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MON-PP015: Prognostic Value of the New Espen Diagnostic Criteria for Malnutrition on Overall Survival and Length of Hospital Stay
Poster tour 8: Techniques and formulations 2
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MON-PP015 Outstanding abstract PROGNOSTIC VALUE OF THE NEW ESPEN DIAGNOSTIC CRITERIA FOR MALNUTRITION ON OVERALL SURVIVAL AND LENGTH OF HOSPITAL STAY A.L. Rondel1 , J.A. Langius1,2 , M.A. de van der Schueren1,3 , H.M. Kruizenga1,4 . 1 Nutrition and Dietetics/Internal Medicine, VU University Medical Center, Amsterdam, 2 Faculty of Health, Nutrition and Sport, The Hague University of Applied Sciences, The Hague, 3 Department of Nutrition, Sports and Health, HAN University of Applied Sciences, Nijmegen, 4 Dutch Malnutrition Steering Group, Amsterdam, Netherlands Rationale: Recently, the European Society for Clinical Nutrition and Metabolism (ESPEN) presented new consensus criteria for the diagnosis of malnutrition [1]. The aim of this study was to investigate the association between the new ESPEN criteria for malnutrition and three-months, one-year and five-years overall survival and length of hospital stay (LOS). Methods: 335 hospitalized adult patients of the VU University Medical Center Amsterdam (60% female, age 58±18 y) were included. The ESPEN definition, which defined malnutrition as low BMI (<18.5 kg/m2 ) or a combination of unintentional weight loss, low FFMI (sex-specific cut-offs) and/or low BMI (age-specific) [1] was applied to all patients at the first day of admission. The association between malnutrition and overall survival (three-months, one-year and five-years) and LOS was analysed respectively by log rank tests and Cox regression, and linear regression analyses. In multivariate analyses, adjustments were made for gender and age. Results: According to the new ESPEN criteria, 49 patients (15%) were malnourished. Malnourished patients had significantly lower survival rates at all-time points than those not malnourished. (82%, 69%, 55% versus 96%, 90%, 72% for 3 months, 1 year and 5 years resp.; p < 0.01). After adjustment, malnutrition remained significantly associated with survival after three-months (HR:3.50, p = 0.01), oneyear (HR:2.42, p < 0.01) and five-years (HR:1.69, p < 0.04). Malnourished patients had a longer LOS of 1.28 days (p < 0.02). Conclusion: The new ESPEN diagnostic criteria for malnutrition have a good prognostic value for short term and long term overall survival and length of hospital stay. References [1] Cederholm T, et al. Diagnostic criteria for malnutrition Consensus Statement. Clin Nutr 2015; 34(3): 1 6.
Brazilians, using Air Displacement Plethysmography (ADP) as gold standard. Methods: Estimation of body FM by ADP, anthropometric measurements [height, abdominal (AC) and hip (HC) circumferences, weight and body mass index (BMI)] and calculation of BAI were performed in 144 Brazilian obese (108F/36M). Data were randomly divided in 2 distinct databases containing a same number of patients [Estimating databases (ED) and Validation databases (VD)], by using the function sample of R software. Data from ED served to develop a predictive model that was validated and tested using VD data. Additionally, this initial model was adjusted by gender and ethnicity as independent variables. Results: The final model obtained showed an improvement of 2.1% of the adjusted R2 and the effect of gender was significant, implying the design of two different formulas to calculate the new score: Female, FM = 48.8 + 0.087(AC) + 1.147(HC) 0.003[(HC)2 ]. Male, FM = 48.8 + 0.087(AC) + 1.147(HC) 0.003[(HC)2 ] 7.195. The Pearson correlation (0.72 vs 0.69 BAI), agreement of Lin (0.673 vs 0.551 for BAI) and IC ( 8.1 7.2 vs 7.5 14.8 BAI, with higher absolute average 0.4% vs 03.7% BAI) obtained from the new score were better than those from BAI. Finally, when we adjusted FM regression model by ADP according to the prediction of BAI and the prediction of the new score separately, their respective R2 were 45.1% vs 50.7%. Conclusion: The new Body Adiposity Score designed was superior to BAI to estimate FM in obese Brazilians. Disclosure of Interest: The authors have no conflicts of interest to declare. This study was approved by Ethical Committee of University of S˜ ao Paulo and Metanutri-Lim 35 support. Research supported by FAPESP 2011/09612-3 e Research Grant 2012/15677-3.
