Risk Of Malnutrition In Patients Research Articles

Selected nutritional risk parameters in patients with laryngeal cancer – a comparison with other patients hospitalized in a Department of Laryngology and patients with colorectal cancer

Background: It is assumed that neoplasm greater in size may affect a patients’ nutritional status and prognosis stronger than smaller one. The aim of this study was to compare the nutritional status and prognosis of patients with laryngeal cancer (LC), recognized as tumour smaller in size, and patients with colorectal cancer (CRC) who were hospitalized in our hospital during the one year period. Methods: The retrospective review of medical documentation of all 1,134 patients hospitalized in a Department of Otolaryngology. Results: The laryngeal tumour was smaller than colorectal. Nutritional risk concerned 9% of patients with LC, was greater than in patients with other laryngeal disorders (1.4%), and lower than in patients with CRC (37%). A Nutritional Risk Screening (NRS) 2002 score ≥ 3 was the only significant factor influencing the risk of in-hospital all-cause mortality, 14- and 30-day readmissions in patients with LC, and the risk of 14-day rehospitalization in patients with CRC. Conclusions: Risk of malnutrition in patients with LC was lower than in counterparts with CRC, and concern 9% and 37% of patients, respectively. Nutritional risk diagnosed in patients with LC had a stronger association with the prevalence of the measured outcomes (in-hospital death, the risk of 14-day and 30-day readmission, length of hospitalization) than in individuals with CRC.

Nutritional assessment of patients with end-stage renal disease using the MNA scale.

Patient malnutrition is a significant problem in the process of rehabilitation and treatment. One of the tools that can reveal the risk of malnutrition is a series of standardized nutritional questionnaires. The aim of the study was to assess the nutritional status of patients with end-stage renal disease (ESRD) by means of the minimal nutritional assessment (MNA) scale. The study group included respondents suffering from ESRD who were patients of the Dialysis Center at the Clinic of Nephrology and Transplantation Medicine at the University Clinical Hospital in Wrocław. The study was conducted in 47 dialysis patients (22 women and 25 men), mean age 69.68 ±8.95 years. A standardized MNA scale was used to evaluate the nutritional status of the patients. In the study group, women had a significantly lower score on the MNA scale than men (23.95 vs 25.26 points). Using the MNA scale, the risk of malnutrition was found in 13 patients, while malnutrition was found in 1 patient. Among females, the mean body mass index (BMI) was 27.28, and it was significantly correlated with the MNA score. In males, the mean BMI was 29.61, but it did not correlate with the MNA score. The time spent undergoing renal replacement therapy was 7.63 years for women and 7.24 years for men. This correlated significantly with the MNA score only in the case of men. Significant correlations were established between eating habits and MNA scores in both groups. The results obtained using the MNA scale showed a significant risk of malnutrition in patients with ESRD. In women only, a low score on the MNA scale significantly correlated with the BMI. The time of renal replacement therapy had a significant impact on the MNA scale only in the case of men. An influence of comorbidities on the MNA scores recorded by men and women was not observed. Major health incidents and other stressful situations significantly affected the nutritional status in men.

Nutritional screening in a case management program for community-living older individuals at high risk of hospital admission.

The prevalence of malnutrition in older persons depends on the healthcare setting. In recent years, hospital-based case management programs (CM Programs) targeting individuals in the community with chronic multimorbidity and high use of hospital resources (admissions or emergency visits) have been developed in many countries to reduce the need for complex health care. The objective of this study was to assess the prevalence of risk of malnutrition, using the Short Form of the Mini-Nutritional assessment, of community dwelling patients included in a chronic CM Program. Factors associated with malnutrition risk were also explored. Patients included in a hospital-based integrated CM Program for older persons at high risk for hospital readmission after an index admission were studied. MNA-SF was used at program inclusion to assess the risk of malnutrition. An array of factors potentially associated with malnutrition were explored (including feeding route, use of dental prosthesis, dysphagia, consistency of foods, specific therapeutic diets, use of oral nutritional supplements, polypharmacy, falls, and other diseases and geriatric syndromes). 791 participants were included, mean age 79.8years, 50.1% females. Risk of malnutrition was present in 44.9%. Participants at risk of malnutrition were more frequently female, had a lower BMI, were less likely to be fed orally and used more nutritional supplements. They also had a higher prevalence of dysphagia, needing changes in food consistency or using specific therapeutic diets, and had dementia or cancer more frequently. They also showed a higher need for palliative care. Risk of malnutrition in patients included in a CM Program is higher than in non-selected community dwelling older individuals. This information may help inform screening policies in similar populations at risk of hospital readmission.

