Nutritional Status Of Adult Patients Research Articles

Administration of vitamin D3 topical in increasing serum vitamin D level: A literature review

Background: Vitamin D is an essential fat-soluble vitamin that is required daily by the body. Deficiency in vitamin D is experienced by most of the world's population. Vitamin D plays a role in maintaining the skin barrier by regulating keratinocyte proliferation and differentiation, promoting filaggrin formation, and intraepidermal lipids. Discussion: The vital role of vitamin D, non-compliance with supplement consumption, and poor nutritional status of adult patients and the elderly with deficiency and insufficiency of vitamin D encourage studies regarding vitamin D delivery via the transdermal route. The lipophilicity of vitamin D allows it to penetrate through the skin barrier. Conclusion: Research indicates that topical application of vitamin D3 is not only safe but also effective in increasing serum vitamin D levels. Thus, topical delivery is a promising alternative method for providing vitamin D supplementation or as a therapeutic option for specific conditions that leads to improved skin hydration and serum vitamin D levels.

Short-term effects of Mediterranean diet on nutritional status in adults affected by Osteogenesis Imperfecta: a pilot study

BackgroundOsteogenesis Imperfecta (OI) is a heterogeneous group of connective tissue disorders, characterized by varying degrees of skeletal fragility. Patients experience a range of comorbidities, such as obesity, cardiovascular, and gastrointestinal complications, especially in adulthood. All aspects that could benefit from dietary intervention. The aim of this study was to evaluate the effects of a 6-months restricted Mediterranean Diet (rMD) on nutritional status in adult patients affected by OI.We carried out a 6-months longitudinal pilot study. 14 adults (median age: 35 years; 7 women; 7 OI type III) where recruited in 2019 among the members of As.It.O.I., the Italian Association of Osteogenesis Imperfecta. As.It.O.I. All the evaluations were performed at the University of Milan, Italy. The rMD provided a reduction of 30% from daily total energy expenditure. 45% of calories derived from carbohydrates, 35% from fat and 0.7–1.0 g/kg of body weight from proteins. Comparisons of continuous variables after 6 months of intervention were performed by the paired t-test. All P-values were two-tailed, and p < 0.05 was considered significant.ResultsPatients showed significant improvement in anthropometric measurements (BMI = 30.5 vs 28.1 kg/cm2, p < 0.001; Body Fat % = 32.9 vs 29.9, p = 0.006; Waist circumferences = 83.6 vs 79.6 cm; p < 0.001; Arm Fat Area = 29.8 vs 23.07 cm2; p < 0.011) and energy expenditure (REE/kg = 27.2 vs 29.2 kcal/kg, p < 0.001). Glucose and lipid profiles improved (Δglycemia = − 8.6 ± 7.3 mg/dL, p = 0.003; ΔTC = − 14.6 ± 20.1 mg/dL, p = 0.036; ΔLDL = − 12.0 ± 12.1 mg/dL, p = 0.009). Adherence to the MD significantly increased, moving from a moderate to a strong adherence and reporting an increased consumption of white meat, legumes, fish, nuts, fruits and vegetables.ConclusionA rMD was effective in improving nutritional status and dietary quality in adults with OI. These results underscores the need to raise awareness of nutrition as part of the multidisciplinary treatment of this disease.

Nutritional status of adult patients with traumatic injuries

Nutritional status of adult patients with traumatic injuries

Immunosuppressive Therapy and Nutritional Status of Patients after Kidney Transplantation: A Protocol for a Systematic Review.

