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PP132-MON COMPARISON OF SIX NUTRITIONAL RISK SCREENING TOOLS TO DETECT UNDERNUTRITION IN ONE HOSPITAL
190 index [BMI]) and clinical (cardiac and liver involvement, kidney function, C-reactive protein [CRP]) parameters with serum prealbumin levels in 187 newly diagnosed and untreated outpatients affected by immunoglobulin lightchain amyloidosis. Results: Serum prealbumin levels were associated with CRP and short-term energy intake (p < 0.001 for both). A significant association was also detected with age (p = 0.023), serum creatinine (p = 0.017), liver involvement (p = 0.002) and the presence of peripheral edema (p = 0.032). In a pre-specified subgroup analysis (N = 140) on patients with normal CRP (<0.5 mg/dL), all the other associations were confirmed. A significant relationship was also observed with gender (p = 0.022) and BMI (p = 0.041). Conclusion: Serum prealbumin is associated with shortterm energy intake independently of the presence of multiple organ involvement and inflammation. Its serum levels should be always interpreted in light of its influencing factors, among which inflammation, liver and kidney function appear predominant. Disclosure of Interest: R. Caccialanza Grant/Research Support from: From Nutricia Italia, the Fondazione Grigioni per il Morbo di Parkinson and the Fondazione IRCCS Policlinico San Matteo, Consultant of: Nutricia Italia, G. Palladini: None Declared, C. Klersy: None Declared, E. Cereda: None Declared, C. Bonardi: None Declared, L. Quarleri: None Declared, G. Vadacca: None Declared, G. Merlini: None Declared.
PP132-MON COMPARISON OF SIX NUTRITIONAL RISK SCREENING TOOLS TO DETECT UNDERNUTRITION IN ONE HOSPITAL N. Valdes1 , A. Ayastuy2 , P. Men´ endez3 , M.A. Meana3 , 3 2 C. Coalla , L. Corti˜ nas , P. Martinez4 , E. Valdes5 . 1 Endocrinology, Hospital Central de Asturias, Oviedo, 2 Pharmacy, 3 Endocrinology, Hospital de Cabue˜ nes, Gij´ on, 4 Hospital Central de Asturias, Oviedo, 5 Nephrology, Hospital de Cabue˜ nes, Gij´ on, Spain Rationale: Before implementing a nutritional screening tool in a hospital, one must determine how well it will work in its setting. Therefore, the aim of this study was to determine the most valid nutritional screening tool to implement in our clinical setting. Methods: We conducted a cross-sectional study from June to December 2009 in surgical and medical services. Patients were randomly selected and assessed at hospital admission by six screening tools (NRS-2002, MUST, MST, SNAQ, CONUT and NRI index). Undernutrition was diagnosed according to SENPE recommendations (GOLD standard). To compare the tools, the results were reorganized into: patients at risk of undernutrition and not at risk. Sensitivity, specificity and predictive values were calculated to evaluate these screening tools compared to GOLD. The concordance between screening tools and GOLD was analysed by kappa index. Results: 223 patients were randomly selected, 139 (62.3%) were male, average age was 69.48±13.65 years. 85 (38.1%) patients were undernourished, and prevalence of patients at nutritional risk with the NRS-2002, MUST, MST, SNAQ, CONUT and NRI index was 52.7%; 48.2%; 54.1%; 32.4%; 66.2% and 69.4%, respectively. Values for sensitivity, specificity, predictive values and kappa index are shown in Table 1.
Poster presentations Table 1. Sensitivity, specificity, predictive values, and kappaindex of the nutritional screening tools
NRS MUST MST SNAQ CONUT NRI index
Sensitivity
Specificity
PPV
PNV
K
84.9% 72.1% 74.4% 54.7% 89.2% 96.5%
67.6% 66.9% 58.8% 81.6% 50.9% 47.4%
62.4% 57.9% 53.3% 65.3% 57.4% 53.2%
87.6% 79.1% 78.4% 74% 86.4% 95.6%
0.493 0.373 0.310 0.374 0.374 0.381
Conclusion: NRS-2002 was the only nutritional risk screening tool with moderate concordance with the GOLD standard, and showed the best parameters of criterion validity. Disclosure of Interest: None Declared.
PP133-MON NEEDLELESS CLOSED SYSTEM DOES NOT REDUCE CENTRAL VENOUS CATHETER-RELATED BLOODSTREAM INFECTION: A RETROSPECTIVE STUDY M. Ishizuka1 , H. Nagata1 , K. Takagi1 , K. Kubota1 . 1 Department of Gastroenterological Surgery, Dokkyo Medical University, Mibu, Japan Rationale: In order to prevent central venous catheterrelated bloodstream infection (CVC-RBSI), several improved anti-infection strategies have been introduced. Among them, the needleless closed system (NCS) has been disseminated in several clinical fields to prevent CVCRBSI, in place of the conventional Luer cap system (LCS). The purpose of this study is to examine whether NCS is really superior to conventional LCS for prevention of CVC-RBSI. Methods: Between May 2002 and December 2008, 1767 patients received CVC in our department. The time interval from insertion to development of CVC-RBSI was compared retrospectively between selected patients who were treated using the conventional LCS (Group 1, n = 89, before June 2006) and the NCS (Group 2, n = 406, June 2006 and after). Results: Although Group 1 patients had a higher proportion of females, a longer inserted catheter length and duration of catheter insertion, higher rate of surgery and administration of parenteral nutrition, a lower rate of chemotherapy administration, and a higher frequency of fever than Group 2 patients, Kaplan Meier analysis revealed no significant difference in the time interval from insertion to development of CVC-RBSI between the two groups. Conclusion: NCS does not reduce CVC-RBSI in adult CRC patients who undergo CVC insertion. References Menyhay SZ, Maki DG. Preventing central venous catheterassociated bloodstream infections: development of an antiseptic barrier cap for needleless connectors. Am J Infect Control 2008; 36: 171 175. Salgado CD, Chinnes L, Paczesny TH, Cantey JR. Increased rate of catheter-related bloodstream infection associated with use of a needleless mechanical valve device at a long-term acute care hospital. Infect Control Hosp Epidemiol 2007; 28: 684 688. Disclosure of Interest: None Declared.