MON-PP017 Outstanding abstract PERFORMANCE OF BODY ADIPOSITY INDEX IN ESTIMATING FAT MASS IN A BRAZILIAN OBESE POPULATION G. Belarmino1 , L.M. Horie1 , P.C. Sala1 , R.S. Torrinhas1 , S. Heymsfield2 , D. Waitzberg1 . 1 Department of Gastroenterology, Surgical Division, University of S˜ ao Paulo, School of Medicine, S˜ ao Paulo, Brazil; 2 Pennington Biomedical Research Center, Pennington Biomedical Research Center, Baton Rouge, Louisiana, United States
an ESPEN
Disclosure of Interest: None declared
MON-PP016 Outstanding abstract DEVELOPMENT OF A NEW BODY ADIPOSITY SCORE FOR FAT MASS ESTIMATION IN BRAZILIAN OBESE POPULATION G. Belarmino1 , L.M. Horie1 , P.C. Sala1 , R.S. Torrinhas1 , S. Heymsfield2 , D. Waitzberg1 . 1 Department of Gastroenterology, Surgical Division, University of S˜ ao Paulo, School of Medicine, S˜ ao Paulo, Brazil; 2 Pennington Biomedical Research Center, Baton Rouge, Louisiana, United States Rationale: Recently, we found a weak performance of the current Body Adiposity Index (BAI) to estimate fat mass (FM) in Brazilian obese. The present study aimed to develop a new score, based on current BAI, to estimate FM in obese
Rationale: Recently, the Body Adiposity Index (BAI) was created to estimate body fat mass (FM) and showed a better performance than body mass index (BMI) for this purpose in Mexican-American and African-American populations. This study aimed to evaluate the performance of BAI in estimating FM in Brazilian obese, using Air Displacement Plethysmography (ADP) as gold standard. Methods: Estimation of body FM by ADP, anthropometric measurements (height, abdominal and hip circumferences, weight and BMI) and calculation of BAI were performed in 72 obese (53F/19M). The R 3.1.0 software and the ggplot2 package were used for the statistical treatment of the data. Results: The percentage value for fat mass obtained was 52.05±5.66 for ADP and 47.65±7.38 for BAI, with a correlation coefficient of 0.67 between them. For each studied variable (table) BAI introduced a systematic bias, where low values of FM tended to be underestimated by the regression model.
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MON-PP015 Outstanding abstract PROGNOSTIC VALUE OF THE NEW ESPEN DIAGNOSTIC CRITERIA FOR MALNUTRITION ON OVERALL SURVIVAL AND LENGTH OF HOSPITAL STAY A.L. Rondel1 , J.A. Langius1,2 , M.A. de van der Schueren1,3 , H.M. Kruizenga1,4 . 1 Nutrition and Dietetics/Internal Medicine, VU University Medical Center, Amsterdam, 2 Faculty of Health, Nutrition and Sport, The Hague University of Applied Sciences, The Hague, 3 Department of Nutrition, Sports and Health, HAN University of Applied Sciences, Nijmegen, 4 Dutch Malnutrition Steering Group, Amsterdam, Netherlands Rationale: Recently, the European Society for Clinical Nutrition and Metabolism (ESPEN) presented new consensus criteria for the diagnosis of malnutrition [1]. The aim of this study was to investigate the association between the new ESPEN criteria for malnutrition and three-months, one-year and five-years overall survival and length of hospital stay (LOS). Methods: 335 hospitalized adult patients of the VU University Medical Center Amsterdam (60% female, age 58±18 y) were included. The ESPEN definition, which defined malnutrition as low BMI (<18.5 kg/m2 ) or a combination of unintentional weight loss, low FFMI (sex-specific cut-offs) and/or low BMI (age-specific) [1] was applied to all patients at the first day of admission. The association between malnutrition and overall survival (three-months, one-year and five-years) and LOS was analysed respectively by log rank tests and Cox regression, and linear regression analyses. In multivariate analyses, adjustments were made for gender and age. Results: According to the new ESPEN criteria, 49 patients (15%) were malnourished. Malnourished patients had significantly lower survival rates at all-time points than those not malnourished. (82%, 69%, 55% versus 96%, 90%, 72% for 3 months, 1 year and 5 years resp.; p < 0.01). After adjustment, malnutrition remained significantly associated with survival after three-months (HR:3.50, p = 0.01), oneyear (HR:2.42, p < 0.01) and five-years (HR:1.69, p < 0.04). Malnourished patients had a longer LOS of 1.28 days (p < 0.02). Conclusion: The new ESPEN diagnostic criteria for malnutrition have a good prognostic value for short term and long term overall survival and length of hospital stay. References [1] Cederholm T, et al. Diagnostic criteria for malnutrition Consensus Statement. Clin Nutr 2015; 34(3): 1 6.
