4CPS-202 Nutritional risk evaluation in institutionalised elderly patients in a public nursing home

Abstract

Background and importance Malnutrition and/or involuntary weight loss increases the risk of mortality and disability, decreasing quality of life. Nutritional status is an independent predictor of mortality per year, especially in the institutionalised elderly patient. Aim and objectives To determine the prevalence of nutritional risk and malnutrition in institutionalised elderly patients in a public nursing home (NH) and make recommendations about use of enteral nutrition (EN). Material and methods All institutionalised patients in a public NH were selected. The main variable was the classification of patients according to the risk of malnutrition using the abbreviated nutritional screening tool MNA-SF (mini nutritional assessment), validated in elderly patients in different settings, and clinical interview. Patients were classified into three groups: normal nutritional status, risk of malnutrition (with or without weight loss) and malnutrition (with or without weight loss). As secondary variables, we made recommendations about use of EN based on the MNA-SF, and the types of EN recommended were recorded. The sources of information used were the electronic prescription programme for demographic data and nutritional information was obtained through clinical interview. Results Between 29 August and 12 September 2019, 86 of 92 patients institutionalised in a public NH (93.5%) were nutritionally assessed: 52.3% were men (45/86) and mean age was 78.6 years (53–101). It was possible to weigh 53.5% of the patients (46/86) while the rest of the patients were assessed through calf circumference. The average BMI was 26.3 kg/m2. We found that 48.8% of patients were classified as normal nutritional status (42/86), 33.7% as a risk of malnutrition (29/86), of whom 7 patients had weight loss, and 17.4% were classified as malnutrition (15/86), of whom 4 patients had weight loss. EN use was recommended in 20 patients (23.3%), all of them classified as malnutrition (with and without weight loss) or as risk of malnutrition with weight loss. The types of EN recommended were: hypercaloric–hyperprotein (n=12), normocaloric–hyperprotein (n=6), hypercaloric–normoprotein (n=1) and normocaloric–normoprotein (n=1). In addition, recommendations were made about the periodicity based on the MNA-SF, according to nutritional risk classification. Conclusion and relevance The prevalence of nutritional risk and malnutrition in a public NH reached approximately half of the patients, according to the abbreviated MNA-SF scale. The use of a validated scale showed that protein malnutrition associated with minimum weight loss was the major alteration in institutionalised elderly patients in a public NH and, therefore, hyperprotein formulas were recommended the most often. References and/or acknowledgements No conflict of interest.