(1) Background: Kidney transplantation is widely recognized as the most effective method of treating end-stage renal disease. Immunosuppressive therapy plays a pivotal role in the treatment of kidney transplant patients, encompassing all patients (except identical twins), and is administered from organ transplantation until the end of its function. The aim of this systematic review is to identify the evidence of the association between immunosuppressive therapy and nutritional status of patients following kidney transplantation. (2) Methods: This protocol has been designed in line with Preferred Items for Systematic Reviews (PRISMA-P). Our search encompasses several databases, including MEDLINE (via PubMed), EMBASE (Elsevier), Scopus and Web of Science. We intend to include observational studies (cross-sectional, case-control, and cohort designs), randomized controlled trials (RCTs), as well as completed and ongoing non-randomized study designs. We will confine our search to studies published in English within the past decade (from inception to 17 February 2023). Qualitative studies, case studies, and conference reports will be excluded. The selection process will be done in Covidence by two independent reviewers. Data extraction will be conducted using a standardized MS Excel template version 16.0. Quality assessment of included studies will be performed using the Cochrane Risk of Bias tool for randomized trials (RoB2), or the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool. Risk-of-bias plots will be generated using the web application Robvis. Relevant data that have been extracted from eligible studies will be presented in a narrative synthesis. We expect the studies to be too heterogeneous to perform subgroup analyses. (3) Conclusion: This systematic review will offer insights into the evidence regarding association between immunosuppressive therapy and nutritional status of adult patients (18 years of age or older) within the initial year following kidney transplantation. To our knowledge, there is no systematic review addressing that question.

RELATIONSHIP BETWEEN NUTRITIONAL STATUS, DYSPHAGIA, AND FUNCTIONAL EATING LEVEL IN ADULT PATIENTS WITH CEREBRAL PALSY IN LONG INSTITUTIONAL STAYS.

Diets with modified consistencies for patients with dysphagia in long term care health institutions may be associated with malnutrition. : To assess the nutritional status of adult patients with cerebral palsy and dysphagia hospitalized in a health institution for more than 10 years. : This prospective investigation was performed in 56 patients with cerebral palsy (ages 25 to 71 years, mean: 44±12 years) and no other neurological diagnosis in hospital stay for more than 10 years had their nutritional status, dysphagia, and food ingestion capacity assessed in two moments with a 12-month interval in between them, respectively using the body mass index, the dysphagia risk assessment protocol (PARD), and the functional oral ingestion scale (FOIS). : There were no differences between December 2015 and December 2016 in the patients' weight, nutritional status, diet consistency classification, PARD, and FOIS. The limits of prescribed diet consistency (IDDSI-FDS) and the assessments of dysphagia and functional eating level influenced the nutritional status. More intense dysphagia and greater eating restrictions were associated with a worse nutritional status. : The nutritional status of adult patients with cerebral palsy hospitalized in a health long term institution who had modified diets according to their swallowing and mastication capacity did not worsen between assessments with a 12-month interval in between them. The severity of dysphagia and diet restrictions interfere with the patients' nutritional status: dysphagia and more intense eating restrictions are associated with a worse nutritional status.

Nutritional Management in Adult Patients With Dysphagia: Position Paper From Japanese Working Group on Integrated Nutrition for Dysphagic People.

This position paper prepared by the Japanese Working Group on Integrated Nutrition for Dysphagic People (JWIND) aims to summarize the need for nutritional management in adult patients with dysphagia, the issues that nutrition professionals should address, and the promising approaches as well as to propose a vision for the future of nutritional care for adult patients with dysphagia. JWIND is a joint certification system recognized by the Japan Dietetic Association and the Japanese Society of Dysphagia Rehabilitation; its members are mostly experts known as "Certified Specialist of Registered Dietitian for Dysphagia Rehabilitation." Malnutrition and dysphagia are associated with each other. Therefore, malnutrition detection and intervention are essential for patients with dysphagia. However, evidence on the usefulness nutritional assessment and intervention to ensure appropriate nutritional care remains insufficient. Here, we present current knowledge of the relationship between primary diseases causing dysphagia and malnutrition, the indicators used for nutritional assessment, and nutritional interventions such as texture-modified diet (TMD) quality improvement, oral nutritional supplementation, and comprehensive intervention. We also discuss the current status and issues in nutritional care for adult patients with dysphagia. Furthermore, we have proposed measures that nutrition professionals should consider based on 3 perspectives: nutritional assessment, TMD, and nutritional intervention. Individualized and specialized nutritional management by registered dietitians (RDs) through appropriate assessment of the nutritional status of adult patients with dysphagia is needed. To maintain and improve swallowing function and nutritional status, RDs should intervene from the state of risk or early dysphagia onset, providing individualized care per their expertise as part of a multidisciplinary team. However, systematic clinical practice and research regarding the association of nutrition with dysphagia are currently insufficient. Therefore, further clinical practice and evidence building, including the verification of the efficacy on nutritional support through intervention research, are needed.

