Low Risk Of Malnutrition Research Articles

Unveiling the intrinsic role of malnutrition in patients with Crohn's disease undergoing major surgery using entropy balancing weighting analysis.

The negative role of malnutrition in patients with Crohn's disease is known; however, many coexisting disease-related factors could cause misinterpretation of the real culprit. This study aimed to describe the role of malnutrition using a novel methodology, entropy balancing. This was a retrospective analysis of consecutive patients undergoing elective major surgery for Crohn's disease, preoperatively screened following the European Society for Clinical Nutrition guidelines. Two-step entropy balancing was applied to the group of malnourished patients to obtain an equal cohort having a null or low risk of malnutrition. The first reweighting homogenised the cohorts for non-modifiable confounding factors. The second reweighting matched the two groups for modifiable nutritional factors, assuming successful treatment of malnutrition. The entropy balancing was evaluated using the d-value. Postoperative results are reported as mean difference or OR, with a 95 % CI. Of the 183 patients, 69 (37·7 %) were at moderate/high risk for malnutrition. The malnourished patients had lower BMI (d = 1·000), Hb (d = 0·715), serum albumin (d = 0·981), a higher lymphocyte count (d = 0·124), Charlson Comorbidity Index (d = 0·257), American Society of Anaesthesiologists (d = 0·327) and Harvey-Bradshaw scores (d = 0·696). Protective loop ileostomy was more frequently performed (d = 0·648) in the malnourished group. After the first reweighting, malnourished patients experienced a prolonged length of stay (mean difference = 1·9; 0·11, 3·71, days), higher overall complication rate (OR 4·42; 1·39, 13·97) and higher comprehensive complication index score (mean difference = 8·9; 2·2 15·7). After thesecond reweighting, the postoperative course of the two groups was comparable. Entropy balancing showed the independent role of preoperative malnutrition and the possible advantages obtainable from a pre-habilitation programme in Crohn's disease patients awaiting surgery.

The Prognostic Utility of the Triceps Skinfold Thickness Albumin Index in Colorectal Cancer Patients with Cachexia

Purpose To develop a simple and convenient inflammation-nutrition-adiposity biomarker to complement the TNM staging system, further assess the prognosis of patients with colorectal cancer cachexia. Methods This study was a multi-centre cohort study. The triceps skinfold thickness-albumin index (TA) was calculated by combining the triceps skinfold thickness (TSF) and serum albumin levels. Kaplan–Meier analysis and Cox proportional risk regression models were used to assess the relationship between the TA and all-cause mortality. Internal validation was carried out. Results We included 1025 patients with colorectal cancer cachexia, 61.2% of whom were male, with a mean age of 58.91 (12.45) years. As the TA increased, overall mortality decreased in female patients (hazard ratio [HR], 0.95) but not in male patients (HR, 0.99). Multivariate Cox analysis showed that patients in the normal TA group had a significantly lower risk of death than those in the low TA group (HR, 0.53, 95% CI, 0.40–0.72). Patients with a normal TA had a lower risk of malnutrition, poor quality of life, and poor short-term prognosis than those with a low TA. Conclusions TA index enables clinicians to assess the prognosis of patients as early as possible to improve the survival of patients with colorectal cancer cachexia.

Association between malnutrition risk and healthcare utilization in a culturally diverse sample of ambulatory patients with cancer.

254 Background: Malnutrition is prevalent among cancer patients placing them at an increased risk for treatment-related complications and poor clinical outcomes. This study investigated the relationship between malnutrition risk and healthcare utilization in a diverse sample of adult ambulatory cancer patients from the Sylvester Comprehensive Cancer Center. Methods: A retrospective analysis was conducted with data collected through the My Wellness Check (MWC), an electronic health record (EHR)-based assessment. Malnutrition was assessed through the NUTRISCORE, an integrated and validated nutritional screening tool within MWC that evaluates self-reported weight loss, appetite, cancer type, and treatment modality to assess risk of malnutrition. A NUTRISCORE greater or equal to 5 is considered malnutrition risk. Time to an emergency room (ER) visit and hospitalization were calculated in days from the first MWC questionnaire assignment and the first event, respectively. All ER visits and hospitalizations in the University of Miami Health System, self-reported patient demographics, and clinical characteristics were captured from the EHR. Uni- and multi-variate logistic regression models were used to examine factors associated with malnutrition risk. For survival analyses, the Kaplan-Meier method was used to calculate the cumulative incidence function of events and the cox proportional hazards regression models adjusting for patient demographics and clinical characteristics. Results: A total of5,984 ambulatory patients completed the MWC assessment between October 2019, and August 2023, with 31.2% (n=1,868) identified at malnutrition risk (NUTRISCORE ≥5). Patients were predominately White (n=5,092, 85.2%), and Hispanic (n=2,341, 39.1%). Hematologic cancer was the most common diagnosis (n=1284, 21.5%) followed by malignancies in digestive system (n=903, 15.1%) and male genitourinary (n=892, 14.9%). After adjusting for covariates, patients at malnutrition risk were at significantly higher risk for both ER visits (HR 1.57, 95% CI; 1.29 - 1.91, p<0.0001) and hospitalizations (17.4% vs. 7.4% at 100 days, p<0.0001) compared to those with low malnutrition risk. Factors associated with malnutrition risk included Hispanic ethnicity (aOR 1.17, 95% CI; 1.01-1.35), fatigue (aOR 1.62, 95%CI; 1.07-2.45), declined physical function (aOR 1.75, 95% CI;1.37 - 2.24), physical inactivity (aOR 1.20, 95%CI;1.04 - 1.38) and low HRQOL (aOR 2.48, 95%CI; 1.93-3.19). Conclusions: Malnutrition was associated with higher healthcare utilization in a diverse sample of ambulatory cancer patients. Hispanic ethnicity and worse PROs are factors associated with higher risk for malnutrition. Results from this work underscore the need of early nutritional interventions to prevent malnutrition and improve clinical outcomes.

