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SUN-PP083: The Impact of Different Diagnostic Criteria on the Prevalence of Sarcopenia in Healthy Elderly Participants and Geriatric Outpatients
S54 SUN-PP082 A CLINICAL AUDIT OF THE NUTRITIONAL MANAGEMENT OF STROKE PATIENTS E.L. Holmes1 , E.L. Parsons2 . 1 Department of Nutrition and Dietetics, University Hospitals Southampton NHS Foundation Trust, 2 NIHR Biomedical Research Centre, University of Southampton, Southampton, United Kingdom Rationale: The nutritional status of stroke patients may adversely affect morbidity and mortality. The standard of nutritional care received by UK stroke patients has not been fully evaluated. This clinical audit aimed to evaluate the quality of nutritional care on a UK stroke unit. Methods: A nutritional care pathway was developed and audit criteria defined using local and national guidelines. Case notes for patients admitted to the stroke unit in March 2014 were audited (n = 16; stroke type: 94% ischaemic, 6% haemorrhagic; mean age: 76±9 years; mean length of stay: 40±43 days). Audit themes included: nutrition screening (Malnutrition Universal Screening Tool), nutrition support and secondary prevention. Areas of good practice and those requiring improvement were identified. Results: Most patients (80%) were screened for malnutrition on admission. Malnutrition risk increased from 20% on admission to 46% by discharge. Most patients received nasogastric (NG) tube feeding during admission (81%). The mean time from first NG tube placement to first feed commencement was 11±1 hours (mean delay first NGT placement to first x-ray confirmation; 9±4 hours; mean delay first x-ray confirmation to first feed commencement; 3.7±4.7 hours). Enteral feed prescription varied (Mean kcal/d: 1804±1252). Many patients did not receive their entire energy prescription through NGT feeding [mean volume deficit over admission (prescribed v. received) = 43%]. Dietetic reviews did not routinely monitor percentage of feed delivery. Vitamin D status was not routinely assessed during admission and only 50% received lipid profile testing during admission (dyslipidaemia diagnosed; 25%). Only one patient received dietetic secondary prevention advice. Conclusion: The quality of nutritional care provided to stroke patients could be improved. A multidisciplinary team approach will ensure the necessary improvements are made, and monitored through quality improvement cycles. Disclosure of Interest: None declared
Poster presentations SUN-PP083 THE IMPACT OF DIFFERENT DIAGNOSTIC CRITERIA ON THE PREVALENCE OF SARCOPENIA IN HEALTHY ELDERLY PARTICIPANTS AND GERIATRIC OUTPATIENTS E.M. Reijnierse1 , M.C. Trappenburg1 , M.J. Leter1 , G.J. Blauw2 , S. Sipil¨ a3 , E. Sillanp¨ aa ¨3 , M.V. Narici4 , 5 5 J.-Y. Hogrel , G. Butler-Browne , J.S. McPhee6 , H. Gapeyeva7 , M. P¨ aa ¨suke7 , M.A.E. de van der Schueren8 , C.G. Meskers9 , A.B. Maier1 . 1 Internal Medicine, section Gerontology and Geriatrics, VU University medical center, Amsterdam, 2 Gerontology and Geriatrics, Leiden University Medical Centre, Leiden, Netherlands; 3 Health Sciences, University of Jyv¨ askyl¨ a, Jyv¨ askyl¨ a, Finland; 4 Division of Medical Sciences, University of Nottingham, Nottingham, United Kingdom; 5 Institut de Myologie, Paris, France; 6 Manchester Metropolitan University, Manchester, United Kingdom; 7 University of Tartu, Tartu, Estonia; 8 Internal Medicine, section Nutrition and Dietetics, 9 Rehabilitation Medicine, VU University medical center, Amsterdam, Netherlands Rationale: Sarcopenia, low muscle mass, is frequently identified in elderly and associated with physical disability and mortality. Previous diagnostic criteria for sarcopenia incorporated measures of muscle mass, but proposed consensus definitions characterize sarcopenia by the combination of low muscle mass, -strength and/or physical performance. However, consensus on diagnostic criteria for sarcopenia has not been reached yet. Methods: This cross-sectional study compared prevalence rates of sarcopenia using nine frequently used sets of diagnostic criteria applied in two different elderly populations, encompassing 308 healthy elderly participants from the MYOAGE study (mean age 