SUN-PP162: Quality of Care and Quality of Life in Home Parenteral Nutrition (HPN): Assessment Using a Subjective Health Perception Questionnaire

Nutrition and chronic diseases 1 and SG-U status with quartiles of dietary fiber intake was evaluated using multivariate regression, adjusting for relevant confounders and the weighted design of the NHANES sample. A p-value <0.05 was considered statistically significant. Results: Subjects in the highest quartile intake of fiber (>17. 5 grams/day) had FEV1 and FVC measurements that were 212 mL and 291 mL (respectively) higher that the lowest quartile of intake (<10.5 grams/day) and percent predicted FEV1 and FVC values that were 6.2 and 6.5 percentage points higher than participants in the lowest quartile intake. As fiber intake quartile increased, the percentage of those without COPD increased (p = 0.001). Fiber intake appeared especially protective against classification in the SG-U group, with the odds of SG-U status for participants whose intake of fiber is <10.75 g/day being 2.75 times higher than participants whose fiber intake is >17.5 g/day. Conclusion: Intake of fiber appears to be associated with improved measures of lung function and less COPD and less restrictive Spirometry (SG-U). Diet may be a modifiable risk factor in the development of COPD, especially in the highly co-morbid and symptomatic SG-U group. Disclosure of Interest: None declared

SUN-PP160 WHICH NUTRITIONAL PARAMETERS BEST PREDICT SURVIVAL IN HEMODIALYSIS PATIENTS? C. Garagarza1 , A. Valente1 , T. Oliveira1 , C. Caetano1 . 1 Nephrocare, Lisbon, Portugal Rationale: In patients with end-stage renal disease, malnutrition and inflammation are common in these patients and have been associated to adverse clinical outcomes, increased morbidity, mortality and also higher costs in health-care. The aim of this study was to evaluate which nutritional factors may be associated to mortality in maintenance HD patients. Methods: This was a prospective longitudinal observational multicenter study with 12 months of follow-up. Data were obtained on 697 patients concerning anthropometric and laboratory measures (albumin, potassium, phosphorus [P], phosphorus/calcium ratio, normalized protein catabolic rate [nPCR]). All statistical tests were performed using SPSS 20.0 software. A P value less than 0.05 was considered statistically significant. Results: Patient’s mean age was 65.4±14.1 years and mean HD time was 58.3±55.9 months. Of the whole sample, 43.5% were female and 35.6% diabetics. Patients who died had higher age (p < 0.001), lower dry weight (p = 0.002), Body Mass Index (BMI) (p < 0.001), albumin (p < 0.001), potassium (p = 0.046), P (p = 0.048) and nPCR (p = 0.002). The Kaplan Meier analysis displayed a significantly worse survival in patients with diabetes (p = 0.045), BMI <23 kg/m2 (p = 0.005), albumin <3.5 g/dL (p < 0.001), P <3.0 mg/dL (p = 0.019) and nPCR <0.8 g/kg/day (p < 0.001). In the Cox regression analysis the patient overall mortality was related to BMI <23 kg/m2 (HR: 1.965; 95% CI: 1.213, 3.183; p = 0.006), albumin <3.5 g/dL (HR: 4.116; 95% CI: 2.48, 6.831; p < 0.001), P <3.0 mg/dL (HR: 1.853; 95% CI: 1.096, 3.132; p = 0.021) and nPCR <0.8 g/kg/day (HR: 2.727; 95% CI: 1.524, 4.876, p = 0.001). After adjustment nPCR, albumin and BMI remained significant. With the inclusion of albumin in the multivariate adjustment, the association between nPCR and mortality risk was lost.

S83 Conclusion: Hypoalbuminemia, low protein intake (nPCR) and BMI <23 kg/m2 were independent predictors of mortality in HD patients. Disclosure of Interest: None declared

