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PP116-MON: Dietetic Consequences of Disability in Patients with Rheumatoid Arthritis
Nutrition and chronic diseases Clinical Practice guidelines for nutrition in Chronic renal failure, K/DOQI. Am J Kidney Dis; 35: s1 140 (2000). Disclosure of Interest: None Declared.
PP116-MON DIETETIC CONSEQUENCES OF DISABILITY IN PATIENTS WITH RHEUMATOID ARTHRITIS M. Cay´ on1 , R. Menor2 , C. García-Figueras3 . 1 Endocrinology and Nutrition Unit, 2 Rheumatology Unit, 3 Internal Medicine Unit, Hospital Sas de Jerez de la Frontera, Jerez de la Frontera, Spain Rationale: The potential impact that disability caused by rheumatoid arthritis (RA) has on nutritional aspects has not been analyzed. The aim of our study was to determine if dietetic habits are influenced by the degree of disability in these patients. Methods: Cross-sectional study. Frequency of food intake was measured using a validated questionnaire. Quality of intake was evaluated according to adherence to Mediterranean diet. The degree of dysfunction related to food intake was measured using items number 6, 7 and 8 from Health Assessment Questionnaire Spanish Modified (HAQ-20) Item Disability, that evaluate the abilities for “eating”. Each parameter is scored from 0 (no difficulty) to 3 (incapable). According this score, patients were divided in two groups: “low disability” if score was between 0 4 and “moderate-high disability” if 5 9. Results: We included 32 patients (71.9% females, mean age 57.1±14 years). “Moderate-high disability” was found in 18.7% patients. Adherence to Mediterranean diet was lower among patients with higher degree of disability (83.3% vs 34.6%; p = 0.04) mainly associated with a lower frequency of intake of fruits (50% vs 92.3%; p = 0.03) and vegetables (16.7% vs 61.5%; p = 0.04). Also, these patients recognized higher intake of fatty foods (66.7% vs 9.1%; p = 0.01). Although body mass index (BMI) and presence of obesity were higher in patients with higher disability, there were no significant differences between groups (BMI: 29.6±9.1 kgm2 vs 26.1±5.2 kgm2 ; prevalence of obesity: 40% vs 23.1%; p 0.05). Conclusion: A higher degree of disability leads to worse nutritional habits in patients with RA. A higher intake of fatty foods, usually hypercaloric and easier to prepare, was observed in patients with “moderate-high disability”. We consider that its consumption is used to compensate for potential lack of energy related to the disability for eating, with worse consequences on weight. Disclosure of Interest: None Declared.
PP117-MON BIOCHEMICAL PROFILE OF NUTRITIONAL STATUS AND PREVALENCE OF HYPOTIREOIDISM IN PATIENTS WITH HEART FAILURE L. Fernandes De Lima1 , J.R.D.S. Gentil1 , M.V. Sim˜ oes1 , 1 1 A.M. Navarro . Department of Clinical Medicine, University of S˜ ao Paulo, Ribeir˜ ao Preto, Brazil Rationale: Heart failure (HF) patients have metabolic and clinical alterations that may lead to thyroid dysfunction and worsen the patient’s prognosis. We aim to evaluate the prevalence of hypotireoidism and its associations with
S173 the biochemical profile of the nutritional status in patients with HF. Methods: We evaluated 75 patients with chronic and stable HF syndrome enrolled in the Heart Failure Clinic of the Hospital das Clínicas without taking thyroxin. The biochemical profile of nutritional status was assessed through albumin, total protein, C reactive protein, glucose, serum urea and creatinin and thyroid stimulating hormone (TSH). The hypothyroidism state was determined as TSH >4 mUI/mL and euthyroidism as TSH 0.4 4 mUI/ml. The variables were described as mean ± standard desviation and relative frequency. Student t test and Mann Whitney test were performed for comparisons of group means, and Fisher’s exact test was applied to analyse the heterogeneity of distribution of frequencies. The interval confidance was stablished at 95% for all analysis. Results: The mean age was 55±14 years old, 50% were men and 32% had functional class of NYHA III/IV. Hypothyroidism was identified in 22% (n = 17) of the patients. TSH levels were higher in hypothyroidism group compared to the group without hypothyroidism (5.6±2.5 mUI/ml and 2±0.9 mUI/ml, respectively, p < 0.001). No differences in albumin, total protein, C reactive protein, glucose, urea serum and creatinin were found between the groups. However, female was associated with an increased risk of hypothyroidism (p < 0.05; RR 3.34). Conclusion: Hypothyroidism was highly prevalent in patients with advanced heart failure and its presence was increased in female population. The thyroid dysfunction was not related to the biochemical profile of nutritional status in these HF patients. Disclosure of Interest: None Declared.
