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PP192-SUN NUTRITIONAL ASSESSMENT OF INSTITUTIONALIZED ELDERLY VERSUS FOOD INTAKE
Nutritional assessment I achieved. A nutrition steering group has been set up to monitor and evaluate the implementation of nutrition policy on a continuing basis. References [1] Wong S et al (2011) Eur J Clin Nutr DOI: 10.1038/ejcn.2011.209. [2] Royal College of Physicians (2008) Chronic Spinal Cord Injury: Management of Patients in Acute Hospital Settings: National Guidelines. London: RCP, London. Disclosure of Interest: None Declared.
PP190-SUN CORRELATION OF SUBJECTIVE GLOBAL ASSESSMENT RESULTS WITH CALF CIRCUMFERENCE AND BODY MASS INDEX FOR ELDERLY PATIENTS IN A GENERAL HOSPITAL IN BRAZIL M.G. Soares1 , F. Roncoleta1 , C.R. Marques1 , D.C. Bento1 , ˜o, V.C.A. Ferreira1 , C. Rodrigues2 , C. Cukier3 . 1 Nutri¸ca Santa Casa de Miseric´ ordia de Belo Horizonte, Belo Horizonte, 2 Nutri¸ca ˜o, 3 Nutrologia, Comercial 3 Albe, S˜ ao Paulo, Brazil Rationale: Elderly nutritional status has been evaluated by different assessment methods. No gold standard method is proposed and these methods should be compared in this population. Methods: 21097 nutritional assessments were made in elderly patients (60 to 102 years old) in a general hospital for the period of one year The used methods were SGA (Subjective Global Assessment); BMI (Body Mass Index); NRS (Nutritional Risk Screening), CC (Calf Circumference) and CPA (Critical Patient Assessment ASPEN Guidelines 2009). Statistical analysis was performed comparing the different methods. Results: SGA correlated to BMI and CC (69% and 68% 1918 and 2586 patients respectively) for nourished but not for malnourished patients. In malnourished patients NRS and CPA correlated with BMI (82.2% and 98.1% of patients 1029 and 592 patients respectively). SGA do not correlated to any other method in malnourished elderly patients. Conclusion: There still not a gold standard method for malnourished elderly patients. Other methods or associated method should be used for this population. SGA do not correlate with any other assessment method for elderly malnourished patients. Disclosure of Interest: None Declared.
PP191-SUN USE OF BODY MASS INDEX (BMI) AND ARM CIRCUMFERENCE (AC), ON THE NUTRITIONAL STATUS ANALYSIS OF PATIENTS STARTING ORAL DIET IN AN INTENSIVE CARE UNIT (ICU) C.G.R.M. Vaz De Lima1 , F. Roncoleta1 , J.F.G. Santos1 . 1 Nutrition, Grupo Santa Casa de Belo Horizonte, Belo Horizonte, Brazil Rationale: Few studies have evaluated the use of anthropometric parameters for the diagnosis of malnutrition on patientes wiht oral diet (OD) in ICU. Here the aim was to evaluate the correlation between BMI and AC on malnutrition (MT) diagnosis.
101 Methods: Data were collected on March 2012 of all patients who started OD, admitted to ICU of the Santa Casa in Belo Horizonte, Minas Gerais, Brasil. For diagnosis of MT, was used the criteria of BMI and AC. The correlation between these two variables was analized, and, considering the correlation, sought to cut-off points that could improve the accuracy and concordance of nutritional diagnosis. Categorical variables were compared using the chi-square or Fisher’s exact test, and were continuous with the t-Student or Mann Whitney U, as was the case. Differences with p < 0.05 were considered significant. The statistical calculation was done using SPSS 17.0. Results: 81 patients were included in the analysis. The mean age was 54.4±18.7 years, 54.3% male. The mean BMI was 25.0±5.5 and an AC of 29.1±5.0 cm. Of malnourished (MNS) by BMI, 66.7% were MNS by AC, while only 38.5% of MNS people by AC were MNS by BMI, with an overall diagnostic concordance between the two criteria in only 18.5% of patients. In the search for a cutoff value simultaneously in the two variables, which increase the correlation of the diagnosis of MT, we find that an AC less than 28, associated with a BMI below 30, improved the the correlation up to 64.2%. Conclusion: Despite good correlation between BMI and AC, there was a large disagreement in the diagnosis of MT. However, there was a significant improvement in accord when you joined a BMI < 30 with a CB < 28. Disclosure of Interest: None Declared.