Brazilians, using Air Displacement Plethysmography (ADP) as gold standard. Methods: Estimation of body FM by ADP, anthropometric measurements [height, abdominal (AC) and hip (HC) circumferences, weight and body mass index (BMI)] and calculation of BAI were performed in 144 Brazilian obese (108F/36M). Data were randomly divided in 2 distinct databases containing a same number of patients [Estimating databases (ED) and Validation databases (VD)], by using the function sample of R software. Data from ED served to develop a predictive model that was validated and tested using VD data. Additionally, this initial model was adjusted by gender and ethnicity as independent variables. Results: The final model obtained showed an improvement of 2.1% of the adjusted R2 and the effect of gender was significant, implying the design of two different formulas to calculate the new score: Female, FM = 48.8 + 0.087(AC) + 1.147(HC) 0.003[(HC)2 ]. Male, FM = 48.8 + 0.087(AC) + 1.147(HC) 0.003[(HC)2 ] 7.195. The Pearson correlation (0.72 vs 0.69 BAI), agreement of Lin (0.673 vs 0.551 for BAI) and IC ( 8.1 7.2 vs 7.5 14.8 BAI, with higher absolute average 0.4% vs 03.7% BAI) obtained from the new score were better than those from BAI. Finally, when we adjusted FM regression model by ADP according to the prediction of BAI and the prediction of the new score separately, their respective R2 were 45.1% vs 50.7%. Conclusion: The new Body Adiposity Score designed was superior to BAI to estimate FM in obese Brazilians. Disclosure of Interest: The authors have no conflicts of interest to declare. This study was approved by Ethical Committee of University of S˜ ao Paulo and Metanutri-Lim 35 support. Research supported by FAPESP 2011/09612-3 e Research Grant 2012/15677-3.
MON-PP017 Outstanding abstract PERFORMANCE OF BODY ADIPOSITY INDEX IN ESTIMATING FAT MASS IN A BRAZILIAN OBESE POPULATION G. Belarmino1 , L.M. Horie1 , P.C. Sala1 , R.S. Torrinhas1 , S. Heymsfield2 , D. Waitzberg1 . 1 Department of Gastroenterology, Surgical Division, University of S˜ ao Paulo, School of Medicine, S˜ ao Paulo, Brazil; 2 Pennington Biomedical Research Center, Pennington Biomedical Research Center, Baton Rouge, Louisiana, United States
an ESPEN
Disclosure of Interest: None declared
MON-PP016 Outstanding abstract DEVELOPMENT OF A NEW BODY ADIPOSITY SCORE FOR FAT MASS ESTIMATION IN BRAZILIAN OBESE POPULATION G. Belarmino1 , L.M. Horie1 , P.C. Sala1 , R.S. Torrinhas1 , S. Heymsfield2 , D. Waitzberg1 . 1 Department of Gastroenterology, Surgical Division, University of S˜ ao Paulo, School of Medicine, S˜ ao Paulo, Brazil; 2 Pennington Biomedical Research Center, Baton Rouge, Louisiana, United States Rationale: Recently, we found a weak performance of the current Body Adiposity Index (BAI) to estimate fat mass (FM) in Brazilian obese. The present study aimed to develop a new score, based on current BAI, to estimate FM in obese
Rationale: Recently, the Body Adiposity Index (BAI) was created to estimate body fat mass (FM) and showed a better performance than body mass index (BMI) for this purpose in Mexican-American and African-American populations. This study aimed to evaluate the performance of BAI in estimating FM in Brazilian obese, using Air Displacement Plethysmography (ADP) as gold standard. Methods: Estimation of body FM by ADP, anthropometric measurements (height, abdominal and hip circumferences, weight and BMI) and calculation of BAI were performed in 72 obese (53F/19M). The R 3.1.0 software and the ggplot2 package were used for the statistical treatment of the data. Results: The percentage value for fat mass obtained was 52.05±5.66 for ADP and 47.65±7.38 for BAI, with a correlation coefficient of 0.67 between them. For each studied variable (table) BAI introduced a systematic bias, where low values of FM tended to be underestimated by the regression model.