PP118-MON OUTCOME OF ENTEROCUTANEOUS FISTULAS REQUIRING PARENTERAL NUTRITION R.F. Mckee1 , S. Falconer2 , M. Quinn2 . 1 Surgery, 2 Glasgow Royal Infirmary, Glasgow, United Kingdom Rationale: Enterocutaneous fistula (ECF) remains a concerning diagnosis with a variable outcome. This study examined influences on outcome in patients requiring parenteral nutrition (PN) for ECF. Methods: ECF treated with PN in a single institution over 15 years were studied. Fistulas from oesophagus and colon were excluded. PN and patient data have been collected prospectively and extra data were culled from patient notes. Results: 286 ECF patients (M145:F141 median age 64 (20 96) years) had prior surgery in 232 and endoscopy in 6. 104 of 139 with disease proximal to the duodenal-jejunal (DJ) flexure closed without surgery compared to 52 of 147 with disease distal to the DJ flexure (chi-squared 44.8 p < 0.05). Median PN days in these patients were 21 (2 189) with only 16 patients PN days >60 and 8 patients PN days >90. Pre-op deaths in proximal disease (23) were similar to distal disease (24). 43 deaths were due to sepsis or multi-organ failure. 63 patients had operations (12 early for sepsis drainage or proximal stoma; 48 definitive; 5 both) with 3 deaths after early surgery (2 sepsis) and 4 deaths after definitive surgery (all sepsis). All 25 patients who were well enough to be discharged before definitive surgery [time interval to surgery 9 months (3 36); PN days 108 (30 1095); 11 on homePN] survived definitive surgery while 4 of 18 who
PP116-MON DIETETIC CONSEQUENCES OF DISABILITY IN PATIENTS WITH RHEUMATOID ARTHRITIS M. Cay´ on1 , R. Menor2 , C. García-Figueras3 . 1 Endocrinology and Nutrition Unit, 2 Rheumatology Unit, 3 Internal Medicine Unit, Hospital Sas de Jerez de la Frontera, Jerez de la Frontera, Spain Rationale: The potential impact that disability caused by rheumatoid arthritis (RA) has on nutritional aspects has not been analyzed. The aim of our study was to determine if dietetic habits are influenced by the degree of disability in these patients. Methods: Cross-sectional study. Frequency of food intake was measured using a validated questionnaire. Quality of intake was evaluated according to adherence to Mediterranean diet. The degree of dysfunction related to food intake was measured using items number 6, 7 and 8 from Health Assessment Questionnaire Spanish Modified (HAQ-20) Item Disability, that evaluate the abilities for “eating”. Each parameter is scored from 0 (no difficulty) to 3 (incapable). According this score, patients were divided in two groups: “low disability” if score was between 0 4 and “moderate-high disability” if 5 9. Results: We included 32 patients (71.9% females, mean age 57.1±14 years). “Moderate-high disability” was found in 18.7% patients. Adherence to Mediterranean diet was lower among patients with higher degree of disability (83.3% vs 34.6%; p = 0.04) mainly associated with a lower frequency of intake of fruits (50% vs 92.3%; p = 0.03) and vegetables (16.7% vs 61.5%; p = 0.04). Also, these patients recognized higher intake of fatty foods (66.7% vs 9.1%; p = 0.01). Although body mass index (BMI) and presence of obesity were higher in patients with higher disability, there were no significant differences between groups (BMI: 29.6±9.1 kgm2 vs 26.1±5.2 kgm2 ; prevalence of obesity: 40% vs 23.1%; p 0.05). Conclusion: A higher degree of disability leads to worse nutritional habits in patients with RA. A higher intake of fatty foods, usually hypercaloric and easier to prepare, was observed in patients with “moderate-high disability”. We consider that its consumption is used to compensate for potential lack of energy related to the disability for eating, with worse consequences on weight. Disclosure of Interest: None Declared.
