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MON-P026: Geriatric Assessment as a Predictor of Postoperative Complications in Elderly Patients with Hepatocellular Carcinoma
Geriatrics 2 Conclusion: Frailty and malnutrition encompasses health status and quality of life in elderly population. A comprehensive geriatric evaluation including nutritional and frailty assessment are needed. Disclosure of Interest: None declared
MON-P026 GERIATRIC ASSESSMENT AS A PREDICTOR OF POSTOPERATIVE COMPLICATIONS IN ELDERLY PATIENTS WITH HEPATOCELLULAR CARCINOMA M. Kaibori1, K. Matsui1, M. Ishizaki1, H. Iida1, F. Nagashima2. 1 Surgery, Kansai Medical University, Hirakata, 2Medical Oncology, Kyorin University School of Medicine, Mitaka, Japan Rationale: Older patients are considered to have increased risk for complications after major surgery, but age alone is not a reliable predictor of post-operative complications. However, no universal screening test adequately predicts postoperative complications in older patients. This prospective study recorded pertinent baseline geriatric assessment variables to identify risk factors for postoperative complications in hepatocellular carcinoma (HCC) for patients aged ≥70 years who undergo hepatectomy. Methods: We retrospectively analyzed 71 consecutive patients ≥70 years of age. Patients had geriatric assessments of baseline and later cognition, nutritional and functional status, and burden of comorbidities, completed preoperatively and at 1, 3, and 6 months postoperatively. Postoperative morbidities were recorded. Results: Postoperative morbidities developed in 18 patients (25%). Univariate analysis identified serum albumin, operating time and blood loss, cirrhosis, geriatric 8 (G8), and Mini Nutritional Assessment as possible risk factors for postoperative complications, but only G8 < 14 survived multivariate analysis as an independent predictor of complications. Conclusion: Our findings indicate that the G8 score, based on patients’ nutritional assessments, is a useful screening method for older HCC patients who qualify for elective liver resection. Preoperative G8 scores can help forecast postoperative complications in older HCC patients. Future studies with larger numbers of patients, limited to HCC and liver resections, are needed to verify our results. Disclosure of Interest: None declared
MON-P027 NUTRITIONDAY IN NURSING HOMES – WHICH VARIABLES ARE PREDICTORS OF A SIGNIFICANT WEIGHT LOSS WITHIN 6 MONTHS? M. Streicher1, K. Schindler2, C. C. Sieber1, M. Hiesmayr2, D. Volkert1, A. T. N. team3. 1Friedrich-Alexander-Universität Erlangen-Nürnberg, Institute for Biomedicine of Aging, Nuremberg, Germany; 2Medical University of Vienna, 3 NutritionDay worldwide, Vienna, Austria Rationale: Unintended weight loss reflects malnutrition and is associated with a negative outcome. The aim of this analysis was to determine which indicators are predictive of a significant weight loss (WL) within 6 months in nursing home (NH) residents. Methods: NH residents participating in the nutritionDay (nD) between 2007 and 2014, aged ≥65 years, with data on body
S163 weight after 6 months and complete baseline data on 29 variables were included (n = 6,903). Unit characteristics (2 variables), resident characteristics (18), residents’ nutritional status (3) and nutrition (5) at baseline, and number of days in hospital during follow-up (1) were of interest as potential predictors of WL ≥ 10% (no vs yes). Changes in body weight were calculated from baseline and outcome data. Univariate generalized estimating equation (GEE) analyses were performed for all variables, and significant predictors ( p < 0.01) included in a multivariate model. Results: 9.7% had a WL ≥ 10%. 11 variables were identified as predictors and thereof 5 variables remained in the multivariate model (aROC = 0.661, p < 0.001). Odds ratios (OR [95% CI]) of a WL were 2.36 [1.85–3.01] and 3.61 [2.63–4.94] times higher for residents who stayed 4–13 and ≥14 days in a hospital during follow-up compared to residents without hospital admission. Residents with reduced food intake at lunch on nD (“a quarter” (2.19 [1.63–2.94]) or “nothing” (2.60 [1.72–3.92]) vs “all”), severely impaired cognition (1.75 [1.34–2.27]), WL >5 kg in the year before nD (1.44 [1.15–1.80]), and female residents (1.44 [1.10–1.88]) had a higher risk of WL. Conclusion: In NH residents participating in the nutritionDay, hospital stay, reduced food intake at lunch, impaired cognition, weight loss prior to nD, and being female is predictive of a significant weight loss within 6 months. Disclosure of Interest: None declared