Sa1816 - Risk of Malnutrition in Patients with Inflammatory Bowel Diseases: Results from an Italian Multicentre Observational Cross-Sectional Study

Sa1816 - Risk of Malnutrition in Patients with Inflammatory Bowel Diseases: Results from an Italian Multicentre Observational Cross-Sectional Study

The nutrition impact symptoms (NIS) score detects malnutrition risk in patients admitted to nephrology wards.

Nutritional screening tools recommended for the general hospitalised population do not always adequately detect malnutrition risk in patients with kidney disease. The present study assessed the validity and reliability of the Nutrition Impact Symptoms (NIS) score as a nutrition screening tool for hospitalised inpatients prefer in nephrology wards. Nutritional status was classified using Subjective Global Assessment (SGA). NIS scores were calculated from the total score of responses to questions assessing symptoms impacting upon nutritional status from the patient-generated SGA. Concurrent validity of NIS score was assessed using a receiver operating characteristic curve to predict malnutrition risk against SGA. Predictive validity was examined against length of hospital stay (LOS) and 30-day re-admission using Poisson and logistic regression, respectively. Inter-rater reliability of NIS scoring between assessors was determined using intraclass correlation. In 143 patients [90 males; mean (SD) age 57.8 (15.8) years], malnutrition prevalence was 38% (54/143) using SGA (rating B/C). Predicting malnutrition risk with an NIS score of ≥3 had a sensitivity of 0.89 and a specificity of 0.65 (area under the curve = 0.81 [95% confidence interval (CI) = 0.74-0.88]). For each 1-point increase in NIS score, the model predicted a 1.9% rise in the risk of an increased LOS (P = 0.002). Thirty-day re-admission was not associated with NIS score. Inter-rater reliability was moderate (mean difference = 0.53; intraclass correlation coefficient = 0.74; 95% CI = 0.57-0.85). Nutrition impact symptoms score is a valid stand-alone nutrition screening tool for identifying malnutrition risk in nephrology inpatients and is associated with LOS.

Flavor perception and the risk of malnutrition in patients with Parkinson\u2019s disease

Flavor perception involves both olfactory and gustatory function. In patients with Parkinson’s disease (PD), hyposmia is a frequent finding, as well as an increased risk of malnutrition. We performed a pilot study to investigate the relationship between flavor perception and risk of malnutrition in PD patients. 63 PD patients participated to perform an olfactory (Sniffin’ Sticks) and gustatory (Taste Strips) task, and a questionnaire to establish nutritional risk (MUST), which includes BMI measurements. The relationship between olfactory and gustatory function and BMI was analyzed using partial correlations, corrected for disease duration, and regression analysis. Patients displayed a high prevalence of hyposmia (68.3%), and a low prevalence (6.3%) of hypogeusia. A small, but significant correlation was found between olfactory function and BMI (r = 0.261, p = 0.038), and not for gustatory function and BMI (r = 0.137, p = 0.284). Hyposmia, and not hypogeusia, may contribute to weight loss in Parkinson’s disease, and hence increase the risk of malnutrition.