Adult patients with allied disorders of Hirschsprung's disease in emergency department: An 11-year retrospective study.

BACKGROUNDIn the past years, only a few studies with a limited number of adult patients analyzed clinical features of allied disorders of Hirschsprung’s disease (ADHD), most of which were individual case reports or lacked detailed clinical information. Although many studies have reported patients presenting to the emergency department (ED) with recurrent abdominal symptoms for a number of disorders, there are few data involving ADHD. However, owing to a lack of awareness of the disease, misdiagnoses and mistreatments are common. Severe complications such as perforation, bleeding, malabsorption, and even death in ADHD had been reported by many studies.AIMTo assist ED clinicians in having a more comprehensive understanding of this disease and making an early suspected diagnosis of ADHD more effectively.METHODSWe enrolled 53 patients who visited the ED and were eventually diagnosed with ADHD over the past 11 years in our hospital. Their basic information, clinical manifestations, and imaging findings were analyzed. Blood indices were compared between the ADHD and irritable bowel syndrome (IBS) groups.RESULTSAdult patients with ADHD had a mean age of 48.8 ± 14.3 years, and 77.4% had been treated before admission. The transverse colon was the most common dilated part (73.6%), and constipation (67.9%) was the most common symptom. ADHD patients can present with uncommon symptoms and false-negative imaging findings. Logistic regression analysis indicated that body mass index (BMI) [odds ratio (OR) = 0.786, P = 0.013], cholinesterase (per 1000 units; OR = 0.693, P = 0.008), and blood chlorine (OR = 0.816, P = 0.022) were determined to be independent related factors between the ADHD and IBS groups. The area under the receiver operating characteristics curve of these three indices combined was 0.812 (P < 0.001).CONCLUSIONEmergency physicians should be vigilant regarding patients with chronic constipation, abdominal pain, or abdominal distension, and consider the possibility of ADHD despite its rarity. Abdominal computed tomography examination is recommended as a useful tool in the suspected diagnosis of ADHD. BMI, cholinesterase, and blood chlorine have good discriminative abilities between ADHD and IBS. The nutritional status of adult patients with ADHD is worthy of further attention. Surgical treatment for adult patients with ADHD is important and inevitable.

The Impact of Phenylketonuria on Body Composition in Adults

Introduction: Patients with phenylketonuria (PKU) must follow a lifelong phenylalanine (Phe)-restricted diet with additional amino acid supplementations, and this may put them at risk for nutritional disturbances. However, the body composition and nutritional status of adult patients with PKU has only been partially explored. The current study aims to assess the body composition of adult patients with PKU using multifrequency bioimpedance analysis (MF-BIA) and to reveal potential correlations between therapy adherence and body composition. Additionally, we compared body composition of patients with healthy controls. Methods: Fifty adult patients with early-treated PKU (27 female and 23 male) and 40 healthy, age- and gender-matched controls were included in this single-center, cross-sectional study. MF-BIA was performed on all subjects. Additionally, we determined serum nutritional markers for all patients. In the PKU patient group, correlation analyses were performed between body composition parameters and therapy adherence. We compared body composition of patients with PKU and controls using BIA. Results: The proportion of overweight was 56% among all patients with PKU. Female patients with PKU had significantly higher body fat percentage compared with controls. In parallel with higher fat content, we observed lower muscle mass, protein, and mineral content among female patients with PKU compared to controls. Such findings were not observed in male patients. Female patients with PKU had decreased therapy adherence and had significantly lower prealbumin levels compared with males. There was no significant correlation observed between body composition parameters and therapy adherence over the last 10 years in the PKU patient group. Conclusion: Although female patients had less optimal therapy adherence over the last 10 years compared with male patients, our results suggest that this does not influence body composition fundamentally. Our results suggest that obesity is an important comorbidity in young adult patients with PKU, especially in females. We advocate that nutritional assessments and weight management should be additional objectives of PKU management to provide optimal care.

