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PP097-MON DEVELOPMENT OF A NEW NUTRITION SCREENING TOOL IN AN ACUTE CARE HOSPITAL
176 collected once a day. Xylitol was assessed photometrically using a xylitol test kit. Serum levels of liver enzymes, bilirubin and lactate were documented if available. Blood glucose levels, insulin requirement and the necessity of dialysis were reported daily. The control group was designed retrospectively and consisted of the last 67 patients who received PN without xylitol. Statistical analyzes were done using SPSS 19. Results: We established a suitable procedure to determine xylitol in serum in vitro. The measured xylitol levels remained low with a mean value of 4.1±3.7 mg/dl. Already one day after PN was finished or interrupted the xylitol serum levels decreased nearly to baseline values. There were significant differences (p < 0.005) in the insulin requirement between the two groups. The mean values were 39.8±39.7 IU and 60.3±38.7 IU in the verum and control group, respectively. Furthermore, no harmful secondary effects of PN containing xylitol were observed with respect to hepatic and renal function. Conclusion: In the study, no accumulation of xylitol was observed in human serum under PN. The application of PN with xylitol had no adverse effects and was associated with a reduced insulin requirement. Disclosure of Interest: A. Schettler Grant/Research Support from: from B.Braun Comp., Melsungen, Germany, A. Markowski Grant/Research Support from: from B.Braun Comp., Melsungen, Germany, A. Schneider Grant/Research Support from: from B.Braun Comp., Melsungen, Germany, Paid instructor of: from B.Braun Comp., Melsungen, Germany, M. Momma Grant/Research Support from: from B.Braun Comp., Melsungen, Germany, M. Wilhelmi Grant/Research Support from: from B.Braun Comp., Melsungen, Germany.
PP096-MON DO WE MEET THE NUTRITIONAL GOALS FOR INPATIENTS? RESULTS FROM A ONE-DAY SURVEY AT UPPSALA UNIVERSITY HOSPITAL ˚ kerlind3 , S. Wegener1 , M. Sundberg Hjelm2 , L. A 4 5 1 K. Wahlroth , S. Rodebjer . Clinical Nutrition, University hospital, 751 85 Uppsala, 2 Clinical Nutrition, University hospital, Uppsala, 3 Avd 40 B, University Hospital, Uppsala, 4 University Hospital, 751 85 Uppsala, 5 Enk¨ opings Lasarett, Enk¨ oping, Sweden Rationale: In 2010, goals for nutrition were established at the hospital. The goals should be measurable and reachable. A one-day survey was performed, to see at what extent these nutritional goals are reached. Methods: Nutritional goals were: energy intake should reach the level of 75% of estimated energy requirement in 70% of the patients. Screening for nutritional status should have been performed in 50% of the patients. At least 70% of the patients classified as having a risk for malnutrition or as malnourished should have a care plan for nutrition. Criterion for exclusion was: fasting, due to surgery or medical examination. Energy requirement were estimated by using 30 kcal/kgbdw/d for persons <70year, and 25 kcal/kgbdw/d for them aged 70 years. In obese patients, the weight corresponding to BMI 30 were used. Eating problems, undesirable weight changes, and BMI out of normal reference interval, were the criterions used for screening of malnutrition. To set risk for malnutrition two out of three had to be positive.
Poster presentations Results: Data from 505 patients and 46 units (3 missing) were collected. Energy intake: 49% of the patients reached the goal, compared to 57% the year before. Screening for malnutrition; 53%. Risk for malnutrition or malnourished: 25%. Eating problems: 35%. Undesirable weight change: 16%. BMI out of normal range: 34%. Care plan for nutrition: 25%, which meet the standard if it is the same individuals that are classified at risk who has a care plan. Conclusion: Only 49% of the inpatients reached the level of 75% of their calculated energy need, which is far from the goal of75%. One third had eating problems. The goal of screening for malnutrition was reached. There has been no improvement between the last years. Coming closer to the aim of energy intake, probably means tremendous effort in working with education and routines at hospital. Disclosure of Interest: None Declared.
PP097-MON DEVELOPMENT OF A NEW NUTRITION SCREENING TOOL IN AN ACUTE CARE HOSPITAL H. Lee1 , H.J. Shim2 , S.H. Kim3 , J.Y. Jang2 , J.G. Lee2 . 1 Nutrition and Dietetics, Severance Hospital, Yonsei Universtiy Health System, 2 Surgery, Yonsei University College of Medicine, 3 Pharmacy, Severance Hospital, Yonsei Universtiy Health System, Seoul, Korea, Republic Of Rationale: It is important to screen the nutritional risk and start nutritional intervention early in hospitalized patients. This study was the first project in the quality improvement of nutritional care process in an acute care hospital with capacity of 2,000 beds. Methods: This study was prospectively conducted in two steps: 1) Evaluation of the current nutrition screening tool including the percentage of current weight to ideal body weight, plasma albumin concentration and the severity of disease as variables, and 2) development of a new nutritional screening tool. Four-hundred eighty three patients (274 men, 209 female, aged 59.0±12.2 years) were examined to evaluate the efficacy of the current nutrition screening tool. As the second step, nutritional status of 387 patients (215 men, 172 female, aged 57.5±13.3 years) was assessed by the scored PG-SGA. Variables including age, body mass index (BMI), plasma albumin concentration, weight change, oral intake change and disease severity were analyzed to select indices for developing a new Severance nutrition screening index (SNSI). Sensitivities and specificities of the SNSI were calculated using the PG-SGA as a gold standard. Results: The current nutrition screening tool had a poor agreement with the PG-SGA (k = 0.18, p < 0.0001). The SNSI was calculated as follows: SNSI = 1.5 × albumin + 1.0 × BMI + 4.5 × intake change + 1.5 × weight loss (for albumin <3.0, BMI < 20, decreased intake and weight loss >5% of usual body weight). The SNSI had a sensitivity of 91.4% and a specificity of 82.2%, and high agreement (k = 0.70, P < 0.0001) with the PG-SGA. Conclusion: The SNSI appears to be a valid nutrition screening tool for determining the nutritional risk for patients in acute care hospitals. Disclosure of Interest: None Declared.