PP117-MON BIOCHEMICAL PROFILE OF NUTRITIONAL STATUS AND PREVALENCE OF HYPOTIREOIDISM IN PATIENTS WITH HEART FAILURE L. Fernandes De Lima1 , J.R.D.S. Gentil1 , M.V. Sim˜ oes1 , 1 1 A.M. Navarro . Department of Clinical Medicine, University of S˜ ao Paulo, Ribeir˜ ao Preto, Brazil Rationale: Heart failure (HF) patients have metabolic and clinical alterations that may lead to thyroid dysfunction and worsen the patient’s prognosis. We aim to evaluate the prevalence of hypotireoidism and its associations with
S173 the biochemical profile of the nutritional status in patients with HF. Methods: We evaluated 75 patients with chronic and stable HF syndrome enrolled in the Heart Failure Clinic of the Hospital das Clínicas without taking thyroxin. The biochemical profile of nutritional status was assessed through albumin, total protein, C reactive protein, glucose, serum urea and creatinin and thyroid stimulating hormone (TSH). The hypothyroidism state was determined as TSH >4 mUI/mL and euthyroidism as TSH 0.4 4 mUI/ml. The variables were described as mean ± standard desviation and relative frequency. Student t test and Mann Whitney test were performed for comparisons of group means, and Fisher’s exact test was applied to analyse the heterogeneity of distribution of frequencies. The interval confidance was stablished at 95% for all analysis. Results: The mean age was 55±14 years old, 50% were men and 32% had functional class of NYHA III/IV. Hypothyroidism was identified in 22% (n = 17) of the patients. TSH levels were higher in hypothyroidism group compared to the group without hypothyroidism (5.6±2.5 mUI/ml and 2±0.9 mUI/ml, respectively, p < 0.001). No differences in albumin, total protein, C reactive protein, glucose, urea serum and creatinin were found between the groups. However, female was associated with an increased risk of hypothyroidism (p < 0.05; RR 3.34). Conclusion: Hypothyroidism was highly prevalent in patients with advanced heart failure and its presence was increased in female population. The thyroid dysfunction was not related to the biochemical profile of nutritional status in these HF patients. Disclosure of Interest: None Declared.
PP118-MON OUTCOME OF ENTEROCUTANEOUS FISTULAS REQUIRING PARENTERAL NUTRITION R.F. Mckee1 , S. Falconer2 , M. Quinn2 . 1 Surgery, 2 Glasgow Royal Infirmary, Glasgow, United Kingdom Rationale: Enterocutaneous fistula (ECF) remains a concerning diagnosis with a variable outcome. This study examined influences on outcome in patients requiring parenteral nutrition (PN) for ECF. Methods: ECF treated with PN in a single institution over 15 years were studied. Fistulas from oesophagus and colon were excluded. PN and patient data have been collected prospectively and extra data were culled from patient notes. Results: 286 ECF patients (M145:F141 median age 64 (20 96) years) had prior surgery in 232 and endoscopy in 6. 104 of 139 with disease proximal to the duodenal-jejunal (DJ) flexure closed without surgery compared to 52 of 147 with disease distal to the DJ flexure (chi-squared 44.8 p < 0.05). Median PN days in these patients were 21 (2 189) with only 16 patients PN days >60 and 8 patients PN days >90. Pre-op deaths in proximal disease (23) were similar to distal disease (24). 43 deaths were due to sepsis or multi-organ failure. 63 patients had operations (12 early for sepsis drainage or proximal stoma; 48 definitive; 5 both) with 3 deaths after early surgery (2 sepsis) and 4 deaths after definitive surgery (all sepsis). All 25 patients who were well enough to be discharged before definitive surgery [time interval to surgery 9 months (3 36); PN days 108 (30 1095); 11 on homePN] survived definitive surgery while 4 of 18 who