SUN-PP161 DIETARY CALCIUM INTAKE IN RELATION TO SERUM LIPID PROFILE IN TYPE 2 DIABETICS H. Ozcaliskan1 , F.G. Samur2 , H. Sahin1 . 1 Nutrition and Dietetics, Erciyes University, Kayseri, 2 Nutrition and Dietetics, Hacettepe University, Ankara, Turkey Rationale: Dietary calcium has been proposed to help reduce CVDs risk by decreasing intestinal absorption of lipids, increasing lipid excretion and lowering cholesterol levels in the blood. This study aimed to evaluate the adequate dietary calcium intake in improving serum lipid profile in type 2 diabetics. Methods: The study consisted of 119 type 2 diabetics (93 female, mean age 54.7±8.4 years). All subjects underwent biochemical and nutritional assessment. Dietary calcium intakes were estimated from a validated 185-item food frequency questionnaire. Calcium intakes that met at least 67% of the recommended daily allowance were defined as adequate. The data were analysed by using Mann Whitney U test and univariate general linear model. Results: It was found that the majority of patients (53.8%) had an inadequate calcium intake (mean 603.7±103.1 mg/day). In diabetic patients with adequate calcium intake, serum levels of total cholesterol, LDL cholesterol, VLDL cholesterol and triglyceride were significantly lower compared to patients with inadequate calcium intake (respectively 198.1±54.6 vs. 217.1±42.6 mg/dl, 119.1±48.0 vs. 129.3±38.6 mg/dl, 34.6±20.9 vs. 40.3±19.3 mg/dl, 173.2±104.3 vs. 200±94.6 mg/dl; p < 0.05). The statistical significance remained for serum levels of VLDL cholesterol and triglyceride at borderline after adjustment for potential non-dietary and dietary confounders (respectively p = 0.050, p = 0.052). Serum level of HDL cholesterol wasn’t associated with adequacy of dietary calcium intake. Conclusion: In conclusion, our results suggest that an adequate intake of dietary calcium in connection with the consumption milk and dairy products independently may be protective against dyslipidemias which are strongly related to diabetic complications such as CVDs in type 2 diabetics. Disclosure of Interest: None declared

SUN-PP162 QUALITY OF CARE AND QUALITY OF LIFE IN HOME PARENTERAL NUTRITION (HPN): ASSESSMENT USING A SUBJECTIVE HEALTH PERCEPTION QUESTIONNAIRE I. Kagan1 , M. Theilla1 , I. Kagan2 , K. Chernov3 , S. Lev2 , J. Cohen2 , P. Singer2 , on behalf of Department of General Intensive Care and Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Tel Aviv University. 1 Nursing Department, Steyer School of Health Professions, Sackler School of Medicine, Tel Aviv University, Tel Aviv, 2 Institute for Nutrition Research and Critical Care Department, 3 Internal Medicine F, Rabin Medical Center, Petah Tikva, Israel Rationale: Home parenteral nutrition (HPN) patients require support from a specialized team as well as from close relatives

S84 to have the best quality of life. In an attempt to assess the respective influence of this external support, a study using a questionnaire evaluating quality of life (HPN-QOL), team support and relative’s support as well as outcome was used in HPN patients. In addition, a subjective health perception test was evaluated. Methods: 33 HPN patients were enrolled and demographics parameters were collected. Questionnaires exploring last year quality of life HPN-QOL [1], epistemic authority index, subjective health perception (SHP), independency of the patient were included. Statistical analysis used Pearson correlation. Consent was obtained from the patients. Results: Sixteen male and 17 female, aged 51.2±18.2, receiving HPN for 5.1±6.5 years had a general health perception of 6.4±2.1 in a scale of 1 to 10 (best). 26 had no stoma. This SHP was correlated to symptoms index (r = 0.56) mainly affected by asthenia and weakness, insomnia, appetite disorders and difficulty to eat and less by diarrhea or signs of dehydration. These symptoms handicapped the patient for taking vacations (r = 0.53). Adherence index was highly correlated to the presence of a spouse to support (r = 0.48) and to QOL. Epistemic authority index improved with the physician authority (r = 0.39), with a lower number of visits to the GP (r = 0.44). Conclusion: The SHP score is highly correlated with most of the symptoms. The adherence index was related to the presence of a spouse. Physician decision making increased the perception of security and decreased the number of visits to outpatient clinics. References [1] Baxter JP, Fayers PM, McKinlay AW: the clinical and psychometric validation of a questionnaire to assess the quality of life of adults patients. JPEN 2010; 34: 131 142. Disclosure of Interest: None declared