Malnutrition Risk Screening and Dietitian Intervention within an Integrated Care Team for Older Persons

Abstract Background Malnutrition in older adults increases the risk of frailty. Nutritional interventions can improve frailty. A Senior Dietitian joined our Integrated Care for Older Persons Community Specialist Team (ICPOP-CST) in 2022. Our Complete Geriatric Assessment (CGA) form was redesigned in early 2023 which included the Malnutrition Screening Tool (MST). We commenced measuring handgrip strength (HGS) in late 2023. We measured the prevalence of malnutrition risk among our patients, audited MST use and explored dietetic service provision. Methods Data from the first 101 patients with a completed (new) CGA form were obtained from the service’s electronic patient database. Patients with a MST score of 0 or 1 were considered to be at low risk of malnutrition and those with a MST score of 2 or more were considered to be at risk of malnutrition. Results The mean age was 84.8±5.3 years and 65% were female. Malnutrition risk was identified in 39 (38.6%) patients. The MST was completed for 96 (95%) patients and completed correctly in 67 (69.8%). The total score was not summed in 26 out of 29 incorrectly completed screening tools (89.7%). Half (51, 50.5%) of the group of older adults received dietetic assessment and intervention. High protein, high calorie advice was provided for 38 (74.5%) of those seen by the ICPOP dietitian and for 29 (93.5 %) of those at risk of malnutrition. Onward referral to primary care dietitians was made for 14 (27.5%) of those seen by the ICPOP dietitian. HGS measurement was performed in 20 patients - 15 (75.0%) were identified to have probable sarcopenia – 11 (73.3%) of these were at risk of malnutrition. All received dietetic intervention in relation to protein and sarcopenia. Conclusion Malnutrition risk and probable sarcopenia are common among older adults referred to our ICPOP-CST team. The MST screening tool is practical and identifies those requiring dietetic intervention.

Patient Malnutrition Risk or Number of Initial Nutrition Intervention Categories Can Be Used to Develop Registered Dietitian Nutritionist Staffing Models in the Inpatient Adult and Pediatric Hospital Setting: A Cohort Study

BackgroundMore data are needed to guide evidence-based, inpatient registered dietitian nutritionist (RDN) staffing models. ObjectiveIdentify relationships between: 1) patient malnutrition risk or intervention categories and estimated total RDN care time (“care time”); and 2) care time and emergency department (ED) visits. DesignThis study was a prospective cohort study with data collection via RDN surveys, patient interviews, and medical record review. Participants/settingAdult (n = 550) and pediatric (n = 345) patients enrolled at 32 adult and 27 pediatric US hospitals from August 2019 to January 2023. Main outcome measuresCare time and ED visits within 90 days of hospital discharge were measured. Statistical analysisMultilevel, generalized linear, and negative binomial regression models were used to evaluate relationships between patient characteristics and Box-Cox–transformed care time and the relationship between Box-Cox–transformed care time and total ED visits. ResultsAfter adjusting for patient characteristics, adult patients classified as at malnutrition risk vs not at risk required a mean of 8% (95% CI 5% to 11%) more care time. Pediatric patients at medium or high compared with low malnutrition risk needed a mean of 21% (95% CI 4% to 40%) and 31% (95% CI 12% to 54%) more care time, respectively. Number of initial RDN interventions categories per patient (0 to 1 vs 2 to 3 or 4+) was associated with a mean of 10% (95% CI 7% to 14%) or 8% (95% CI 2% to 15%) more care time for adults and 17% (95% CI 5% to 32%) and 39% (95% CI 21% to 61%) more care time for children, respectively. More estimated total RDN care time was associated with significantly higher incidence rate ratios of ED visits (adults: incidence rate ratio 2.8; 95% CI 1.1 to 7.2; children: incidence rate ratio 1.7; 95% CI 1.02 to 2.8). ConclusionsPatient malnutrition risk or breadth of nutrition interventions required can inform nutrition department staffing. Intervention studies may better define relationships between care time and medical outcomes.