PP096-MON DO WE MEET THE NUTRITIONAL GOALS FOR INPATIENTS? RESULTS FROM A ONE-DAY SURVEY AT UPPSALA UNIVERSITY HOSPITAL ˚ kerlind3 , S. Wegener1 , M. Sundberg Hjelm2 , L. A 4 5 1 K. Wahlroth , S. Rodebjer . Clinical Nutrition, University hospital, 751 85 Uppsala, 2 Clinical Nutrition, University hospital, Uppsala, 3 Avd 40 B, University Hospital, Uppsala, 4 University Hospital, 751 85 Uppsala, 5 Enk¨ opings Lasarett, Enk¨ oping, Sweden Rationale: In 2010, goals for nutrition were established at the hospital. The goals should be measurable and reachable. A one-day survey was performed, to see at what extent these nutritional goals are reached. Methods: Nutritional goals were: energy intake should reach the level of 75% of estimated energy requirement in 70% of the patients. Screening for nutritional status should have been performed in 50% of the patients. At least 70% of the patients classified as having a risk for malnutrition or as malnourished should have a care plan for nutrition. Criterion for exclusion was: fasting, due to surgery or medical examination. Energy requirement were estimated by using 30 kcal/kgbdw/d for persons <70year, and 25 kcal/kgbdw/d for them aged 70 years. In obese patients, the weight corresponding to BMI 30 were used. Eating problems, undesirable weight changes, and BMI out of normal reference interval, were the criterions used for screening of malnutrition. To set risk for malnutrition two out of three had to be positive.
Poster presentations Results: Data from 505 patients and 46 units (3 missing) were collected. Energy intake: 49% of the patients reached the goal, compared to 57% the year before. Screening for malnutrition; 53%. Risk for malnutrition or malnourished: 25%. Eating problems: 35%. Undesirable weight change: 16%. BMI out of normal range: 34%. Care plan for nutrition: 25%, which meet the standard if it is the same individuals that are classified at risk who has a care plan. Conclusion: Only 49% of the inpatients reached the level of 75% of their calculated energy need, which is far from the goal of75%. One third had eating problems. The goal of screening for malnutrition was reached. There has been no improvement between the last years. Coming closer to the aim of energy intake, probably means tremendous effort in working with education and routines at hospital. Disclosure of Interest: None Declared.
PP097-MON DEVELOPMENT OF A NEW NUTRITION SCREENING TOOL IN AN ACUTE CARE HOSPITAL H. Lee1 , H.J. Shim2 , S.H. Kim3 , J.Y. Jang2 , J.G. Lee2 . 1 Nutrition and Dietetics, Severance Hospital, Yonsei Universtiy Health System, 2 Surgery, Yonsei University College of Medicine, 3 Pharmacy, Severance Hospital, Yonsei Universtiy Health System, Seoul, Korea, Republic Of Rationale: It is important to screen the nutritional risk and start nutritional intervention early in hospitalized patients. This study was the first project in the quality improvement of nutritional care process in an acute care hospital with capacity of 2,000 beds. Methods: This study was prospectively conducted in two steps: 1) Evaluation of the current nutrition screening tool including the percentage of current weight to ideal body weight, plasma albumin concentration and the severity of disease as variables, and 2) development of a new nutritional screening tool. Four-hundred eighty three patients (274 men, 209 female, aged 59.0±12.2 years) were examined to evaluate the efficacy of the current nutrition screening tool. As the second step, nutritional status of 387 patients (215 men, 172 female, aged 57.5±13.3 years) was assessed by the scored PG-SGA. Variables including age, body mass index (BMI), plasma albumin concentration, weight change, oral intake change and disease severity were analyzed to select indices for developing a new Severance nutrition screening index (SNSI). Sensitivities and specificities of the SNSI were calculated using the PG-SGA as a gold standard. Results: The current nutrition screening tool had a poor agreement with the PG-SGA (k = 0.18, p < 0.0001). The SNSI was calculated as follows: SNSI = 1.5 × albumin + 1.0 × BMI + 4.5 × intake change + 1.5 × weight loss (for albumin <3.0, BMI < 20, decreased intake and weight loss >5% of usual body weight). The SNSI had a sensitivity of 91.4% and a specificity of 82.2%, and high agreement (k = 0.70, P < 0.0001) with the PG-SGA. Conclusion: The SNSI appears to be a valid nutrition screening tool for determining the nutritional risk for patients in acute care hospitals. Disclosure of Interest: None Declared.