MON-P028 IS THE ESPEN DEFINITION FOR MALNUTRITION ASSOCIATED WITH CLINICALLY RELEVANT OUTCOME MEASURES IN GERIATRIC OUTPATIENTS? N. M. van Rijssen1, A. G. Rojer1, M. C. Trappenburg1, E. M. Reijnierse1, C. G. Meskers2, A. B. Maier3, M. A. de van der Schueren4. 1Department of Internal Medicine, Section Gerontology and Geriatrics, 2Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, Netherlands; 3Department of Medicine and Aged Care, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia; 4Department of Internal Medicine, Section Nutrition and Dietetics, VU University Medical Center, Amsterdam, Netherlands Rationale: A body of evidence is supporting the association between malnutrition and physical performance and cognitive status in geriatric outpatients. The associations between the newly proposed ESPEN definition for malnutrition and these clinically relevant outcome measures have not been studied yet. Therefore, this study aims to examine the association between the ESPEN definition for malnutrition and clinically relevant outcome measures in geriatric outpatients. Methods: Associations between malnutrition according to the ESPEN definition for malnutrition and handgrip strength (kg), timed up and go test (seconds), Short Physical Performance Battery (SPPB, score 0–12), history of falls (yes/no) and a low score on the Mini Mental-State Examination (MMSE score ≤24)) were analysed using multivariate linear regression and logistic regression adjusted for age and gender. Results: 185 geriatric outpatients (40% male) with a mean age of 82 years (±7.3) were included. Being malnourished according to the ESPEN definition (8.2%) was associated with a lower handgrip strength (−3.38 kg, p = 0.031), higher timed up and go
MON-P026 GERIATRIC ASSESSMENT AS A PREDICTOR OF POSTOPERATIVE COMPLICATIONS IN ELDERLY PATIENTS WITH HEPATOCELLULAR CARCINOMA M. Kaibori1, K. Matsui1, M. Ishizaki1, H. Iida1, F. Nagashima2. 1 Surgery, Kansai Medical University, Hirakata, 2Medical Oncology, Kyorin University School of Medicine, Mitaka, Japan Rationale: Older patients are considered to have increased risk for complications after major surgery, but age alone is not a reliable predictor of post-operative complications. However, no universal screening test adequately predicts postoperative complications in older patients. This prospective study recorded pertinent baseline geriatric assessment variables to identify risk factors for postoperative complications in hepatocellular carcinoma (HCC) for patients aged ≥70 years who undergo hepatectomy. Methods: We retrospectively analyzed 71 consecutive patients ≥70 years of age. Patients had geriatric assessments of baseline and later cognition, nutritional and functional status, and burden of comorbidities, completed preoperatively and at 1, 3, and 6 months postoperatively. Postoperative morbidities were recorded. Results: Postoperative morbidities developed in 18 patients (25%). Univariate analysis identified serum albumin, operating time and blood loss, cirrhosis, geriatric 8 (G8), and Mini Nutritional Assessment as possible risk factors for postoperative complications, but only G8 < 14 survived multivariate analysis as an independent predictor of complications. Conclusion: Our findings indicate that the G8 score, based on patients’ nutritional assessments, is a useful screening method for older HCC patients who qualify for elective liver resection. Preoperative G8 scores can help forecast postoperative complications in older HCC patients. Future studies with larger numbers of patients, limited to HCC and liver resections, are needed to verify our results. Disclosure of Interest: None declared