Taste alteration and its relationship with nutritional status among cancer patients receiving chemotherapy, cross-sectional study

The aim of this study is to determine the prevalence of taste alterations (TAs) during chemotherapy and their association with nutritional status and malnutrition. In addition to the associated factors with TA, including sociodemographic health-related factors and clinical status, and to investigate coping strategies to manage TA. A multicenter cross-sectional design study was conducted on 120 cancer patients aged at least 18 who had been undergoing at least one round of chemotherapy. TAs were evaluated using the chemotherapy-induced taste alteration scale (CiTAS), the malnutrition universal screening tool (MUST) was used for nutritional screening, the antineoplastic side effects scale (ASES) was used for subjective assessment of chemotherapy side effects, and the Charlson comorbidity index (CCI) was used for comorbidity assessment. SPSS21 software was used to analyze the data, and the independent T-test and one-way ANOVA test were used to determine the association between TAs and a variety of related variables. The prevalence of TAs was 98.3%. Among participants, 48.3% were at low risk of malnutrition, 20% at medium risk, and 31.7% at high risk. Malnutrition risk was associated with taste disorders (p<0.05). Patients’ age, gender, educational level, and physical status were associated with TAs (p<0.05). Type of cancer, chemotherapy regimen, and number of chemotherapy cycles were also associated with TAs (p<0.05). A variety of antineoplastic side effects were associated with TAs (p<0.05), including nausea, vomiting, dry mouth, sore mouth and throat, excessive thirst, swallowing difficulty, appetite changes, weight loss, dizziness, lack of energy, disturbed sleep, anxiety, and difficulty concentrating. TAs were associated with an increased number of comorbidities, and individuals with diabetes, pulmonary diseases, and hypertension were associated with TAs (P<0.05). Patients in this study rarely practice self-management strategies to cope with TAs. A high prevalence (98.3%) of TAs in cancer patients receiving chemotherapy was found, and it was linked to a variety of negative outcomes. Chemotherapy-induced TAs are an underestimated side effect that requires more attention from patients and health care providers.

Relation between nutritional status on clinical outcomes of critically ill patients: emphasizing nutritional screening tools in a prospective cohort investigation

BackgroundMalnutrition is a significant concern reported in adult critically ill patients, yet there is no gold standard to assess nutritional status in this population. This study examines the association between nutritional status and clinical outcomes in intensive care unit (ICU) patients using nutritional risk assessment tools and aims to look for the best tool.MethodIn a single-center prospective cohort study among 165 patients, the predictive performance of high or low malnutrition risk assessed by Nutritional Risk Screening (NRS), Modified Nutrition Risk in Critically Ill (m-NUTRIC), Mini-Nutritional-Assessment Short-Form (MNA-SF), Controlling Nutritional status (CONUT), and Prognostic Nutritional Index (PNI) were evaluated and compared for mortality, organ failure, length of hospitalization, and mechanical ventilation (MV).ResultsDifferent assessment tools showed various nutritional statuses. m-NUTRIC and NRS-2002 were found to be associated more strongly relative to other tools with mortality (RR = 1.72; 95% CI, 1.42–2.08) and (RR = 1.37; 95% CI, 1.08–1.72), organ failure (RR = 1.69; 95% CI, 1.44–1.96) and (RR = 1.22; 95% CI, 0.99–1.48), MV (RR = 1.46; 95% CI, 1.27–1.65) and (RR = 1.21; 95% CI, 1.04–1.39) respectively. There was no correlation between malnutrition levels assessed by mentioned tools except for NRS-2002 and length of hospitalization. In predicting mortality or illness severity, the cut points were different for some tools like NUTRIC-score and all assessed outcomes (3.5), MNA-SF and mortality (6.5), CONUT with mortality, and MV (6.5).ConclusionsA considerable proportion of patients admitted to the ICU are at high risk for malnutrition. Compared to other tools, m-NUTRIC and NRS-2002 proved superior in predicting clinical outcomes in critically ill patients. Other tools overestimated the risk of malnutrition in the ICU so couldn’t predict clinical outcomes correctly.