P678 Risk of malnutrition in patients with inflammatory bowel diseases: Results from an Italian multi-centre observational cross-sectional study

P678 Risk of malnutrition in patients with inflammatory bowel diseases: Results from an Italian multi-centre observational cross-sectional study

Prevalence of Pancreatic Exocrine Insufficiency and its impact on the risk of malnutrition in patients after bariatric surgery

To evaluate the therapeutic potential of I-BET-762, an inhibitor of the bromodomain and extra-terminal (BET) protein family, in experimental acute pancreatitis (AP).AP was induced by retrograde infusion of taurolithocholic acid sulphate into the biliopancreatic duct (TLCS-AP) or 2 intraperitoneal (i.p.) injections of ethanol and palmitoleic acid 1 h apart (FAEE-AP) or 12 hourly i.p. injections of caerulein (CER-AP). In all treatment groups, I-BET-762 (30 mg/kg, i.p.) was administered at the time of disease induction and again 12 h later. AP severity was assessed at 24 h by serum biochemistry, multiple cytokines and histopathology.TLCS-AP, FAEE-AP and CER-AP resulted in characteristic elevations in serum amylase and cytokine levels, increased pancreatic trypsin and myeloperoxidase activity, typical pancreatic histopathological changes and lung injury. Treatment with I-BET-762 significantly reduced biochemical, cytokine and histopathological responses in TLCS-AP and FAEE-AP, but not CER-AP.These results suggest that in different forms of AP there are significant differences in the epigenetic control of gene transcription contributing to the severity of disease responses. There is therapeutic potential in targeting bromodomains for the treatment of gallstone- and alcohol-related pancreatitis.

SUN-P210: Prevalence and Characteristics of Risk for Malnutrition in Patients with Newly Diagnosed Head and Neck Cancer

SUN-P210: Prevalence and Characteristics of Risk for Malnutrition in Patients with Newly Diagnosed Head and Neck Cancer

The risk of malnutrition in patients with a colon carcinoma: An analysis of 13239 patients.

e15057 Background: The problem of under-nutrition and lack of nutrition is increasingly placed in the focus of operational discipline. Many of them are deficient in malnutrition before being hospitalized. In surgical therapy, the prevention of postoperative complications is of utmost importance. Due to a preoperative condition of malnutrition, the complication rate may increase and thus the associated increased treatment therapy costs per patient. The consequence, of course, is also a diminished postoperative treatment quality of the treating clinic. Methods: Prospective Multicentric Observational Study: "Quality Assurance Study Colorectal Cancer from 2010-2014 of the" An Institute for Quality Assurance in Operational Medicine "at the Otto-von-Guericke-University Magdeburg. The screening for lack of nutrition was carried out with the Nutritional Risk Screening (NRS 2002) Kondrup J et al .. Results: 13239 primary data records from 2010 to 2014 were included. With the help of the NRS screening, a total score in the form of a scoring system is possible. The sum of 3 points or more identifies a patient with a nutrition-related risk and should be a cause for further diagnosis and therapy. The median of all colorectal cancer patients was NRS = 3. 65.4% of the patients had an NRS score of > = 3. In morbidity, the complications in colorectal cancer patients with NRS > = 3 points are significantly increased. Also in the case of general complications (such as pneumonia, urinary tract infection, etc.) the rate increases with a larger NRS score. Conclusions: If the risk of malnutrition is small in patients with a colon carcinoma, the morbidity is low.

The risk of malnutrition in patients with rectal carcinoma: An analysis of 9789 patients.