Nutrition in adult patients with selected lysosomal storage diseases

Lysosomal storage disorders (LSDs) are a group of clinically heterogeneous disorders affecting the function of lysosomes and are characterized by an accumulation of undigested substrates within several cell types. In recent years there have been substantial advances in supportive care and drug treatment for some LSDs, leading to improved patient survival, as seen in Gaucher, Pompe and Fabry disease and some Mucopolysaccharidoses; however, many symptoms still persist. Thus it is now even more important to improve patients' quality of life and reduce symptoms and comorbidities. One potential way of achieving this goal is through adjunct nutritional therapy, which is challenging as patients may be overweight with associated consequences, or malnourished, or underweight. Furthermore, drugs used to treat LSDs can modify the metabolic status and needs of patients. There are currently not enough data to make specific dietary recommendations for individual LSDs; however, suggestions can be made for managing clinical manifestations of the diseases, as well as treatment-associated adverse events. The metabolic and nutritional status of adult patients must be regularly assessed and individualized dietary plans may be created to cater to a patient's specific needs. Damage to the autophagic process is a common feature in LSDs that is potentially sensitive to dietary manipulation and needs to be assessed in clinical studies.

Nutrient Intake and Nutritional Status in Adult Patients with Inherited Metabolic Diseases Treated with Low-Protein Diets: A Review on Urea Cycle Disorders and Branched Chain Organic Acidemias.

Low-protein diets (LPDs) are the main treatment for urea cycle disorders (UCDs) and organic acidemias (OAs). In most cases, LPDs start in childhood and must be continued into adulthood. The improved life expectancy of patients with UCDs and OAs raises the question of their consequences on nutritional status in adult subjects. As this topic has so far received little attention, we conducted a review of scientific studies that investigated the nutrient intake and nutritional status in adult patients with UCDs and branched chain organic acidemias (BCOAs) on LPD. Methods: The literature search was conducted in PubMed/MEDLINE, Scopus, EMBASE and Google Scholar from 1 January 2000 to 31 May 2020, focusing on nutrient intake and nutritional status in UCD and OA adult patients. Results: Despite protein restriction is recommended as the main treatment for UCDs and OAs, in these patients, protein intake ranges widely, with many patients who do not reach safety levels. When evaluated, micronutrient intake resulted below recommended values in some patients. Lean body mass resulted in most cases lower than normal range while fat body mass (FM) was often found normal or higher than the controls or reference values. Protein intake correlated inversely with FM both in adult and pediatric UCD patients. Conclusions: The clinical management of adult patients with UCDs and BCOAs should include an accurate assessment of the nutritional status and body composition. However, as little data is still available on this topic, further studies are needed to better clarify the effects of LPDs on nutritional status in adult UCD and BCOA patients.

Value of l-alanyl-l-glutamine parenteral formula in patients with head and neck cancer receiving radiotherapy

Objective The aim was to determine the effect of administration of parenteral l-alanyl-l-glutamine-containing formula on occurrence of treatment-related malnutrition and acute radiotherapy (RT)-related toxicities in patients with head and neck cancer. Background Studies have shown that glutamine-containing nutritional therapy can improve the nutritional status of adult patients with cancer. Patients and methods A total of 40 patients with head and neck carcinoma were randomized to receive either parenteral l-alanyl-l-glutamine-containing formula (0.4 mg/kg) during the first 2 weeks of RT (with or without chemotherapy) or placebo. Nutritional assessment was done for all patients at diagnosis and on weekly basis till end of treatment using subjective global assessment tool and anthropometric measures. Treatment-related toxicity was reported and graded. Quality of life (QoL) was assessed using Functional Assessment of Cancer Therapy for patients with head and neck cancer. Results There was a significant difference between the studied groups regarding subjective global assessment tool score from third week till 7th week (P = 0.019, 0.005, <0.001, <0.001, and 0.021, respectively). Low BMI was more frequent in group 2 patients. Conversely, severe weight loss was significantly different between both groups starting from third week (P = 0.020, 0.010, 0.004, 0.031, and 0.044). There was higher frequency and severity of acute RT toxicities in group 2 patients. There was a significant difference between the two groups regarding QoL as well (P = 0.005). Conclusion l-alanyl-l-glutamine nutritional supplement resulted not only in better nutritional status but also in improved treatment tolerance and QoL.