The relationship between baseline nutritional status with subsequent parenteral nutrition and clinical outcomes in cancer patients undergoing cytoreductive surgery: a retrospective study.

Hyperthermic Intraperitoneal Chemotherapy (HIPEC) with Cytoreductive Surgery (CRS) is the preferred treatment for peritoneal malignancies. This highly complex operation is associated with a high incidence of complications, particularly due to malnutrition. This study aimed to investigate the potential association between preoperative nutritional status and postoperative clinical outcomes in adult cancer patients who underwent CRS/HIPEC for peritoneal malignancy. A retrospective study with 140 adult cancer patients, on parenteral nutrition (PN) (n = 40) and not on PN (n = 100) who underwent CRS with or without HIPEC, was conducted. Patients who received PN had significantly longer post-operative, hospital, and ICU LOS than those who did not (p = 0.001). ICU admission was significantly higher in the non-PN receiving group compared to the PN receiving group. When compared to the PN group, the majority of patients not receiving PN were at low risk of malnutrition (91% vs. 75%, p = 0.020), whereas 17.5% of PN patients were at risk of malnutrition during hospitalization. Multiple regression analyses revealed a strong positive relationship between patients with increased risk of malnutrition and ICU LOS (p = 0.047). Routine preoperative nutrition assessment is essential to identify patients who are at higher nutritional risk, and nutrition support should be provided preoperatively.

Predictors of Skeletal Muscle Index for Patients Treated With Hemodialysis

ObjectiveThere is an increased risk of skeletal muscle mass (SMM) loss among patients with stage 5 chronic kidney disease (CKD) treated with maintenance hemodialysis (MHD). The reduced SMM considerably influences the development of protein-energy wasting (PEW). Patients who develop PEW have higher hospitalization and mortality rates than those without PEW. This study determined if key variables could predict SMM Index (SMM adjusted for height) in patients receiving MHD. MethodsWe conducted a secondary analysis of cross-sectional data obtained from the Rutgers Nutrition and Kidney Database (n=178). Data were utilized to calculate both SMM and SMM Index. Univariate and multiple linear regression models explored the relationship between SMM Index and the following variables: serum albumin (ALB), Kt/V, normalized protein catabolic rate (nPCR), serum creatinine (SCr), and urea reduction ratio (URR). ResultsMost participants were Black/African American (82.9%), male (59.1%), and obese (39%), with a mean age of 55.9 ± 11.9 years. The median SGA score was 5, indicating a lower risk of malnutrition. Participants had a mean SMM of 26.4kg and a median SMM Index of 8.9kg/m2. Univariate regression modeling found URR to be a significant predictor of SMM Index, with increases in the percentage of URR predicting lower SMM Index values. The adjusted regression modeling found similar results, with increases in URR percentage predicting declines in SMM Index. ConclusionThis study found that URR was a predictor of SMM Index in patients receiving MHD. Further research is required to explore these relationships and provide clinicians with a more extensive array of tools to recognize early signs of SMM loss to prevent the progression of PEW.

Association between risk of malnutrition defined by patient-generated subjective global assessment and adverse outcomes in patients with cancer: a systematic review and meta-analysis.

To assess the association between the risk of malnutrition, as estimated by the Patient-Generated Subjective Global Assessment (PG-SGA) numerical scores, and adverse outcomes in oncology patients. Systematic review and meta-analysis. A comprehensive search was conducted in PubMed, Web of Science, Embase, CKNI, VIP, Sinomed and Wanfang databases. Studies that examined the association between the risk of malnutrition, as estimated by the PG-SGA numerical scores, and overall survival (OS) or postoperative complications in oncology patients were included. Patients were classified as low risk (PG-SGA ≤ 3), medium risk (PG-SGA 4-8) and high risk of malnutrition (PG-SGA > 8). Nineteen studies reporting on twenty articles (n 9286 patients). The prevalence of medium and high risk of malnutrition ranged from 16·0 % to 71·6 %. A meta-analysis showed that cancer patients with medium and high risk of malnutrition had a poorer OS (adjusted hazard ratios (HR) 1·98; 95 % CI 1·77, 2·21) compared with those with a low risk of malnutrition. Stratified analysis revealed that the pooled HR was 1·55 (95 % CI 1·17, 2·06) for medium risk of malnutrition and 2·65 (95 % CI 1·90, 3·70) for high risk of malnutrition. Additionally, the pooled adjusted OR for postoperative complications was 4·65 (95 % CI 1·61, 13·44) for patients at medium and high risk of malnutrition. The presence of medium and high risk of malnutrition, as estimated by the PG-SGA numerical scores, is significantly linked to poorer OS and an increased risk of postoperative complications in oncology patients.