e15059 Background: The problem of under-nutrition and lack of nutrition is increasingly placed in the focus of operational discipline. Many of them are deficient in malnutrition before being hospitalized. In surgical therapy, the prevention of postoperative complications is of utmost importance. Due to a preoperative condition of malnutrition, the complication rate may increase and thus the associated increased treatment therapy costs per patient. The consequence, of course, is also a diminished postoperative treatment quality of the treating clinic. Methods: Prospective Multicentre Observational Study: "Quality Assurance Study of Rectal Cancer from 2010-2014 of the" An-Institute for Quality Assurance in Operative Medicine "at the Otto-von-Guericke-University Magdeburg, was screened for Nutritional Risk Screening (NRS 2002) Kondrup J et al Results: 9789 primary data records from 2010 to 2014 were included. With the help of the NRS screening, a total score in the form of a scoring system is possible. The sum of 3 points or more identifies a patient with a food-related risk and should be a cause for further diagnosis and therapy. The median of all rectal carcinoma patients was NRS = 3. 53.9% of the patients had an NRS score of > = 3. In morbidity, the complications in colorectal cancer patients with NRS > = 3 points are significantly increased. Also in the case of general complications (such as pneumonia, urinary tract infection, etc.) the rate increases with a larger NRS score. Conclusions: If the risk of malnutrition is small in patients with a colon carcinoma, the morbidity is low.

Comparison of different methods for nutrition assessment in patients with tumors.

Nutrition screening to identify patients at risk of malnutrition is vital for cancer patients because of the high prevalence of malnutrition in this population. The aim of the present study was to compare different methods of nutrition assessment in patients with tumors. From June 2013 to June 2014, we conducted an observational multicenter study to compare the assessment of nutritional status in patients with tumors by anthropometry, biochemical indicators, nutritional risk screening (NRS-2002) and patient-generated subjective global assessment (PG-SGA). Mann-Whitney test and Kruskal-Wallis H non-parametric test were used for intergroup comparisons. Spearmans rank correlation coefficients were calculated to evaluate the association between different methods of nutritional assessment. The κ statistic was used to evaluate the agreement between two assessment methods. A total of 927 oncology inpatients underwent full nutritional assessment and nutrition screening. The PG-SGA tool determined that 13.7% of patients were well-nourished (PG-SGA from 0–1) and the rest (86.3%) were malnourished. Among the malnourished patients, 57.8% were moderately malnourished (PG-SGA from 2–8) and 28.5% were severely malnourished (PG-SGA ≥9). According to NRS-2002, 30.7% of patients were at nutritional risk (NRS-2002 ≥3). There was a significant positive correlation between PG-SGA scores and NRS-2002 scores in both men and women. Compared to albumin, the PG-SGA had a sensitivity of 93.78% and specificity of 21.80%. In comparison, NRS-2002 had a low sensitivity of 43.13% and relatively higher specificity of 82.16%. In conclusion, the relationship between PG-SGA, NRS-2002 and nutritional status is statistically significant. Compared with NRS-2002, PG-SGA is a suitable screening tool for detecting the risk of malnutrition in patients with cancer.

Effects of stepwise and fine-grained dietary management on the diet control of liver cirrhosis patients complicated with gastrointestinal hemorrhage

Objective To evaluate the effects of stepwise and fine-grained dietary management on the diet control of liver cirrhosis patients complicated with gastrointestinal hemorrhage. Methods Eighty liver cirrhosis patients complicated with gastrointestinal hemorrhage were assigned to experimental group (41 cases) and control group(39 cases) by random digits table method. The patients in experimental group were treated with stepwise and fine-grained dietary management and the patients in control group were given conventional dietary treatments. The compliance diet, mastery of nutrition knowledge, malnutrition risk at admission, intake food, discharge and 2 months after discharge between two groups were monitored. The incidence of rebleeding was tracked after 1 year of discharge. Results The incidence of malnutrition risk in Child-Pugh class C was higher than that in Child-Pugh class B(Z =-4.3, P < 0.05 ) . The incidence of malnutrition risk in patients with high education level was lower than that in patients with lower education(r =-0.453, P <0.05 ). The experimental group significantly outperformed control group in mastery of nutrition knowledge at discharge: 80(70, 84) points vs. 52(42, 64) points, in compliance diet and malnutrition risk after 2 months after discharge: 86(76, 91)% vs. 53(46,57)%, 1(1, 2) points vs. 2(1,3) points, the rebleeding rate in experimental group was significantly less than that in control group within 1 year after discharge 14.6% (6/41) vs. 35.9% (14/39), and the differences were statistically significant between two groups (χ2= 4.226-51.232, all P < 0.05 ). Conclusions Stepwise and fine-grained dietary management can improve the mastery of nutrition knowledge, compliance diet and nutritional status, and reduce the occurrence of rebleeding, worth popularizing further in clinical care of liver cirrhosis patients complicated with gastrointestinal hemorrhage. Key words: Liver cirrhosis; Gastrointestinal hemorrhage; Stepwise and fine-grained dietary Management

