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OP018 ASSOCIATION BETWEEN OROPHARYNGEAL DYSPHAGIA AND MALNUTRITION IN ELDERLY PATIENTS WITH ACUTE DISEASES ADMITTED TO A GENERAL HOSPITAL
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Oral presentations
concentrations. Therefore, a protein-energy enriched formula may be an effective and safe tool to improve arginine availability in critically ill children.
OP019 THE DECREASE OF ENERGY EXPENDITURE WITH AGEING IS NOT ONLY RELATED TO LOSS OF BODY CELL MASS
References
L. Genton1 , V.L. Karsegard1 , U.G. Kyle2 , C. Pichard1 . 1 Clinical Nutrition, University Hospital, Geneva, Switzerland; 2 Pediatric Critical Care Medicine, Baylor College of Medicine/Texas Children’s Hospital, Houston, Texas, United States
[1] van Waardenburg DA, de Betue CT, et al. Plasma arginine and citrulline concentrations in critically ill children: strong relation with inflammation. Am J Clin Nutr 2007; 86(5): 1438 44. Disclosure of Interest: None Declared.
ESPEN Best Abstracts 2012 & ESPEN Travel Awards OP018 ASSOCIATION BETWEEN OROPHARYNGEAL DYSPHAGIA AND MALNUTRITION IN ELDERLY PATIENTS WITH ACUTE DISEASES ADMITTED TO A GENERAL HOSPITAL S. Carri´ on1 , M. Cabr´ e2 , R. Monteis2 , M. Roca3 , 4 e1 . 1 Functional Gastrointestinal E. Palomera , P. Clav´ 2 Unit, Acute Geriatric Unit, 3 Dietetic Service, 4 Research Unit, Hospital de Matar´ o, Matar´ o, Barcelona, Spain Rationale: To determine the relationship between oropharyngeal dysphagia (OD), nutritional status and clinical outcome in elderly patients with acute diseases admitted to a general hospital. Methods: Prospective observational study of 1662 patients over 70 years of age consecutively hospitalized in an acute geriatric unit (AGU) in a general hospital. Dysphagia was clinically assessed with the volumeviscosity swallow test (V-VST) and nutritional status with the Mini Nutritional Assessment. Other measurements taken during admission were anthropometry and laboratory values, comorbidities (Charlson index), cognitive status (Pfeiffer) and functional capacity (Barthel index). Mortality during admission, referral to nursing homes and mortality at 12 months after discharge were also monitored. Results: Up to 52.6% patients admitted to the AGU presented clinical signs of OD and a) more comorbidities (2.42+1.6 vs 2.02+1.6 p < 0.001), poorer functionality both pre-admission and at discharge (p < 0.001), more geriatric syndromes (93.3% vs 72.5% p < 0.001) and poorer outcome (1 year mortality 48.7 vs 25.1%) (p < 0.001) and b) higher prevalence of malnutrition (MNA < 17 45.3% vs 18%, p < 0.001; BMI 25.5 vs 26.8, p < 0.001) and albumin <3 g/dl (62.9% vs 37.1%, p < 0.001). Regardless of their functional status and comorbidities, elderly patients with OD were at increased risk of malnutrition (OR 2.31 (1.70 3.14)), referral to nursing homes (OR 1.57 (1.12 2.19)) and increased mortality one year after discharge (OR 1.91 (1.48 2.46)). Conclusion: Oropharyngeal dysphagia is a very prevalent disease among elderly patients with acute diseases admitted to a general hospital, and is closely related to high prevalence of malnutrition and poor outcome. Disclosure of Interest: None Declared.
Rationale: We have previously shown that resting energy expenditure (REE) adjusted for lean body mass (LBM) and body cell mass (BCM) was higher in elderly women than men [1]. However, we ignore the evolution of REE adjusted for lean components. This study aims at describing the evolution over three years of REE normalized for lean components. Methods: During a 3h session, 118 healthy elderly community-dwelling subjects, recruited through advertisement, underwent measurements of REE by indirect calorimetry (fasting, 30 min at rest, Deltatrac II® , Finland), LBM by dual-energy x-ray absorptiometry (Discovery® , Hologic) and BCM by whole-body 40 K counting. These measurements were repeated three years later in all subjects who accepted to participate and were healthy enough to come to the outpatient clinic. Comparisons between time-points were performed with paired t-tests. Results: Follow-up was available for 28 women and 34 men (mean age at baseline 78.4±5.7 yrs). Weight was stable during follow-up in women (65.1±10.6 vs. 63.8±11.1 kg, p = 0.09) and men (75.5±10.2 vs. 74.5±11.1 kg/m2 , p = 0.19). Women
REE (kcal) BCM (kg) LBM (kg) REE/BCM (kcal/kg) REE/LBM (kcal/kg)
Men
Baseline
Follow-up
Baseline
Follow-up
1223±156 18.5±2.4 42.5±4.5 67.5±14.2 28.8±2.8
1165±164* 17.8±3.6 41.9±4.7* 63.4±8.7 27.8±1.9*
1498±211 25.0±4.2 56.5±6.4 57.9±9.8 26.5±2.8
1423±193* 25.7±3.7 55.3±6.6* 56.0±8.8 25.8±2.8
*p < 0.05 (paired t-test).
REE and LBM decreased significantly with age in both genders. When adjusting REE for lean components, REE still tended to decrease in both genders, but the decrease was significant only for REE/LBM in women (p = 0.02). Conclusion: REE adjusted for lean components tended to decrease with ageing in both genders. This suggests that the significant decrease of REE with ageing is not related only to loss of BCM or LBM. References [1] V.L. Karsegard et al. Clin Nutr, OP039, 2011. Disclosure of Interest: None Declared.