PP192-SUN NUTRITIONAL ASSESSMENT OF INSTITUTIONALIZED ELDERLY VERSUS FOOD INTAKE M. Cebola1 , C. Sousa2 , L. Mendes3 . 1 Adjunct Professor of the scientific area of Dietetics, in degree of Dietetics and Nutrition, Health Technology School of Lisbon, 2 Degree of Dietetics and Nutrition, 3 Scientific Area of Dietetics, in degree of Dietetics and Nutrition, Higher School of Health Technology of Lisbon-ESTeSl, Lisbon, Portugal Rationale: Assessment of the nutritional state and food intake of elderly. Compare nutritional status with the anthropometric evaluation and food intake. Draw: transversal descriptive study. Sample: 36 elderly living in the geriatric institution at Odivelas with medium age of 81.19 years (65 98). Methods: Mini Nutritional Assessment (MNA® ) has been used to evaluate nutritional status and was made a food intake registry of three days. Results: 38.9% of elderly was wellnourished, 47.2% in risk of malnutrition and 13.9% were malnutrition. The average of the BMI (Body Massa Index), calf circunference (CC) and arm circunference (AC) was 26.95; 33.58 and 28.19, respectively. It has been verified that the average percentage of the adequation of the intake was inferior for all the nutrients evaluated except for vitamin B12, iron, sodium, and magnesium. Significative differences have been verified between the nutritional status, BMI, CC and energy (p < 0.05). It has been verified that the medium distribution of AC averages, fiber and B12 vitamin varied according to the nutritional status (p < 0.05).
102 Conclusion: Wellnourished elderly presented a better anthropometric evaluation as well as energetic intake. In what concerns to the nutritional status there were significative differences in the energetic intake and the CC. It has been concluded that the average distribution on fibre intake, AC and B12 vitamin was not equal to all the groups. Identifying the nutritional state does not imply the eradication of malnutrition or risk of malnutrition, thus being necessary in the future to test the efficiency of the interventions. Disclosure of Interest: None Declared.
PP193-SUN IMPACT OF LENGTH OF STAY IN NUTRITIONAL STATUS IN A GENERAL HOSPITAL IN BRAZIL C. Rodrigues1 , A.G. Fonseca2 , G.D.S. Ribeiro2 , ˜o, J.C.D. Guimar˜ aes2 , M.S. Pires3 , C. Cukier4 . 1 Nutri¸ca Comercial 3 Albe, S˜ ao Bernardo do Campo, 2 Nutri¸ca ˜o, Santa Casa de Miseric´ ordia de Belo Horizonte, 3 Nutri¸ca ˜o, Comercial 3 Albe, Belo Horizonte, 4 Nutrologia, Comercial 3 Albe, S˜ ao Bernardo do Campo, Brazil Rationale: Lengh of stay (LOS) can impact on nutritional status. Malnutrition can be achieved in long term interned patients and impact in increasing complications. Methods: 14270 nutritional assessments were performed for the period of one year in a general hospital. Adult patients were followed in different periods during stay. 1400 for period A (1 2 days), 4411 for B (3 7 days), 1851 for C (8 10 days), 2034 for D (11 15 days) and 4574 for E (more than 16 days) and studied by subjective global assessment. Results: Malnutrition was found in 21% of patients up to the 15th day with no difference compared to admission assessment. After the 16th day of stay malnutrition was found in 40% of the patients. Conclusion: Special attention should be given to patients with long term hospital stay in order to avoid malnutrition complications in this population. Disclosure of Interest: None Declared.