SUN-PP163 KNOWLEDGE RELATED WITH THE NUTRITIONAL TREATMENT IN PATIENTS WITH HEN anchez Navajas2 , C. WandenK. Cheikh Moussa1 , A.M. S´ Berghe1 , on behalf of Human Nutrition Group Foundation for the Promotion of Health and Biomedical Research from the Valencian Community (FISABIO). 1 University General Hospital of Alicante, 2 Inspecci´ on de Servicios Sanitarios de la Consellería de Sanidad de Alicante, Alicante, Spain Rationale: Determine the level of knowledge of patients fed with enteral nutrition via oral and tube about their therapeutic plan or of their caregivers. Methods: A cross-sectional study of their knowledge related to the nutritional treatment that they receive and the regime of administration. Patients receiving home artificial nutrition by oral and tube route were selected of Alicante health department. An ad hoc survey was structured and when patient wasn’t able to answer his/her caregiver was questioned. A descriptive and analytical study was performed using chi square. Results: Initially 1569 patients were located, a total of 362 accepted to participate in the study, the reasons for which the rest of them were not included are shown in Figure 1. The median age of the patients was 78 (IIQ 60 86), the younger one had 2 years and the older 102 years and 59.4% of

Poster presentations them were women. The most frequent route of administration was oral 82.6% while a 17.4% were by tube. A 42.3% of the patients or caregivers didn’t know the diagnosis, this fact was more frequent between women (p = 0.002). Patients who explained the reason for which they are taking the nutrition were 92% of them and knew the name of product to consume were 52.7%. However only a 36.7% knew the indications of how to take or administrate it (Fig. 3). No differences were found between by gender, being the neurologic and oncologic one the most unaware, but patients that ignore the diagnosis declare to know exactly how to administrate the nutrition p < 0.001. Conclusion: A lack of knowledge was observed among patients and caregivers about the diagnosis and how to administer nutrition which indicates that it is necessary to implement intervention strategies in the training of these patients or caregivers. Disclosure of Interest: K. Cheikh Moussa Grant/Research Support from: VEGENAT S.A., A. M. S´ anchez Navajas: None declared, C. Wanden-Berghe Grant/Research Support from: VEGENAT S.A.

SUN-PP164 COMPARISON OF COMPLICATIONS ASSOCIATED WITH PERIPHERALLY INSERTED CENTRAL CATHETERS AND HICKMANTM CATHETERS IN PATIENTS WITH INTESTINAL FAILURE RECEIVING HOME PARENTERAL NUTRITION. SIX-YEAR FOLLOW UP STUDY L.D. Christensen1 , M. Holst1 , L.F. Bech2 , L. Drustrup2 , L. Nygaard2 , A. Skallerup2 , H.H. Rasmussen1 , L. Vinter-Jensen1 . 1 Centre for Nutrition and Bowel Disease, Department of Gastroenterology, 2 School of Medicine and Health, Aalborg University, Aalborg University Hospital, Aalborg, Denmark Rationale: Patients with intestinal failure (IF) are dependent on parenteral nutrition delivered through central access such as HickmanTM catheters. The peripherally inserted central line (PICC) is becoming increasingly popular for the purpose. The aim of the present study was to compare complication rates between the two types of catheters. Methods: Over a six-year period (2008 2014), we included 136 patients with IF receiving home parenteral nutrition (HPN). These patients had a total of 295 catheters (169 HickmanTM catheters and 126 PICCs). Data were collected by reviewing their medical records. Incidences are given per 1000 catheter days. Data are given as mean ± standard deviation (SD) and compared using independent student’s t-tests, Mann Whitney-Wilcoxon, and X2 -tests. A survival analysis for time to the first infection was conducted using Cox regression. Results: The total number of catheter days was 54912 days for HickmanTM catheters (mean dwell time 325±402) and 15974 days for PICCs (mean dwell time 127±121), respectively. The incidence of catheter-related blood stream infection (CRBSI) per 1000 catheter days was significantly lower for HickmanTM catheters compared to PICCs (0.56 vs. 1.63, p < 0.05). The mean time to first CRBSI was significantly shorter for PICCs compared to HickmanTM catheters (84±94 days vs. 297±387 days, p < 0.05). In addition, PICCs were more often removed due to local infection and mechanical causes (p < 0.001). Conclusion: This study demonstrates that PICCs are appropriate for use in HPN for at least three months. If used for a