SUN-P162: Does Completing the PG-SGA Short form Improve Patient Awareness Regarding Malnutrition Risk in Patients with Head and Neck Cancer?

SUN-P162: Does Completing the PG-SGA Short form Improve Patient Awareness Regarding Malnutrition Risk in Patients with Head and Neck Cancer?

E45 - Use of The Mini Nutritional Assessment to determine the Prevalence of Malnutrition And Cachexia In Patients Undergoing Surgery For Colorectal Carcinoma

Background: The cancer disease is the clinical condition most often associated with the concept of protein-calorie malnutrition that affects 8% to 84% of cancer patients and can worsen until determining cachexia also called “Wasting Disease”. Cancer-Related Anorexia-Cachexia Syndrome (CACS), is a complex metabolic syndrome characterized by a negative protein balance and energy caused both by a reduced caloric intake from both metabolic abnormalities associated with loss of muscle mass with or without loss of mass fat and considerable weight loss; it is estimated that about 20% of all cancer deaths occur for malnutrition. It is necessary to complement clinical examination of the patient also with review the nutritional status in order to evaluate the therapeutic process in these patients. Objective: The aim of this study was to assess the prevalence of malnutrition or the risk of malnutrition in patients undergoing to surgery for colorectal carcinoma. Methods: A total of 53 patients, 26 male and 27 female media age: 70,5 (42-86 yrs) undergoing to surgery for colorectal carcinoma in our Institute between November 2014 and April 2015, were evaluated to determine individual nutritional status, using the Mini Nutritional Assessment (MNA®) that includes 18 items grouped in four rubrics: anthropometric assessment, general assessment and lifestyle, short dietary assessment and subjective perception of health and nutrition. Results: The overall mean score for the MNA, was 26.2 ± 13.2 (range 6.0-27.0);15/53 patients (24.5%) presented a normal nutritional status (mean 24.8; range 24.0 to 27.5), 25/53 (47%) reported a risk of malnutrition while 13/53 (24.5%) reported a severe malnutrition that was found to be more common in men than in women. Besides, all malnourished patients had in the previous six months from the date of diagnosis, a significant weight loss (> 10 kg), muscle mass loss and severe reduction in the intake of food due loss of appetite and altered taste perception. Instead, patients at risk for malnutrition reported a weight loss of 3 to 5 kg and a moderate reduction in food intake. Conclusions: More than 50% of patients had moderate or severe malnutrition and the majority of them needed nutritional intervention before and during chemotherapy. Our preliminary data show the importance of nutritional assessment in cancer patients in order to set the appropriate treatment plan, improve its quality of life and increase overall survival in cancer patient.

Malnutrition associated with head and neck cancers

Article type Review article Cancerous patients, under the chemotherapy or radiotherapy, are at high risk of malnutrition due to the associated complications with the treatment procedures such as chewing problems, dysphagia, nausea etc. Considering the patients' history of alcohol consumption, smoking or any other diseases and performing several physical examinations are essential in early identification of high-risk patients for nutritional complications, losing unintentional weight and fat free mass. In this review, we tried to briefly explain the risk of malnutrition in patients with head and neck cancers who are undergoing surgery, chemotherapy and radiotherapy. Oral nutrition, nasogastric tube and percutaneous endoscopic gastrostomy are different methods of nutritional interventions, which have been compared due to their efficacy in maintaining the patients' weight. In this study, we reviewed the results obtained in clinical trials about the efficacy of intense nutritional intervention on limiting the chemoradiotherapy- associated complications in patients with head and neck cancers.