PP194-SUN PERCEPTION OF PATIENTS HOSPITALIZED ON THE VOLUME OF NUTRITIONAL SUPPLEMENTATION OFFERED L.D.F. Ferraz1 , A.C.F. Campos1 . 1 Nutrition, Hospital ´ lvaro, Santos, Brazil Guilherme A Rationale: Check the perception of patients admitted to a public hospital in Brazil on the volume of oral nutritional therapy offered. Methods: A questionnaire was answered by a professional nutritionist in 100 adult patients of both genders, both medical and surgical addressing this issue. Results: Of the patients who received oral supplementation of 200 ml 2 times a day, 35% reported that the volume is good, 57% fair and 8% poor. Those who were supplemented with 125 ml three times daily, 46% rated as good, be regular 50% and 4% poor. Finally, the nutritional therapy of 30 ml three times daily, 55% of the sample reported the amount offered to be good, be regular 40% and 5% bad. Conclusion: The results show that the nutritional therapy of oral low volume is more accepted in the hospital. This
Poster presentations information becomes of paramount importance to the dietitian in making their conduct, so as to avoid waste and provides a greater adherence to supplementation. Disclosure of Interest: None Declared.
PP195-SUN EVALUATION OF THE DIETARY MANAGEMENT OF DYSPHAGIA IN PATIENTS ADMITTED TO THE CARE OF NEUROSCIENCE J.M. S´ anchez-Migall´ on Montull1 , M.J. Creus Macías2 , 1 M. Cachero Triad´ u , E. Martínez Lopez1 , C. Joaquim Ortiz1 , R. Puig Pi˜ na1 . 1 Nutrition and Dietetics, 2 Neuroscience Nursing, Germnas Trias i Pujol University Hospital, Barcelone, Spain Rationale: (1) To analyze the prevalence of dysphagia and nutritional risk in patients admitted to the care of Neuroscience. (2) To evaluate the detection of dysphagia and the dietary prescription during admission and their registration in nursing documentation. Methods: We analyzed patients admitted on the 20/01/2011. Dysphagia was assessed by the Clinical Examination Method of dysphagia Volume-Viscosity (CEMV-V) and nutritional risk by Nutritional Risk Screening (NRS-2002). We consulted; nursing documents, medical history, prescriptions and diet program requests. Results: We studied 26 patients, 50% female, age: 63.5±15.6 years. In nursing reports, weight was noted for 42.3% of the patients and height for 30.8%. 46.2% of patients had dysphagia and 65.4% had risk of malnutrition. There were no noted differences in nutritional risk among patients with dysphagia and those who had not. Dysphagia was assesed in 66.9% of patients (applying the 30.8% water test, 7.7% CEMV-V or 15.4% CEMV-V with video-endoscopy). Dysphagia was noted in half of the cases of the nursing reports. Doctors had observed the dietary pattern in 53.8% of patients who tolerated an oral diet. When patients nedeed a modified texture diet, this was only obseved in 35.7% of cases. Modified texture noted by the doctors was correct in only 33.3% of cases. Conclusion: The high prevalence of dysphagia and nutritional risk patients justifies systematic screening. It should implement the registration of weight and height, as well as dietary pattern, including texture, in prescription medications. The high number of inconsistancies found in dietary reports has led us to consider the benefit of having only one report for dietary prescription. Disclosure of Interest: None Declared.