P356 Can nurse-provided education affect improvement of lung function and nutritional status in adult patients with cystic fibrosis?

P356 Can nurse-provided education affect improvement of lung function and nutritional status in adult patients with cystic fibrosis?

Association between Health-Related Quality of Life and Nutritional Status in Adult Patients with Crohn's Disease.

This study aimed to assess health related quality of life (HRQoL) in adult patients with Crohn’s disease (CD), considering disease severity and gender differences, and also its relationship with nutritional status. Consecutive adult patients aged 18–65 years with CD were recruited. Disease activity was clinically defined by the Crohn’s Disease Activity Index (CDAI) in active and quiescent phases. HRQoL was evaluated using the validated short form (SF)-36 questionnaire for the Italian population. Additionally, anthropometry, bioimpedance analysis, and handgrip-strength (HGS) were performed. Findings showed that 135 patients (79 men and 56 women) were included, having a mean age of 38.8 ± 14 years and a BMI of 23.2 ± 3.7 kg/m2. Overall, active CD patients had a lower perception of their QoL compared to those clinically quiescent, while gender differences emerged mostly in the quiescent group. Interestingly, HRQoL was significantly associated with many nutritional variables, and muscle strength was the main predictor. Therefore, HRQoL is perceived lower in active compared to quiescent patients, but women experienced poorer QoL than men, especially in the quiescent phase. Finally, higher QoL scores were found in subjects being in clinical remission phase with a preserved muscle function. However, further studies are still required to verify these findings.

The Prognostic Impact of Pretransplantation Inflammatory and Nutritional Status in Adult Patients after Myeloablative Single Cord Blood Transplantation

Markers of inflammatory and nutritional status, such as the Controlling Nutritional Status (CONUT) score, Prognostic Nutritional Index, Glasgow Prognostic Score, and C-reactive protein-albumin ratio (CAR) has been demonstrated to be associated with poor prognosis in patients with various cancers. Although the relatively low cell dose of a single cord blood unit restricts the indication for cord blood transplantation (CBT) to pediatric and relatively smaller and lighter adult patients, the impact of malnutrition on outcomes after CBT is unclear. We retrospectively analyzed 165 adult patients who underwent myeloablative single-unit CBT in our institute. In multivariate analysis, a higher CONUT score, which is indicative of poor inflammatory and nutritional status, was significantly associated with poor outcomes, including low neutrophil engraftment and development of extensive chronic graft-versus-host disease. A higher CAR, which is also suggestive of poor inflammatory and nutritional status, was significantly associated with poor neutrophil engraftment and higher overall mortality. Body mass index (BMI) was not associated with transplantation outcomes. These data suggest that poor pretransplantation inflammatory and nutritional status might be a more practical parameter than lower BMI, for predicting transplantation outcomes after single CBT for adults.

25 hydroxyvitamin D and nutritional parameters correlation in adults with stage 4 chronic kidney disease

Serum concentrations of 25-hydroxyvitamin D (abbreviated "25(OH)D") and parameters of nutritional status both decline as chronic kidney disease (CKD) progresses. The objective of this study was to measure and correlate 25(OH)D concentrations with alterations in the nutritional status of adult patients with stage 4 CKD. The study was cross-sectional, included patients with stage 4 CKD (CKD-Epi between 15 and 30ml/min/1.73m2), between the ages of 18 and 65, who sought services at the Department of Nephrology between April 2016 and April 2017. seventy participants were evaluated; the median age was 47 years old (interquartile range [IQR] of 33-53 years), and 54% of the participants were women. All of the participants presented 25(OH)D serum concentrations below 30ng/ml. According to a Subjective Global Assessment, 32.6% of the study population was malnourished and 14% presented protein energy wasting. An inverse and proportional correlation was found between levels of 25(OH)D and urea (r=-0.342), cholesterol (r=-0.383), triglycerides (r=-0.316), and extracellular water (r=-0.399). In contrast, levels of 25(OH)D were directly proportional with serum albumin (r=0.388), serum hemoglobin (r=0.331), phase angle (r=0.355), resistance (r=0.518), and reactance (r=0.580) in a statistically significant manner (p<0.05). All the participants in this study presented levels of 25(OH)D considered to be deficient. Levels of 25(OH)D were shown to be significantly correlated with alterations in nutritional status. It is necessary to implement effective interventions to help correct these deficiencies in patients with CKD.