PP132-MON COMPARISON OF SIX NUTRITIONAL RISK SCREENING TOOLS TO DETECT UNDERNUTRITION IN ONE HOSPITAL N. Valdes1 , A. Ayastuy2 , P. Men´ endez3 , M.A. Meana3 , 3 2 C. Coalla , L. Corti˜ nas , P. Martinez4 , E. Valdes5 . 1 Endocrinology, Hospital Central de Asturias, Oviedo, 2 Pharmacy, 3 Endocrinology, Hospital de Cabue˜ nes, Gij´ on, 4 Hospital Central de Asturias, Oviedo, 5 Nephrology, Hospital de Cabue˜ nes, Gij´ on, Spain Rationale: Before implementing a nutritional screening tool in a hospital, one must determine how well it will work in its setting. Therefore, the aim of this study was to determine the most valid nutritional screening tool to implement in our clinical setting. Methods: We conducted a cross-sectional study from June to December 2009 in surgical and medical services. Patients were randomly selected and assessed at hospital admission by six screening tools (NRS-2002, MUST, MST, SNAQ, CONUT and NRI index). Undernutrition was diagnosed according to SENPE recommendations (GOLD standard). To compare the tools, the results were reorganized into: patients at risk of undernutrition and not at risk. Sensitivity, specificity and predictive values were calculated to evaluate these screening tools compared to GOLD. The concordance between screening tools and GOLD was analysed by kappa index. Results: 223 patients were randomly selected, 139 (62.3%) were male, average age was 69.48±13.65 years. 85 (38.1%) patients were undernourished, and prevalence of patients at nutritional risk with the NRS-2002, MUST, MST, SNAQ, CONUT and NRI index was 52.7%; 48.2%; 54.1%; 32.4%; 66.2% and 69.4%, respectively. Values for sensitivity, specificity, predictive values and kappa index are shown in Table 1.
Poster presentations Table 1. Sensitivity, specificity, predictive values, and kappaindex of the nutritional screening tools
NRS MUST MST SNAQ CONUT NRI index
Sensitivity
Specificity
PPV
PNV
K
84.9% 72.1% 74.4% 54.7% 89.2% 96.5%
67.6% 66.9% 58.8% 81.6% 50.9% 47.4%
62.4% 57.9% 53.3% 65.3% 57.4% 53.2%
87.6% 79.1% 78.4% 74% 86.4% 95.6%
0.493 0.373 0.310 0.374 0.374 0.381
Conclusion: NRS-2002 was the only nutritional risk screening tool with moderate concordance with the GOLD standard, and showed the best parameters of criterion validity. Disclosure of Interest: None Declared.
PP133-MON NEEDLELESS CLOSED SYSTEM DOES NOT REDUCE CENTRAL VENOUS CATHETER-RELATED BLOODSTREAM INFECTION: A RETROSPECTIVE STUDY M. Ishizuka1 , H. Nagata1 , K. Takagi1 , K. Kubota1 . 1 Department of Gastroenterological Surgery, Dokkyo Medical University, Mibu, Japan Rationale: In order to prevent central venous catheterrelated bloodstream infection (CVC-RBSI), several improved anti-infection strategies have been introduced. Among them, the needleless closed system (NCS) has been disseminated in several clinical fields to prevent CVCRBSI, in place of the conventional Luer cap system (LCS). The purpose of this study is to examine whether NCS is really superior to conventional LCS for prevention of CVC-RBSI. Methods: Between May 2002 and December 2008, 1767 patients received CVC in our department. The time interval from insertion to development of CVC-RBSI was compared retrospectively between selected patients who were treated using the conventional LCS (Group 1, n = 89, before June 2006) and the NCS (Group 2, n = 406, June 2006 and after). Results: Although Group 1 patients had a higher proportion of females, a longer inserted catheter length and duration of catheter insertion, higher rate of surgery and administration of parenteral nutrition, a lower rate of chemotherapy administration, and a higher frequency of fever than Group 2 patients, Kaplan Meier analysis revealed no significant difference in the time interval from insertion to development of CVC-RBSI between the two groups. Conclusion: NCS does not reduce CVC-RBSI in adult CRC patients who undergo CVC insertion. References Menyhay SZ, Maki DG. Preventing central venous catheterassociated bloodstream infections: development of an antiseptic barrier cap for needleless connectors. Am J Infect Control 2008; 36: 171 175. Salgado CD, Chinnes L, Paczesny TH, Cantey JR. Increased rate of catheter-related bloodstream infection associated with use of a needleless mechanical valve device at a long-term acute care hospital. Infect Control Hosp Epidemiol 2007; 28: 684 688. Disclosure of Interest: None Declared.