PP196-SUN DO THE BODY MASS INDEX (BMI), FAT MASS (FM) AND PHYSICAL ACTIVITY (PA) OF UNIVERSITY STUDENTS DIFFER FROM THE NORMS AND CHANGE BETWEEN THE UNIVERSITY YEARS? C. Joly1 , V.L. Karsegard1 , A. Clerc1 , L. Genton1 , C. Pichard1 . 1 Clinical Nutrition, Geneva University Hospital, Geneva, Switzerland Rationale: Students are potentially at risk of being overweight and physically inactive. However, information on their body composition and PA are scarce. This prospective study compares the BMI, FM and PA of
PP190-SUN CORRELATION OF SUBJECTIVE GLOBAL ASSESSMENT RESULTS WITH CALF CIRCUMFERENCE AND BODY MASS INDEX FOR ELDERLY PATIENTS IN A GENERAL HOSPITAL IN BRAZIL M.G. Soares1 , F. Roncoleta1 , C.R. Marques1 , D.C. Bento1 , ˜o, V.C.A. Ferreira1 , C. Rodrigues2 , C. Cukier3 . 1 Nutri¸ca Santa Casa de Miseric´ ordia de Belo Horizonte, Belo Horizonte, 2 Nutri¸ca ˜o, 3 Nutrologia, Comercial 3 Albe, S˜ ao Paulo, Brazil Rationale: Elderly nutritional status has been evaluated by different assessment methods. No gold standard method is proposed and these methods should be compared in this population. Methods: 21097 nutritional assessments were made in elderly patients (60 to 102 years old) in a general hospital for the period of one year The used methods were SGA (Subjective Global Assessment); BMI (Body Mass Index); NRS (Nutritional Risk Screening), CC (Calf Circumference) and CPA (Critical Patient Assessment ASPEN Guidelines 2009). Statistical analysis was performed comparing the different methods. Results: SGA correlated to BMI and CC (69% and 68% 1918 and 2586 patients respectively) for nourished but not for malnourished patients. In malnourished patients NRS and CPA correlated with BMI (82.2% and 98.1% of patients 1029 and 592 patients respectively). SGA do not correlated to any other method in malnourished elderly patients. Conclusion: There still not a gold standard method for malnourished elderly patients. Other methods or associated method should be used for this population. SGA do not correlate with any other assessment method for elderly malnourished patients. Disclosure of Interest: None Declared.
PP191-SUN USE OF BODY MASS INDEX (BMI) AND ARM CIRCUMFERENCE (AC), ON THE NUTRITIONAL STATUS ANALYSIS OF PATIENTS STARTING ORAL DIET IN AN INTENSIVE CARE UNIT (ICU) C.G.R.M. Vaz De Lima1 , F. Roncoleta1 , J.F.G. Santos1 . 1 Nutrition, Grupo Santa Casa de Belo Horizonte, Belo Horizonte, Brazil Rationale: Few studies have evaluated the use of anthropometric parameters for the diagnosis of malnutrition on patientes wiht oral diet (OD) in ICU. Here the aim was to evaluate the correlation between BMI and AC on malnutrition (MT) diagnosis.
101 Methods: Data were collected on March 2012 of all patients who started OD, admitted to ICU of the Santa Casa in Belo Horizonte, Minas Gerais, Brasil. For diagnosis of MT, was used the criteria of BMI and AC. The correlation between these two variables was analized, and, considering the correlation, sought to cut-off points that could improve the accuracy and concordance of nutritional diagnosis. Categorical variables were compared using the chi-square or Fisher’s exact test, and were continuous with the t-Student or Mann Whitney U, as was the case. Differences with p < 0.05 were considered significant. The statistical calculation was done using SPSS 17.0. Results: 81 patients were included in the analysis. The mean age was 54.4±18.7 years, 54.3% male. The mean BMI was 25.0±5.5 and an AC of 29.1±5.0 cm. Of malnourished (MNS) by BMI, 66.7% were MNS by AC, while only 38.5% of MNS people by AC were MNS by BMI, with an overall diagnostic concordance between the two criteria in only 18.5% of patients. In the search for a cutoff value simultaneously in the two variables, which increase the correlation of the diagnosis of MT, we find that an AC less than 28, associated with a BMI below 30, improved the the correlation up to 64.2%. Conclusion: Despite good correlation between BMI and AC, there was a large disagreement in the diagnosis of MT. However, there was a significant improvement in accord when you joined a BMI < 30 with a CB < 28. Disclosure of Interest: None Declared.