Oral presentations
concentrations. Therefore, a protein-energy enriched formula may be an effective and safe tool to improve arginine availability in critically ill children.
OP019 THE DECREASE OF ENERGY EXPENDITURE WITH AGEING IS NOT ONLY RELATED TO LOSS OF BODY CELL MASS
References
L. Genton1 , V.L. Karsegard1 , U.G. Kyle2 , C. Pichard1 . 1 Clinical Nutrition, University Hospital, Geneva, Switzerland; 2 Pediatric Critical Care Medicine, Baylor College of Medicine/Texas Children’s Hospital, Houston, Texas, United States
[1] van Waardenburg DA, de Betue CT, et al. Plasma arginine and citrulline concentrations in critically ill children: strong relation with inflammation. Am J Clin Nutr 2007; 86(5): 1438 44. Disclosure of Interest: None Declared.
ESPEN Best Abstracts 2012 & ESPEN Travel Awards OP018 ASSOCIATION BETWEEN OROPHARYNGEAL DYSPHAGIA AND MALNUTRITION IN ELDERLY PATIENTS WITH ACUTE DISEASES ADMITTED TO A GENERAL HOSPITAL S. Carri´ on1 , M. Cabr´ e2 , R. Monteis2 , M. Roca3 , 4 e1 . 1 Functional Gastrointestinal E. Palomera , P. Clav´ 2 Unit, Acute Geriatric Unit, 3 Dietetic Service, 4 Research Unit, Hospital de Matar´ o, Matar´ o, Barcelona, Spain Rationale: To determine the relationship between oropharyngeal dysphagia (OD), nutritional status and clinical outcome in elderly patients with acute diseases admitted to a general hospital. Methods: Prospective observational study of 1662 patients over 70 years of age consecutively hospitalized in an acute geriatric unit (AGU) in a general hospital. Dysphagia was clinically assessed with the volumeviscosity swallow test (V-VST) and nutritional status with the Mini Nutritional Assessment. Other measurements taken during admission were anthropometry and laboratory values, comorbidities (Charlson index), cognitive status (Pfeiffer) and functional capacity (Barthel index). Mortality during admission, referral to nursing homes and mortality at 12 months after discharge were also monitored. Results: Up to 52.6% patients admitted to the AGU presented clinical signs of OD and a) more comorbidities (2.42+1.6 vs 2.02+1.6 p < 0.001), poorer functionality both pre-admission and at discharge (p < 0.001), more geriatric syndromes (93.3% vs 72.5% p < 0.001) and poorer outcome (1 year mortality 48.7 vs 25.1%) (p < 0.001) and b) higher prevalence of malnutrition (MNA < 17 45.3% vs 18%, p < 0.001; BMI 25.5 vs 26.8, p < 0.001) and albumin <3 g/dl (62.9% vs 37.1%, p < 0.001). Regardless of their functional status and comorbidities, elderly patients with OD were at increased risk of malnutrition (OR 2.31 (1.70 3.14)), referral to nursing homes (OR 1.57 (1.12 2.19)) and increased mortality one year after discharge (OR 1.91 (1.48 2.46)). Conclusion: Oropharyngeal dysphagia is a very prevalent disease among elderly patients with acute diseases admitted to a general hospital, and is closely related to high prevalence of malnutrition and poor outcome. Disclosure of Interest: None Declared.
Rationale: We have previously shown that resting energy expenditure (REE) adjusted for lean body mass (LBM) and body cell mass (BCM) was higher in elderly women than men [1]. However, we ignore the evolution of REE adjusted for lean components. This study aims at describing the evolution over three years of REE normalized for lean components. Methods: During a 3h session, 118 healthy elderly community-dwelling subjects, recruited through advertisement, underwent measurements of REE by indirect calorimetry (fasting, 30 min at rest, Deltatrac II® , Finland), LBM by dual-energy x-ray absorptiometry (Discovery® , Hologic) and BCM by whole-body 40 K counting. These measurements were repeated three years later in all subjects who accepted to participate and were healthy enough to come to the outpatient clinic. Comparisons between time-points were performed with paired t-tests. Results: Follow-up was available for 28 women and 34 men (mean age at baseline 78.4±5.7 yrs). Weight was stable during follow-up in women (65.1±10.6 vs. 63.8±11.1 kg, p = 0.09) and men (75.5±10.2 vs. 74.5±11.1 kg/m2 , p = 0.19). Women
REE (kcal) BCM (kg) LBM (kg) REE/BCM (kcal/kg) REE/LBM (kcal/kg)
Men
Baseline
Follow-up
Baseline
Follow-up
1223±156 18.5±2.4 42.5±4.5 67.5±14.2 28.8±2.8
1165±164* 17.8±3.6 41.9±4.7* 63.4±8.7 27.8±1.9*
1498±211 25.0±4.2 56.5±6.4 57.9±9.8 26.5±2.8
1423±193* 25.7±3.7 55.3±6.6* 56.0±8.8 25.8±2.8
*p < 0.05 (paired t-test).
REE and LBM decreased significantly with age in both genders. When adjusting REE for lean components, REE still tended to decrease in both genders, but the decrease was significant only for REE/LBM in women (p = 0.02). Conclusion: REE adjusted for lean components tended to decrease with ageing in both genders. This suggests that the significant decrease of REE with ageing is not related only to loss of BCM or LBM. References [1] V.L. Karsegard et al. Clin Nutr, OP039, 2011. Disclosure of Interest: None Declared.