Nutritional status of elderly patients previously ill with COVID-19: Assessment with nutritional risk screening 2002 (NRS-2002) and mini nutritional assessment (MNA-sf)

BackgroundLong-term effects of COVID-19 showed a wide range of symptoms. Also, it was found that older patients were five times more likely than younger patients to develop long-COVID symptoms (1). This study aimed to investigate the use of Nutrition Risk Screening 2002 (NRS-2002) and the Mini Nutrition Assessment–Short Form (MNA-sf) among COVID-19 in elderly patients in Saudi Arabia. MethodsA total of (n = 159) COVID-19 elderly patients were recruited in the study; the relationship between patients' characteristics, including age, gender, Body Mass Index (BMI), infection history, vaccination and chronic disease were evaluated using NRS-2002 and MNA-sf. Multivariate logistic regression to estimate the Odd Ratio (OR) by comparing the OR of different variables between normal nutritional Status and at-risk and Cohen's kappa (κ) coefficient was assessed to analyse the agreement between both tools. ResultsMNA-sf showed a positive association between age and malnutrition risk ≥ 66 years old P = 0.035. Both tools showed a negative association between BMI (P < 0.001 and P = 0.046), respectively and vaccination (P = 0.002 and P = 0.01), respectively, with risk for malnutrition. There was no significant association between Diabetes (DM) and malnutrition risk, but elderly Cardiovascular Disease (CVD) were at malnutrition risk using the NRS- 2002 tool P = 0.003. Inversely, people infected six months or more before malnutrition assessment have a lower risk of malnutrition P = 0.05. ConclusionsBoth tools were valuable and practical tools for screening elderly people with COVID-19 who are at nutritional risk and those in need of additional nutritional intervention. Further research needed to be applied in the relationship between nutritional status during and post-infectious disease for elderly people using cross-sectional and intervention studies in order to prevent malnutrition complications in Saudi Arabia.

Nutritional status of chronic kidney disease patients undergoing hemodialysis in Colombo, Sri Lanka

Introduction: Malnutrition is a common condition among patients receiving hemodialysis and one of the principal indicators of mortality and morbidity.Objectives: The main aim of the study was to assess the nutritional status of hemodialysis recipients.Methods: A cross-sectional study was conducted on fiftyfive patients in two nephrology clinics in Colombo. Data were collected under four categories; an interviewer administered questionnaire, anthropometric measurements, biochemical investigations and derived calculations. Urea reduction ratio and Kt/V were calculated to assess the dialysis efficiency. Nutritional Risk Index was employed to evaluate the malnutrition risk.Results: In the study population, 70.9% were males and mean age, mean dialysis duration were recorded as 56.05±13.16 years and 13±12 months respectively. According to BMI, 10.9% of the patients were underweight, 38.2%; normal, 14.5%; overweight and 36.4% were obese. Low levels of serum albumin, total protein, iron and hemoglobin were reported among 30.9%, 14.5%, 41.8% and 89.1% of patients respectively. More than 50% of the population had an increased CRP level, depicting an inflammatory reaction. Mean URR and Kt/V of the population were 65.8±9.6% and 1.3±0.3 respectively, which were above the recommended level. Malnutrition risk was negatively correlated with serum total calcium level (r=-0.49, p&lt;0.001), total protein level (r=-0.415, p&lt;0.05), dialysis duration (r=-0.351, p&lt;0.05), diastolic blood pressure (r=-0.35, p&lt;0.05) and MUAC (r=-0.332, p&lt;0.05) and positively correlated with absolute lymphocyte count (r=0.332, p&lt;0.05).Conclusion: Majority of the patients had an efficient dialysis session. High, moderate and low risk of malnutrition were analyzed as 7.3%, 29.1% and 63.6%. In a binomial logistic regression, total calcium level (p&lt;0.001, Exp(B); 0.027) and appetite of patients (p=0.04, Exp(B);13.816) were identified as strong predictors of malnutrition risk.

Prognostic Power of Nutrition-Inflammation Indicators in Patients With Breast Cancer