Severe malnutrition evaluated by patient-generated subjective global assessment results in poor outcome among adult patients with acute leukemia: A retrospective cohort study.

To evaluate nutritional status in adult patients with acute leukemia (AL) using patient-generated subjective global assessment (PG-SGA) and to investigate the influence of nutritional status on prognosis.We observationally investigated 68 adult patients with newly diagnosed AL who received PG-SGA at the First Hospital of Jilin University between May 2013 and July 2015. Clinical features, chemotherapy regimens, biochemical indexes, body composition, complete remission (CR) rate, minimal residual disease (MRD), survival time, and side-effects of chemotherapy were compared between patients with and without severe malnutrition.Mean PG-SGA scores of the total patients were 6.1 ± 4.0, and 19 of 68 (27.9%) patients had severe malnutrition (PG-SGA score ≥9). Patients with acute myeloid leukemia (AML) had higher scores than those with acute lymphocytic leukemia (ALL; P = .011) and high-risk patients had higher scores regardless of whether they had AML or ALL (AML, P = .012; ALL, P = .043). Univariate analysis showed that severe malnutrition was correlated with age (P = .041), transferrin (P = .042), Karnofsky Performance Status score (P = .006), and C-reactive protein (CRP) (P = .018). Multivariate analysis demonstrated that severe malnutrition was associated with CRP (hazard ratio [HR] = 1.020, 95% confidence interval [CI]: 1.002-1.039, P = .026). No difference was found in CR rate (P = .831) between patients with and without malnutrition, but those who were severely malnourished had higher MRD (P = .048 in AML patients, P = .036 in ALL patients) and more gastrointestinal side-effects (P = .014). Severe malnutrition was also associated with inferior overall survival (HR = 0.243, 95% CI: 0.063-0.945, P = .041) but not with event-free survival (HR = 0.808, 95% CI: 0.338-1.934, P = .663).Severe malnutrition defined by PG-SGA in adult patients with de novo AL may result in poor outcome.

Keterkaitan Status Gizi Dengan Kejadian Phlebitis Pada Pasien Dewasa Di Ruang Flamboyan RSUD Gambiran Kota Kediri

Phlebitis is inflammation of the vein wall due to intravenous fluid therapy, which is characterized by pain, redness, palpable soft, swollen and warm to the location of the stabbing (Prastika, 2011). Plebitis as one form of nosocomial infection is still a serious problem faced by hospitals throughout the world, especially hospitals in developing countries (Ministry of Health, 2008). The study design used by researchers is the correlation, this surveys or research that attempts to explore how and why the health phenomena occur. The population in this study are all adult patients in hospitals Gambiran Flamboyan Room Kediri in May. Sampling technique, which is used in this study is the probability sampling which simple random sampling method. Data already collected was processed and identified, then analyzed analytically using logistic regression test. Results of the study appear no link nutritional status in adult patients with phlebitis incidence (p=0.604; 0.05). The risk of the occurrence of phlebitis is caused by chemical factors, mechanical factors and infection.; Keywords: Nutrition, Plebitis, infection

Assessment of the nutritional status of adult patients with acute myeloid leukemia during induction chemotherapy.

To the best of our knowledge, few studies have evaluated the nutritional status in patients with acute myeloid leukemia (AML) during induction treatment. The aim of this retrospective study was to describe nutritional status of newly diagnosed adult patients with AML at admission and during induction chemotherapy. We included consecutive newly diagnosed adult patients with AML who were admitted to the Department of Hematology (Limoges University Hospital) from April 2010 to January 2014. Nutritional assessment included body mass index (BMI) and weight loss to diagnose undernutrition. Weekly laboratory tests were collected and total energy expenditure was calculated to adapt food intake. Of 95 patients, 14 (15%) presented with undernutrition at admission: low BMI values (P<0.001) and weight loss >5% for 9.5% patients. After chemotherapy induction, 17 patients (18%) were undernutrition (P=0.05). Patients without undernutrition had a significantly lower median weight, BMI, and serum albumin level at discharge compared with their admission values (P<0.05); whereas their serum transthyretin levels were higher (P=0.03). They also had shorter hospital stays than patients with undernutrition (31 versus 39d; P=0.03) and longer survival at 12mo (89.9 versus 58.3%; P=0.002). Patients with AML with good nutritional status undergoing induction chemotherapy have shorter hospital stays and longer survival.