OC-074 Nutritional Optimisation And Pancreatic Enzyme Supplementation In Chronic Pancreatitis: Are We Giving Our Patient’s Enough Advice?

IntroductionThere is a significant risk of malnutrition in patients with Chronic Pancreatitis (CP) with evidence to suggest that good dietary counselling for a balanced homemade diet is as good as...

Mini-Nutritional Assessment (MNA) is Useful for Assessing the Nutritional Status of Patients with Chronic Obstructive Pulmonary Disease: A Cross-sectional Study

Malnutrition is prevalent in patients with chronic obstructive pulmonary disease (COPD) but is often neglected in clinical practice. This study examined the usefulness of the Mini Nutritional Assessment (MNA) for assessing the nutritional status of patients with COPD. We recruited 83 patients with COPD in stable condition from the pulmonary rehabilitation unit of a medical center in northern Taiwan. Each patient was interviewed with a structured questionnaire to elicit personal and health-related data, and measured for anthropometric and blood biochemical indicators. Nutritional status was rated with two Taiwanese-specific versions of the MNA, MNA-T1 and MNA-T2. Fat-free mass was measured with bioelectrical impedance analysis (BIA), and exercise capacity indicators with the 6-Minute Walk Test. The two MNA versions showed high agreement (kappa = 0.949) in predicting the nutritional risk, and both versions predicted the FFMI well (area under the curve of the Receiver Operating Characteristics = 0.804, p < 0.001 for MNA-T1; and 0.813, p < 0.001 for MNA-T2). MNA scores decreased with increasing disease severity and were highly correlated with FFMI, BMI, mid-arm circumference, calf circumference, and oxygen saturation at rest and during exercise (all p < 0.01). The MNA score was positively correlated with FEV1, FVC and 6-minute walking distance, and negatively correlated with GOLD stages (all p < 0.05). However, the MNA score was not significantly correlated with blood biochemical indicators, perhaps due to inflammatory status associated with COPD. The MNA appears appropriate for rating the nutritional risk of patients with COPD. Routine use of the MNA may help reduce the risk of malnutrition in patients with COPD.

Malnutrition and Risk of Malnutrition in Patients With Stroke

Although various studies have shown high prevalence of malnutrition in hospitalized patients with stroke, recent studies on how the nutritional status of patients with acute stroke develops during the first weeks of hospital stay are scarce. Information is lacking concerning the identification of patients with stroke who are at risk of malnutrition during an acute hospital stay, because these patients may have a significant chance to improve their nutritional status. This study aimed to investigate the prevalence of malnutrition and risk of malnutrition of patients with acute stroke during the first 10 days of hospitalization. A prospective, descriptive study was conducted in a neurological department of a university hospital in The Netherlands. Seventy-three patients with acute stroke were included, of which 23 patients could be followed up after 10 days. The nutritional status was determined with the Mini Nutritional Assessment at admission and after 10 days. At admission, 5% of the patients (n = 73) were malnourished, 14% were at risk of malnutrition, and 81% were well nourished. Of the patients who could be followed up (n = 23), at admission, no patients were malnourished, 9% were at risk of malnutrition, and 91% were well nourished; whereas 10 days later, 26% of these patients were malnourished, 39% were at risk of malnutrition, and 35% were well nourished. This means that, within the followed-up group, the proportion of patients with malnutrition or risk of malnutrition increased significantly during hospital stay from 9% to 65%. Our study shows that the prevalence of malnutrition and risk of malnutrition in patients with acute stroke increases strongly during the first 10 days of admission. Therefore, screening of the nutritional status of these patients throughout this period is highly recommended to enable timely nutritional intervention and nutritional management of these patients.

THU0463-HPR Malnutration in rheumatology in acute care setting, riskfactors and interventions

BackgroundThe prevalence of malnutrition in hospitalized patients in Switzerland is up to 40%. Only few studies about malnutrition have been conducted in rheumatology and often only with a small sample....