BackgroundInflammation and nutritional statuses are closely related to the survival of patients with cancer. Breast cancer is the one with low level of inflammation and low risk of malnutrition. Does inflammation burden and nutrition status affect the prognosis of patients with breast cancer? MethodsTotally 1158 patients with breast cancer from Nutrition Status and its Clinical Outcome of Common Cancers study were included, 15 nutrition-inflammation indicators (NIIs) from literatures were adopted in this study. Area under the curve and C-index were used to compare the predictive value of 15 NIIs in overall patients and subgroup in different menstrual statuses. ResultsNutrition status indicators prognostic nutritional index, controlling nutritional status score, glucose-to-lymphocyte ratio among 15 NIIs were found to be significantly associated with prognosis of breast cancer, and remained stable in patients in different menstrual statuses. The C-index of inflammation indicators lymphocyte-to-C-reactive protein ratio, lymphocyte-C-reactive protein ratio score, and C-reaction protein (CRP) increased with age, but the predictive value of 3 inflammation indicators did not exceed the value of nutritional indicators throughout the whole life of patients with breast cancer. ConclusionsPrognostic nutritional index, controlling nutritional status score, glucose-to-lymphocyte ratio had better predictive value for the survival of patients with breast cancer. Nutritional indicators surpassed inflammation indicators in prognostic ability for patients in different menstrual statuses. These results provide an important insight for the care of patients with breast cancer.

Impact of Malnutrition on Clinical Outcomes of Acutely Hospitalised Heart Failure Patients at Two Tertiary Hospitals in Australia: An Observational Study.

Malnutrition is common in patients with heart failure (HF) but is often neglected, despite guidelines suggesting that all hospitalised patients should undergo nutritional screening within 24-hours of admission. This study investigated the nutritional screening rates and determined the immediate and long-term clinical outcomes in patients with HF admitted at two tertiary hospitals in Australia. Nutritional screening was assessed by the Malnutrition Universal Screening Tool (MUST) completion rates. Patients were classified into two categories based on their MUST scores (0=low malnutrition risk and ≥1=at risk of malnutrition). Propensity-score-matching (PSM) was used to match 20 variables depending upon the risk of malnutrition. Clinical outcomes included the days-alive-and-out-of-hospital at 90 days of discharge (DAOH90), length of hospital stay, in-hospital, 30-day and 180-day mortality and 30-day readmissions. There were 5,734 HF admissions between 2013-2020, of whom, only 789 (13.8%) patients underwent MUST screening. The mean (SD) age was 76.2 (14.0) years and 51.9% were males. Five-hundred and fifty-four (554) (70.2%) patients were at low malnutrition risk and 235 (29.8%) at risk of malnutrition. In HF patients, who were at risk of malnutrition, the DAOH90 were lower by 5.9 days (95% CI -11.49 to -0.42, p=0.035) and 180-day mortality was significantly worse (coefficient 0.10, 95% CI 0.02-0.18, p=0.007) compared to those who were at low risk of malnutrition. However, other clinical outcomes were similar between the two groups. Nutrition screening is poor in hospitalised HF patients and long-term but not short-term clinical outcomes were worse in malnourished HF patients.

NRS‑2002 scale impact on nutritional status screening of patients with acute cerebrovascular accident

Evaluation of the nutritional status at an early stage of hospitalization in patients with acute cerebrovascular insufficiency (CVA) is important for providing timely nutritional support. According to the Russian clinical guidelines for nutritional support of patients with stroke, the NRS‑2002 scale is essential to assessment the nutritional status. However, due to the obesity, about 30 % of patients do not entered into the general category of patients with CVA to get the standard examination.Aim. To analyze the NRS‑2002 scale effectiveness in patients with acute cerebrovascular accident, taking into account the somatic and visceral protein pools.Materials and methods. In the case of the prospective study the 140 patients with CVA were hospitalized in the primary vascular department of the City Clinical Hospital n. a. V. V. Vinogradov (Moscow, Russia), and were screened by the simplified malnutrition scoring system and the NRS‑2002 scale.Results. The research reveals: A low risk of malnutrition in 34,3 % of all cases and 72,7 % in patients under 70 years; the high BMI – Me‑26,6 (24,2–30,8) kg/m²; the protein deficiency in 140 (25.7 %) of patients with normal somatic protein pool and in 66 (28.8 %) of patients under 70 years.Conclusions. Detecting the risk of malnutrition with the NRS‑2002 scale in the early stage after hospitalization is not always informative due to the overweight and the age less than 70 years. The visceral protein pool analysis should be performed in all patients, independently of the NRS‑2002 scale and the somatic protein pool results.

