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PP064-SUN EFFECTS OF NUTRITIONAL INTERVENTION ON IMMUNE MARKERS IN MALNOURISHED ELDERLY
Geriatrics I
51
for supra-iliac skin fold thickness remained statistically significant. Baseline Energy (kcal) I 1268 (67) C 1304 (65) Weight (kg) I 69.1 (1.4) C 67.6 (1.5)
1 week
3 months
6 months
I 1703 (60) C 1488 (50)
I 1699 (58) C 1602 (61) I 70.4 (1.4) C 67.3 (1.5)
I 1763 (66) C 1762 (72) I 70.6 (1.5) C 67.9 (1.5)
Conclusion: Intensive dietetic counselling and ONS for 3 months improved nutritional intake of both macro- and micronutrients, and induced weight gain in elderly subjects after hip fracture. Disclosure of Interest: None Declared.
PP064-SUN EFFECTS OF NUTRITIONAL INTERVENTION ON IMMUNE MARKERS IN MALNOURISHED ELDERLY F. Neelemaat1 , M.A. van Bokhorst-de van der Schueren1 , H.J. Bontkes2 , J.C. Seidell3 , S. Hougee4 , A. Thijs5 . 1 Nutrition and Dietetics/Internal Medicine, 2 Pathology, Unit Medical Immunology, VU University Medical Center, 3 Health Sciences, Faculty of Earth and Life Sciences, VU University, Amsterdam, 4 Nutricia Advanced Medical Nutrition, Danone Research, Centre for Specialised Nutrition, Wageningen, 5 Internal Medicine, VU University Medical Center, Amsterdam, Netherlands Rationale: Both malnutrition and advanced age are known to negatively impact the immune system. This exploratory randomized controlled trial studied the effects of a composed nutritional intervention on immune markers, endocrine markers and a selection of micronutrients in malnourished ill elderly patients. Methods: Malnourished elderly patients (>60) newly admitted to a university medical center were randomised to receive either usual care plus a nutritional intervention (energy and protein enriched diet, comprising oral nutritional support, calcium-vitamin D supplement, dietetary counselling) commencing in the hospital and continued for 3 months post-discharge or usual care alone. Immune markers (interleukins, complement, C-reactive protein, albumin, TNF-a), endocrine markers (growth factors) and micronutrients (iron, ferritin, vitamin A, E and D), were measured at baseline and at 3 months following hospital discharge. Results: 210 patients were included in this study. For 89 patients (46 intervention, 43 control) both measurements were available. This selection of patients were in a better health status compared to the total group. At baseline, most of the analysed immune markers, endocrine markers and micronutrients showed values within the normal range, with no statistically significant differences between groups. The majority of immune markers, endocrine markers and micronutrients tended to improve over time, without statistically significant differences between groups, except for vitamin D (p = 0.008), confirming the supplementation in the intervention group. Conclusion: A 3 months nutritional intervention in malnourished ill elderly patients could not demonstrate measurable additional influence on measured immune markers, endocrine markers and selected micronutrients
at three months compared to baseline. The improved outcomes were presumably caused by patients’ improved health status during time. Disclosure of Interest: F. Neelemaat: None Declared, M. van Bokhorst-de van der Schueren: None Declared, H. Bontkes: None Declared, J. Seidell: None Declared, S. Hougee Other: SH is an employee of Danone Research, A. Thijs: None Declared.
PP065-SUN EFFECT OF NUTRITIONAL INTERVENTION ON LENGTH OF STAY, POSTOPERATIVE COMPLICATIONS, FUNCTIONAL STATUS AND MORTALITY IN HIP FRACTURE PATIENTS: A MULTI-CENTRE RANDOMISED CONTROLLED TRIAL (RCT) C.E. Wyers1 , P.L. Reijven2 , J.J. Breedveld-Peters1 , S. van Helden3 , M. Schotanus4 , B. Meesters5 , M.C. van Dongen1 , P.A. van den Brandt1 , P.C. Willems6 , P.C. Dagnelie1 . 1 Epidemiology, Maastricht University, 2 Dietetics, 3 Trauma Surgery, Maastricht University Medical Centre, Maastricht, 4 Orthopaedic Surgery, Orbis Mecial Centre, Sittard, 5 Surgery, Atrium Medical Centre, Heerlen, 6 Orthopaedic Surgery, Maastricht University Medical Centre, Maastricht, Netherlands Rationale: Hip fractures have a high burden on health care resources and as a consequence high health care costs. Our aim was to assess whether nutritional intervention in elderly hip fracture patients reduces length of stay, postoperative complications, and one-year mortality rate, and improves functional status and quality of life. Methods: Design: multi-centre RCT. Patients in the intervention group received nutritional intervention comprising intensive dietetic counselling (10 face-to-face contacts and/or telephone calls) and oral nutritional supplements (ONS) for 3 months. Patients in the control group received usual dietetic care. Primary outcome measure was total length of stay in hospital and rehabilitation clinic. Secondary outcome measures were functional, mental and cognitive status, quality of life and complications over 6 months post-surgery and one-year mortality. Data were analysed according to intention-to-treat, by Cox proportional hazards analysis or linear/logistic regression analysis as appropriate. Results: Of 152 patients enrolled, 73 were randomised to the intervention group and 79 to the control group. Median total length of stay was 36 (4 185) days in intervention group vs. 38 (3 183) days in control group (p = 0.85). In hospital and in rehabilitation clinic separately length of stay was also comparable in both groups. No significant effect of nutritional intervention on secondary outcomes at 3 and 6 months postoperatively was detected. Conclusion: Intensive nutritional intervention comprising intensive dietetic counselling and ONS for 3 months after hip fracture did not influence length of stay, postoperative complication rate, functional, mental, and cognitive status, quality of life, or one-year mortality. Disclosure of Interest: None Declared.