Body Mass Index at 3 Weeks after Intensive Induction Regimen Is a Prognostic Factor for the Risk of Relapse and/or Failure in Patients with Acute Myeloid Leukemia

Introduction:Cancer-related malnutrition occurred in 30 to 80 % of patients (pts) with cancer (Br J Cancer. 2010;102:966). Malnutrition affects well-being and it is associated with an impaired survival in pts with solid cancer (Eur J Cancer 2008;44:1238). By contrast, few studies focused on the nutritional status of adult patients with acute myeloid leukemia (AML) eligible to intensive therapy and its prognostic consequences.Materials and methods:Therefore, we systematically assessed nutritional status with the body mass index (BMI) before starting induction therapy and again 3 weeks later in AML patients who received intensive induction regimen from January 2008 to December 2011 at Amiens University Hospital. Weight loss, albumin and Glasgow prognostic score (GPS, Brit J Cancer, 2003; 89: 1028) were also monitored during hospitalization and enteral or parenteral nutrition was initiated in case of denutrition. The prognostic value associated with nutrition parameters was evaluated with the model of Fine and Gray (JASA, 94: 496 1999) in order to take the 2 competing risks of relapse/initial failure (R/F) or death without R/F into account.Results:A total of 106 AML pts (mean age 49.8 years [18-75 years], M/F=0.88) entered the study. Eleven pts presented with acute promyelocytic leukemia. Mean serum albumin concentration was 35.6 g/L (15.7-40.8). At treatment initiation, underweight, normal weight, overweight and obesity was identified by BMI in 4%, 41%, 22% and 33% of pts respectively and 3 weeks later in 4%, 49%, 26% and 21% of pts respectively. Severe infections (Common Terminology Criteria for Adverse Events grade 3 to 5) occurred during the hospitalization in 68 pts. Fifteen pts died during hospitalization. Twelve pts failed to respond to induction chemotherapy regimen, all but one received a salvage regimen. Allogeneic bone marrow transplantation was performed in 15 pts. R/F occurred in 33 pts and 17 have died in remission after initial hospitalization. Finally, 62 pts have died at the stopping date. With a median follow-up of 64.6 months in alive pts, median overall survival was 29.3 months, and it was only negatively influenced by advanced age (p=0.003) and adverse molecular characteristics (p=0.01). BMI, GPS and albumin evaluated at treatment initiation and 3 weeks later did not influence the duration of hospitalization (p>0.16) nor the risk of severe infection during the initial hospitalization (p>0.14 in a logistic regression model). Among parameters listed above, only high BMI at 3 weeks after initiation of the induction regimen was significantly associated with an increased risk of R/F (p=0.04, hazard ratio 1.45, [1.01-2.12]), whereas none of these parameters retained a significant prognostic value for the risk of death without R/F.Conclusion:We confirmed the high incidence of overweight in adult pts with AML treated with intensive induction regimen and the absence of prognostic value of initial BMI (Am J Hematol 2016; 91: 199). However, high BMI at 3 weeks after treatment initiation was associated with an increased risk of subsequent R/F. Further studies are ongoing to assess the role of delay or dose reduction in treatment delivery and the potential statistical interactions between nutritional status and molecular characteristics of AML. Thus, our findings highlight the importance of taking any nutritional status into account during the management of AML pts with intensive induction chemotherapy. DisclosuresNo relevant conflicts of interest to declare.

P598. Dietetic intervention and nutritional status in adult patients with Crohn’s disease: preliminary results

P598. Dietetic intervention and nutritional status in adult patients with Crohn’s disease: preliminary results