New nutritional screening tool for hospitalized patients with chronic kidney disease: translation, cross-cultural adaptation of Renal iNUT into Spanish and comparison with classic questionnaires

Chronic kidney disease (CKD) is characterized by its high prevalence of malnutrition, difficult to detect as it is underestimated by the usual tools. There is no valid or hospital-level nutritional screening tool in Spanish to identify patients with CKD at risk of malnutrition. to translate and accomplish the transcultural adaptation of Jackson's questionnaire (Renal Inpatient Nutrition Screening Tool [Renal iNUT]) to Spanish, which detects the risk of malnutrition in CKD inpatients and compares it with other nutritional tools. phase 1: translation, back-translation and transcultural adaptation of the questionnaire from the English to the Spanish version. A pilot test was carried out by nursing staff together with a satisfaction questionnaire. Phase 2: comparison of Renal iNUT with Malnutrition Universal Screening Tool (MUST) and Subjective Global Assessment (SGA). phase 1: the nursing staff's perception was highly favorable. They found it easy or very easy to use and 90 % of them did it in a maximum of ten minutes. Phase 2: from 48 patients included, Renal iNUT detected 44 % at low risk of malnutrition, 28 % at intermediate risk and 28 % at high risk. Increased sensitivity of Renal iNUT (p < 0.007) vs MUST (62.5 vs 33.3 %) and similar specificity (87.1 vs 90.6 %) were found, together with an acceptable correlation compared to SGA (r = 0.75, 95 % CI: 0.67 to 0.83). the Spanish version of Renal iNUT is a useful and easy-to-understand tool for health professionals. We also confirm its good correlation with SGA, with greater sensitivity than MUST for the risk of malnutrition detection in CKD inpatients.

Phase angle, nutritional status, and mortality in systemic sclerosis: An exploratory pilot study

ObjectivesSystemic sclerosis (SSc) is a rare autoimmune disease characterized by microvascular damage and fibrosis of the skin and internal organs. Among SSc complications, changes in nutritional status have a negative effect on quality of life and predispose patients to malnutrition. The aim of this exploratory pilot study was to examine whether bioelectrical impedance analysis-derived phase angle (PhA) is a parameter of nutritional status and a marker of mortality in patients with SSc. MethodsConsecutive adult patients with SSc were included in the study. Biochemical analyses, anthropometric data, and bioelectrical impedance analysis assessments were recorded at the time of enrollment. The Malnutrition Universal Screening Tool (MUST) and Global Leadership Initiative on Malnutrition (GLIM) were applied to assess nutritional status. ResultsA total of 104 patients with SSc (88 women; median age: 55 y [interquartile range (IQR), 45.5– 66 y]) were enrolled. In patients with SSc and high malnutrition risk according to MUST, mean values of PhA were significantly lower than those of patients with SSc and low malnutrition risk (4° [IQR, 3.7°–4.4°] vs 4.6° [IQR, 4.2°–5.1°]; P = 0.004). Patients with SSc and malnutrition according to the GLIM criteria showed significantly lower PhA than patients with SSc but without malnutrition (3.8° [IQR, 3.5°–4.3°] vs 4.6° [IQR, 4.2°–5.1°]; P < 0.0001). Kaplan–Meier curves demonstrated that overall survival was significantly shorter (34.57 mo [±13.35] vs 48 mo [±0]; P = 0.001) in patients with SSc and PhA <3.75°. In the multivariate analysis, only PhA was a predictive factor for death (hazard ratio: 0.283; 95% confidence interval, 0.083–0.965; P = 0.044). ConclusionsThe data obtained suggest that lower PhA values in patients with SSc are associated with an increased malnutrition risk with MUST, malnutrition with GLIM, and increased mortality. Additional studies are necessary to confirm these preliminary results.

Malnutrition risk and frailty in head and neck cancer patients: coexistent but distinct conditions

PurposeBoth malnutrition and frailty are associated with adverse treatment outcomes. Malnutrition (risk) and frailty are each commonly present in patients with head and neck cancer (HNC). However, their coexistence and association is unknown. Main goal of this study is to determine the coexistence of, and the association between malnutrition risk and frailty in patients with HNC.MethodsIn this retrospective analysis on prospectively collected data, newly diagnosed patients with HNC, enrolled in the OncoLifeS databiobank were included. The Patient-Generated Subjective Global Assessment Short Form (PG-SGA SF) was used to assess malnutrition risk. The Groningen Frailty Indicator (GFI) was used to assess frailty status. Multivariate logistic regression analyses were performed, taking into account several patient- and tumor-related factors.ResultsIn total, 197 patients were included. Seventy-six patients (39%) had a medium or high malnutrition risk and 71 patients (36%) were frail. In 38 patients (19%), malnutrition risk coexisted with frailty. Patients with medium and high malnutrition risk were, respectively, 4.0 (95% CI 1.5–11.2) and 13.4 (95% CI 4.0–48.7) times more likely to be frail, compared to patients with low malnutrition risk. In turn, frail patients were 6.4 times (95% CI 2.6–14.9) more likely to have malnutrition risk compared to non-frail patients.ConclusionsMalnutrition risk and frailty frequently coexist but not fully overlap in newly diagnosed patients with HNC. Therefore, screening for both conditions is recommended.