MON-P027 NUTRITIONDAY IN NURSING HOMES – WHICH VARIABLES ARE PREDICTORS OF A SIGNIFICANT WEIGHT LOSS WITHIN 6 MONTHS? M. Streicher1, K. Schindler2, C. C. Sieber1, M. Hiesmayr2, D. Volkert1, A. T. N. team3. 1Friedrich-Alexander-Universität Erlangen-Nürnberg, Institute for Biomedicine of Aging, Nuremberg, Germany; 2Medical University of Vienna, 3 NutritionDay worldwide, Vienna, Austria Rationale: Unintended weight loss reflects malnutrition and is associated with a negative outcome. The aim of this analysis was to determine which indicators are predictive of a significant weight loss (WL) within 6 months in nursing home (NH) residents. Methods: NH residents participating in the nutritionDay (nD) between 2007 and 2014, aged ≥65 years, with data on body
S163 weight after 6 months and complete baseline data on 29 variables were included (n = 6,903). Unit characteristics (2 variables), resident characteristics (18), residents’ nutritional status (3) and nutrition (5) at baseline, and number of days in hospital during follow-up (1) were of interest as potential predictors of WL ≥ 10% (no vs yes). Changes in body weight were calculated from baseline and outcome data. Univariate generalized estimating equation (GEE) analyses were performed for all variables, and significant predictors ( p < 0.01) included in a multivariate model. Results: 9.7% had a WL ≥ 10%. 11 variables were identified as predictors and thereof 5 variables remained in the multivariate model (aROC = 0.661, p < 0.001). Odds ratios (OR [95% CI]) of a WL were 2.36 [1.85–3.01] and 3.61 [2.63–4.94] times higher for residents who stayed 4–13 and ≥14 days in a hospital during follow-up compared to residents without hospital admission. Residents with reduced food intake at lunch on nD (“a quarter” (2.19 [1.63–2.94]) or “nothing” (2.60 [1.72–3.92]) vs “all”), severely impaired cognition (1.75 [1.34–2.27]), WL >5 kg in the year before nD (1.44 [1.15–1.80]), and female residents (1.44 [1.10–1.88]) had a higher risk of WL. Conclusion: In NH residents participating in the nutritionDay, hospital stay, reduced food intake at lunch, impaired cognition, weight loss prior to nD, and being female is predictive of a significant weight loss within 6 months. Disclosure of Interest: None declared
MON-P028 IS THE ESPEN DEFINITION FOR MALNUTRITION ASSOCIATED WITH CLINICALLY RELEVANT OUTCOME MEASURES IN GERIATRIC OUTPATIENTS? N. M. van Rijssen1, A. G. Rojer1, M. C. Trappenburg1, E. M. Reijnierse1, C. G. Meskers2, A. B. Maier3, M. A. de van der Schueren4. 1Department of Internal Medicine, Section Gerontology and Geriatrics, 2Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, Netherlands; 3Department of Medicine and Aged Care, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia; 4Department of Internal Medicine, Section Nutrition and Dietetics, VU University Medical Center, Amsterdam, Netherlands Rationale: A body of evidence is supporting the association between malnutrition and physical performance and cognitive status in geriatric outpatients. The associations between the newly proposed ESPEN definition for malnutrition and these clinically relevant outcome measures have not been studied yet. Therefore, this study aims to examine the association between the ESPEN definition for malnutrition and clinically relevant outcome measures in geriatric outpatients. Methods: Associations between malnutrition according to the ESPEN definition for malnutrition and handgrip strength (kg), timed up and go test (seconds), Short Physical Performance Battery (SPPB, score 0–12), history of falls (yes/no) and a low score on the Mini Mental-State Examination (MMSE score ≤24)) were analysed using multivariate linear regression and logistic regression adjusted for age and gender. Results: 185 geriatric outpatients (40% male) with a mean age of 82 years (±7.3) were included. Being malnourished according to the ESPEN definition (8.2%) was associated with a lower handgrip strength (−3.38 kg, p = 0.031), higher timed up and go