and categorical variables and corrected for age, AMA, BMI and diagnosis category (benign/malignant) as covariates. Results: Both men and women exhibited a significant stepwise decrease of grip strength when moderately or severely malnourished. Age, gender, SGA categories B and C (moderate and severe malnutrition), BMI and AMA were significant predictors of grip strength. The GLM revealed a significant gender × malnutrition effect, since grip strength was similarly decreased in moderate malnutrition in men and women when compared to good nutritional status (8.5% in men and 10.5% in women, n.s.), but the further reduction of grip strength in severe malnutrition was significantly different between men and women (10.6% vs. 4.1%, P = 0.033). (SGA C compared to SGA B in men vs. women: b: 2.732, p = 0.033).