S930 Identifying Risk Factors and Predictors of Malnutrition in Patients With Inflammatory Bowel Disease at a Tertiary Care Center

Introduction: Malnutrition is highly prevalent in patients with inflammatory bowel disease (IBD). Nutritional assessment tools have been created to identify malnourished individuals and facilitate prompt nutritional intervention. The Malnutrition Universal Screening Tool (MUST) is a validated tool recommended for patients across all healthcare settings. In the present study, we implemented the MUST among patients with IBD at outpatient clinics in an academic health system. The aim of this study was to examine the relationship between patient and clinical characteristics, and laboratory markers of nutrition with the MUST nutritional risk score in patients with IBD. Methods: This was a multi-center retrospective study conducted in outpatient clinics throughout the MedStar Healthcare System. 199 patients with IBD were screened using the MUST between February 10, 2022, and May 31, 2022. Low, medium, and high nutritional risk scores were defined as a score of 0, 1, or ≥ 2, respectively. We examined the association between the MUST scores and patient demographic data, markers of nutrition, and markers of disease activity. Univariate and multivariate logistic regression was used to examine associations between independent risk factors with nutritional risk score. Results: Among the 199 patients screened, 87% were classified as low risk for malnutrition, 9% as moderate risk, and 4% as high risk. There was no statistically significant association between nutritional risk score and sex, IBD diagnosis, or age. In univariate analysis, IBD-related hospitalizations within one year of screening (p = 0.022), recent steroid use (p < .001), and elevated C-reactive protein (CRP) (p = 0.027) were associated with moderate-to-high risk of malnutrition as compared to low risk (Table). Decreased albumin (OR: 0.10; 95% CI: 0.02-0.57) and decreased hemoglobin (OR: 0.58; 95% CI: 0.40-0.84) were also significant predictors of malnutrition. In multivariate analysis, recent steroid use remained an independent risk factor for malnutrition. Conclusion: In this study, we demonstrate that MUST screening correlates to markers of disease activity, inflammation, and nutrition in patients with IBD. Univariate analysis identified IBD-related hospitalizations, recent steroid use, elevated CRP, decreased albumin, and decreased hemoglobin as risk factors. Only recent steroid use was identified as an independent risk factor. Further study on nutritional risk screening and disease markers in larger populations is warranted. Table 1. - Univariate analysis of risk factors associated with moderate-high risk nutritional risk score Characteristic Odds Ratio 95% Confidence Interval P-Value Lower Limit Upper Limit Steroid Use 7.314 2.346 22.805 < .001 IBD-related Hospitalization 4.632 1.247 17.213 0.022 CRP (mg/L) 1.129 1.014 1.257 0.027 Fecal Calprotectin (mcg/gm) 1.001 1.000 1.002 0.062 Albumin (gm/dL) 0.101 0.018 0.570 0.009 Hemoglobin (gm/dL) 0.580 0.403 0.835 0.003

Prevalence of malnutrition and associated factors among children aged 6–24 months under poverty alleviation policy in Shanxi province, China: A cross-sectional study

IntroductionChild malnutrition continues to be a major public health issue, accounting for 54% of all child mortality globally. This study aimed to determine the prevalence of childhood malnutrition and its associated risk factors as well as to explore the best developmental strategy among infants and young children (IYC). MethodologyThis cross-sectional study was conducted six months after the distribution of nutritious YingYangBao (YYB). It involved children aged 6–24 months in Shaanxi Province, China. Data were collected via interviews with parents of IYC, followed by measurements of the children's height and weight. Data were analyzed using EpiInfo software and SPSSv.26, which encompassed descriptive statistics, Pearson Chi-square, and multivariate logistic regression analysis. Ethics approval and parents' informed consent were attained prior to the study. ResultA total of 3431 data were analyzed in the study. The prevalence of stunting was highest among IYC between 12 and 18 months (3.9%). Prevalence of underweight (0.5%) and wasting (1.5%) were highest among IYC aged 18–24 months while the prevalence of overweight was highest among IYC aged 6–12months (9.0%). Significant associating risk factors of malnutrition were IYC from Northern Shaanxi (aOR = 2.24; 95%CI:1.68–2.98) and mothers with parity ≥3 (aOR = 1.52; 95%CI:1.10–2.10). IYC with a higher educated father (aOR = 0.79; 95%CI:0.66–0.95), YYB intervention (aOR = 0.77; 95%CI:0.65–0.90), correct supplementary food time (aOR = 0.84; 95%CI:0.71–1.00) and separate supplementary food preparation (aOR = 0.79; 95%CI:0.66–0.95) were significantly associated with lower risk of malnutrition. ConclusionEven though the prevalence of stunting, underweight, and wasting were relatively low (<5%), there is still a need to strengthen existing policies on child nutrition.