PP192-SUN NUTRITIONAL ASSESSMENT OF INSTITUTIONALIZED ELDERLY VERSUS FOOD INTAKE M. Cebola1 , C. Sousa2 , L. Mendes3 . 1 Adjunct Professor of the scientific area of Dietetics, in degree of Dietetics and Nutrition, Health Technology School of Lisbon, 2 Degree of Dietetics and Nutrition, 3 Scientific Area of Dietetics, in degree of Dietetics and Nutrition, Higher School of Health Technology of Lisbon-ESTeSl, Lisbon, Portugal Rationale: Assessment of the nutritional state and food intake of elderly. Compare nutritional status with the anthropometric evaluation and food intake. Draw: transversal descriptive study. Sample: 36 elderly living in the geriatric institution at Odivelas with medium age of 81.19 years (65 98). Methods: Mini Nutritional Assessment (MNA® ) has been used to evaluate nutritional status and was made a food intake registry of three days. Results: 38.9% of elderly was wellnourished, 47.2% in risk of malnutrition and 13.9% were malnutrition. The average of the BMI (Body Massa Index), calf circunference (CC) and arm circunference (AC) was 26.95; 33.58 and 28.19, respectively. It has been verified that the average percentage of the adequation of the intake was inferior for all the nutrients evaluated except for vitamin B12, iron, sodium, and magnesium. Significative differences have been verified between the nutritional status, BMI, CC and energy (p < 0.05). It has been verified that the medium distribution of AC averages, fiber and B12 vitamin varied according to the nutritional status (p < 0.05).
102 Conclusion: Wellnourished elderly presented a better anthropometric evaluation as well as energetic intake. In what concerns to the nutritional status there were significative differences in the energetic intake and the CC. It has been concluded that the average distribution on fibre intake, AC and B12 vitamin was not equal to all the groups. Identifying the nutritional state does not imply the eradication of malnutrition or risk of malnutrition, thus being necessary in the future to test the efficiency of the interventions. Disclosure of Interest: None Declared.
PP193-SUN IMPACT OF LENGTH OF STAY IN NUTRITIONAL STATUS IN A GENERAL HOSPITAL IN BRAZIL C. Rodrigues1 , A.G. Fonseca2 , G.D.S. Ribeiro2 , ˜o, J.C.D. Guimar˜ aes2 , M.S. Pires3 , C. Cukier4 . 1 Nutri¸ca Comercial 3 Albe, S˜ ao Bernardo do Campo, 2 Nutri¸ca ˜o, Santa Casa de Miseric´ ordia de Belo Horizonte, 3 Nutri¸ca ˜o, Comercial 3 Albe, Belo Horizonte, 4 Nutrologia, Comercial 3 Albe, S˜ ao Bernardo do Campo, Brazil Rationale: Lengh of stay (LOS) can impact on nutritional status. Malnutrition can be achieved in long term interned patients and impact in increasing complications. Methods: 14270 nutritional assessments were performed for the period of one year in a general hospital. Adult patients were followed in different periods during stay. 1400 for period A (1 2 days), 4411 for B (3 7 days), 1851 for C (8 10 days), 2034 for D (11 15 days) and 4574 for E (more than 16 days) and studied by subjective global assessment. Results: Malnutrition was found in 21% of patients up to the 15th day with no difference compared to admission assessment. After the 16th day of stay malnutrition was found in 40% of the patients. Conclusion: Special attention should be given to patients with long term hospital stay in order to avoid malnutrition complications in this population. Disclosure of Interest: None Declared.