51
for supra-iliac skin fold thickness remained statistically significant. Baseline Energy (kcal) I 1268 (67) C 1304 (65) Weight (kg) I 69.1 (1.4) C 67.6 (1.5)
1 week
3 months
6 months
I 1703 (60) C 1488 (50)
I 1699 (58) C 1602 (61) I 70.4 (1.4) C 67.3 (1.5)
I 1763 (66) C 1762 (72) I 70.6 (1.5) C 67.9 (1.5)
Conclusion: Intensive dietetic counselling and ONS for 3 months improved nutritional intake of both macro- and micronutrients, and induced weight gain in elderly subjects after hip fracture. Disclosure of Interest: None Declared.
PP064-SUN EFFECTS OF NUTRITIONAL INTERVENTION ON IMMUNE MARKERS IN MALNOURISHED ELDERLY F. Neelemaat1 , M.A. van Bokhorst-de van der Schueren1 , H.J. Bontkes2 , J.C. Seidell3 , S. Hougee4 , A. Thijs5 . 1 Nutrition and Dietetics/Internal Medicine, 2 Pathology, Unit Medical Immunology, VU University Medical Center, 3 Health Sciences, Faculty of Earth and Life Sciences, VU University, Amsterdam, 4 Nutricia Advanced Medical Nutrition, Danone Research, Centre for Specialised Nutrition, Wageningen, 5 Internal Medicine, VU University Medical Center, Amsterdam, Netherlands Rationale: Both malnutrition and advanced age are known to negatively impact the immune system. This exploratory randomized controlled trial studied the effects of a composed nutritional intervention on immune markers, endocrine markers and a selection of micronutrients in malnourished ill elderly patients. Methods: Malnourished elderly patients (>60) newly admitted to a university medical center were randomised to receive either usual care plus a nutritional intervention (energy and protein enriched diet, comprising oral nutritional support, calcium-vitamin D supplement, dietetary counselling) commencing in the hospital and continued for 3 months post-discharge or usual care alone. Immune markers (interleukins, complement, C-reactive protein, albumin, TNF-a), endocrine markers (growth factors) and micronutrients (iron, ferritin, vitamin A, E and D), were measured at baseline and at 3 months following hospital discharge. Results: 210 patients were included in this study. For 89 patients (46 intervention, 43 control) both measurements were available. This selection of patients were in a better health status compared to the total group. At baseline, most of the analysed immune markers, endocrine markers and micronutrients showed values within the normal range, with no statistically significant differences between groups. The majority of immune markers, endocrine markers and micronutrients tended to improve over time, without statistically significant differences between groups, except for vitamin D (p = 0.008), confirming the supplementation in the intervention group. Conclusion: A 3 months nutritional intervention in malnourished ill elderly patients could not demonstrate measurable additional influence on measured immune markers, endocrine markers and selected micronutrients
at three months compared to baseline. The improved outcomes were presumably caused by patients’ improved health status during time. Disclosure of Interest: F. Neelemaat: None Declared, M. van Bokhorst-de van der Schueren: None Declared, H. Bontkes: None Declared, J. Seidell: None Declared, S. Hougee Other: SH is an employee of Danone Research, A. Thijs: None Declared.
PP065-SUN EFFECT OF NUTRITIONAL INTERVENTION ON LENGTH OF STAY, POSTOPERATIVE COMPLICATIONS, FUNCTIONAL STATUS AND MORTALITY IN HIP FRACTURE PATIENTS: A MULTI-CENTRE RANDOMISED CONTROLLED TRIAL (RCT) C.E. Wyers1 , P.L. Reijven2 , J.J. Breedveld-Peters1 , S. van Helden3 , M. Schotanus4 , B. Meesters5 , M.C. van Dongen1 , P.A. van den Brandt1 , P.C. Willems6 , P.C. Dagnelie1 . 1 Epidemiology, Maastricht University, 2 Dietetics, 3 Trauma Surgery, Maastricht University Medical Centre, Maastricht, 4 Orthopaedic Surgery, Orbis Mecial Centre, Sittard, 5 Surgery, Atrium Medical Centre, Heerlen, 6 Orthopaedic Surgery, Maastricht University Medical Centre, Maastricht, Netherlands Rationale: Hip fractures have a high burden on health care resources and as a consequence high health care costs. Our aim was to assess whether nutritional intervention in elderly hip fracture patients reduces length of stay, postoperative complications, and one-year mortality rate, and improves functional status and quality of life. Methods: Design: multi-centre RCT. Patients in the intervention group received nutritional intervention comprising intensive dietetic counselling (10 face-to-face contacts and/or telephone calls) and oral nutritional supplements (ONS) for 3 months. Patients in the control group received usual dietetic care. Primary outcome measure was total length of stay in hospital and rehabilitation clinic. Secondary outcome measures were functional, mental and cognitive status, quality of life and complications over 6 months post-surgery and one-year mortality. Data were analysed according to intention-to-treat, by Cox proportional hazards analysis or linear/logistic regression analysis as appropriate. Results: Of 152 patients enrolled, 73 were randomised to the intervention group and 79 to the control group. Median total length of stay was 36 (4 185) days in intervention group vs. 38 (3 183) days in control group (p = 0.85). In hospital and in rehabilitation clinic separately length of stay was also comparable in both groups. No significant effect of nutritional intervention on secondary outcomes at 3 and 6 months postoperatively was detected. Conclusion: Intensive nutritional intervention comprising intensive dietetic counselling and ONS for 3 months after hip fracture did not influence length of stay, postoperative complication rate, functional, mental, and cognitive status, quality of life, or one-year mortality. Disclosure of Interest: None Declared.