74 years, SD 7.0) and 123 geriatric outpatients (mean age 81 years, SD 3.2). Diagnostic criteria included relative and absolute muscle mass, muscle strength and physical performance. Results: Prevalence rates of sarcopenia varied between 0% and 15% in healthy elderly participants and between 2% and 34% in geriatric outpatients, dependent on the applied set of diagnostic criteria. Agreement between the applied sets was minimal: only one of the outpatients was classified as sarcopenic according to all applied sets of diagnostic criteria; this was true for none of the healthy elderly participants. The lack of agreement can be explained by the use of different measures (muscle mass, -strength, physical performance), correction factors (height, body mass, BMI), cut-offs and by methodological issues. Conclusion: This study clearly demonstrates the dependency of sarcopenia prevalence rates on the applied diagnostic criteria and indicates the importance of defining sarcopenia and the need to reach consensus. Consensus on the diagnostic criteria should be based on evidence on the relation of diagnostic measures and clinically relevant muscle-related outcomes, useful correction factors and valid cut-offs. Disclosure of Interest: None declared
Poster presentations SUN-PP083 THE IMPACT OF DIFFERENT DIAGNOSTIC CRITERIA ON THE PREVALENCE OF SARCOPENIA IN HEALTHY ELDERLY PARTICIPANTS AND GERIATRIC OUTPATIENTS E.M. Reijnierse1 , M.C. Trappenburg1 , M.J. Leter1 , G.J. Blauw2 , S. Sipil¨ a3 , E. Sillanp¨ aa ¨3 , M.V. Narici4 , 5 5 J.-Y. Hogrel , G. Butler-Browne , J.S. McPhee6 , H. Gapeyeva7 , M. P¨ aa ¨suke7 , M.A.E. de van der Schueren8 , C.G. Meskers9 , A.B. Maier1 . 1 Internal Medicine, section Gerontology and Geriatrics, VU University medical center, Amsterdam, 2 Gerontology and Geriatrics, Leiden University Medical Centre, Leiden, Netherlands; 3 Health Sciences, University of Jyv¨ askyl¨ a, Jyv¨ askyl¨ a, Finland; 4 Division of Medical Sciences, University of Nottingham, Nottingham, United Kingdom; 5 Institut de Myologie, Paris, France; 6 Manchester Metropolitan University, Manchester, United Kingdom; 7 University of Tartu, Tartu, Estonia; 8 Internal Medicine, section Nutrition and Dietetics, 9 Rehabilitation Medicine, VU University medical center, Amsterdam, Netherlands Rationale: Sarcopenia, low muscle mass, is frequently identified in elderly and associated with physical disability and mortality. Previous diagnostic criteria for sarcopenia incorporated measures of muscle mass, but proposed consensus definitions characterize sarcopenia by the combination of low muscle mass, -strength and/or physical performance. However, consensus on diagnostic criteria for sarcopenia has not been reached yet. Methods: This cross-sectional study compared prevalence rates of sarcopenia using nine frequently used sets of diagnostic criteria applied in two different elderly populations, encompassing 308 healthy elderly participants from the MYOAGE study (mean age 74 years, SD 7.0) and 123 geriatric outpatients (mean age 81 years, SD 3.2). Diagnostic criteria included relative and absolute muscle mass, muscle strength and physical performance. Results: Prevalence rates of sarcopenia varied between 0% and 15% in healthy elderly participants and between 2% and 34% in geriatric outpatients, dependent on the applied set of diagnostic criteria. Agreement between the applied sets was minimal: only one of the outpatients was classified as sarcopenic according to all applied sets of diagnostic criteria; this was true for none of the healthy elderly participants. The lack of agreement can be explained by the use of different measures (muscle mass, -strength, physical performance), correction factors (height, body mass, BMI), cut-offs and by methodological issues. Conclusion: This study clearly demonstrates the dependency of sarcopenia prevalence rates on the applied diagnostic criteria and indicates the importance of defining sarcopenia and the need to reach consensus. Consensus on the diagnostic criteria should be based on evidence on the relation of diagnostic measures and clinically relevant muscle-related outcomes, useful correction factors and valid cut-offs. Disclosure of Interest: None declared