PP194-SUN PERCEPTION OF PATIENTS HOSPITALIZED ON THE VOLUME OF NUTRITIONAL SUPPLEMENTATION OFFERED L.D.F. Ferraz1 , A.C.F. Campos1 . 1 Nutrition, Hospital ´ lvaro, Santos, Brazil Guilherme A Rationale: Check the perception of patients admitted to a public hospital in Brazil on the volume of oral nutritional therapy offered. Methods: A questionnaire was answered by a professional nutritionist in 100 adult patients of both genders, both medical and surgical addressing this issue. Results: Of the patients who received oral supplementation of 200 ml 2 times a day, 35% reported that the volume is good, 57% fair and 8% poor. Those who were supplemented with 125 ml three times daily, 46% rated as good, be regular 50% and 4% poor. Finally, the nutritional therapy of 30 ml three times daily, 55% of the sample reported the amount offered to be good, be regular 40% and 5% bad. Conclusion: The results show that the nutritional therapy of oral low volume is more accepted in the hospital. This
Poster presentations information becomes of paramount importance to the dietitian in making their conduct, so as to avoid waste and provides a greater adherence to supplementation. Disclosure of Interest: None Declared.
PP195-SUN EVALUATION OF THE DIETARY MANAGEMENT OF DYSPHAGIA IN PATIENTS ADMITTED TO THE CARE OF NEUROSCIENCE J.M. S´ anchez-Migall´ on Montull1 , M.J. Creus Macías2 , 1 M. Cachero Triad´ u , E. Martínez Lopez1 , C. Joaquim Ortiz1 , R. Puig Pi˜ na1 . 1 Nutrition and Dietetics, 2 Neuroscience Nursing, Germnas Trias i Pujol University Hospital, Barcelone, Spain Rationale: (1) To analyze the prevalence of dysphagia and nutritional risk in patients admitted to the care of Neuroscience. (2) To evaluate the detection of dysphagia and the dietary prescription during admission and their registration in nursing documentation. Methods: We analyzed patients admitted on the 20/01/2011. Dysphagia was assessed by the Clinical Examination Method of dysphagia Volume-Viscosity (CEMV-V) and nutritional risk by Nutritional Risk Screening (NRS-2002). We consulted; nursing documents, medical history, prescriptions and diet program requests. Results: We studied 26 patients, 50% female, age: 63.5±15.6 years. In nursing reports, weight was noted for 42.3% of the patients and height for 30.8%. 46.2% of patients had dysphagia and 65.4% had risk of malnutrition. There were no noted differences in nutritional risk among patients with dysphagia and those who had not. Dysphagia was assesed in 66.9% of patients (applying the 30.8% water test, 7.7% CEMV-V or 15.4% CEMV-V with video-endoscopy). Dysphagia was noted in half of the cases of the nursing reports. Doctors had observed the dietary pattern in 53.8% of patients who tolerated an oral diet. When patients nedeed a modified texture diet, this was only obseved in 35.7% of cases. Modified texture noted by the doctors was correct in only 33.3% of cases. Conclusion: The high prevalence of dysphagia and nutritional risk patients justifies systematic screening. It should implement the registration of weight and height, as well as dietary pattern, including texture, in prescription medications. The high number of inconsistancies found in dietary reports has led us to consider the benefit of having only one report for dietary prescription. Disclosure of Interest: None Declared.
PP196-SUN DO THE BODY MASS INDEX (BMI), FAT MASS (FM) AND PHYSICAL ACTIVITY (PA) OF UNIVERSITY STUDENTS DIFFER FROM THE NORMS AND CHANGE BETWEEN THE UNIVERSITY YEARS? C. Joly1 , V.L. Karsegard1 , A. Clerc1 , L. Genton1 , C. Pichard1 . 1 Clinical Nutrition, Geneva University Hospital, Geneva, Switzerland Rationale: Students are potentially at risk of being overweight and physically inactive. However, information on their body composition and PA are scarce. This prospective study compares the BMI, FM and PA of