Screening Of Nutritional Status Research Articles

Comprehensive assessment of nutritional status and nutritional-related complications in newly diagnosed esophageal cancer patients: A cross-sectional study

Malnutrition is prevalent in upper gastrointestinal cancer patients. The purpose of this study was a comprehensive assessment of nutritional status in newly diagnosed patients with esophageal cancer. Newly diagnosed esophageal cancer patients were referred to a chemo-radiation referral center in Mashhad, Iran, between February 2017 to February 2019. Anthropometric indices, a Patient-Generated Subjective Global Assessment (PG-SGA) tool, body composition, dietary intake, nutritional-related complications, and laboratory tests were assessed. One hundred and eighty-nine patients with a mean age of 67.1±12 and a male to female ratio of 98 to 91 were included. Ninety-seven (51.3%) of patients had experienced significant weight loss and 56 (29.6%) were underweight at diagnosis. According to PG-SGA, 179 (94.7%) needed nutritional interventions. Reduced muscle mass and low handgrip strength were observed in 70 (39.4%) and 26 (14.4%) of patients, respectively. Inadequate intakes of energy (less than 24kcal/kg/day) and protein (less than 1.2g/kg/day) were found in 146 (77.8%) and 171 (91%) patients, respectively. The mean total daily energy and protein intakes of subjects were 943.8±540kcal/day, and 30.6±21g/day, respectively. The most common nutritional-related complications were as follows: dysphagia (84.8%), anorexia (31.6%), constipation (62.1%), esophageal pain (48.4%), and dyspepsia (41.1%). Our study demonstrated a high prevalence of malnutrition in newly diagnosed esophageal cancer patients. This fact demonstrates the importance of early screening of nutritional status via PG-SGA tool, clinical evaluation, dietary intake evaluations, and laboratory tests, based on which effective nutritional interventions and Symptoms management may be introduced in these patients.

Training program to support posbindu cadre knowledge and community health centre staff in the Geriatric Nutrition Service

The geriatric minimal service standard (SPM) coverage in Depok has steadily decreased from 37.53% in 2013 to 11.8% in 2018. One factor affecting the problem is a lack of patient participation and the inability of posbindu (integrated service post for older people) cadres to perform their tasks. To increase the coverage of older people visiting posbindu, it is necessary to raise the knowledge and skill levels of posbindu cadres and community health centre staff in Depok. The skills include performing nutritional status assessment (NSA) and screening, early detection of dementia, independence assessment, and elderly nutrition counselling. This is a case-based article focusing on geriatric nutrition training for posbindu cadres and community health service staffs. We undertook training for 35 subjects (22 posbindu cadres and 13 community health centre staff). At the end of the training, the mean score of the elderly nutrition knowledge had increased to 52.5 points. The score before training significantly differed with post-training (p = 0.001). The knowledge of subjects who have the previous training was also significantly different from those who did not have the previous training (p = 0.017). The knowledge of posbindu cadres and community health centre staffs can be improved through elderly nutrition training. Technical assistance and monitoring performed three months after the training measured their ability to perform the geriatric nutrition services. They should be able to demonstrate how to educate older people in the diabetes mellitus nutrition campaign, metabolic syndrome, nutrition-balanced diet, and gout; also, how to conduct predicted height measurements using the knee-height predictor, and how to fill MNA, MMSE, BADL, and IADL instruments. We suggest the geriatric nutrition training program will increase SPM coverage at Depok City.

Extended growth charts for Indian children

Abstract Objectives While growth charts depicting 7 percentile lines for height and weight are useful for healthcare workers and pediatricians, endocrinologists need indication-specific z score cutoffs to plan investigations and treatment. The current Indian charts do not offer lower percentile/z scores (−2.25, −2.5, and −3 z score) lines. Also, increasing prevalence of childhood overweight and obesity necessitates a quick screening of nutritional status without calculations while using the same growth chart. Our objectives were to produce extended and user-friendly growth charts for 0–18-year-old Indian children that depict −2.25, −2.5, and −3 z score height lines in addition to the standard 7 lines and to add a quick BMI assessment tool as an inset. Methods LMS values from IAP 2015 growth charts (5–18 years) and WHO 2006 MGRS charts (<5 years) were used to generate −2.25, −2.5, and −3 z score height lines (1.2, 0.6, and 0.1 percentiles, respectively) from 0–18 year for boys and girls. These newly generated lines were added to standard 7 (3, 10, 25, 50, 75, 90, 97) percentile lines for height charts. In addition, modified BMI quick screening tool was incorporated as an inset. Results The extended height charts (with 10 lines), standard (7 lines) weight charts, and quick BMI assessment tool are presented in a single unified chart for use by endocrinologists. Conclusions These charts will help in defining specific height z score cutoffs as well as screen for overweight and obesity without any calculations in Asian Indian children.

Malnutrition and Sarcopenia in Community-Dwelling Adults in Singapore: Yishun Health Study.

To determine the overlapping prevalence of malnutrition and sarcopenia and the association between parameters of malnutrition with muscle mass and strength in a community-dwelling Singaporean adult population. This was a cross-sectional study. Large north-eastern residential town of Yishun in Singapore. Random sampling of community-dwelling Singaporeans aged 21-90 years old (n=541). Anthropometry, body composition and handgrip strength (muscle strength) were measured. Sarcopenia was identified using dual-energy x-ray absorptiometry scan (muscle mass). Nutritional status was measured using Mini Nutritional Assessment (MNA-SF). Other questionnaires collected included physical activity and cognition. Associations between nutritional status with sarcopenia as well as with muscle mass and strength were analysed using multinomial logistics and linear regressions. The overall population-adjusted prevalence of those at nutritional risk and malnourished were 18.5% and 0.1% respectively. More than a third of participants (35%) who were at nutritional risk were sarcopenic. Malnourished participants were all sarcopenic (100%, N=2) whereas those who were sarcopenic, 27.0% (N=37) were at nutritional risk/malnourished. Being at nutritional risk/malnourished was significantly associated with 2 to 3 times increased odds of sarcopenia in multivariate analyses adjusting for age, gender, physical activity level and cognition, and fat mass index. Favourable MNA parameter scores on food intake and BMI were positively associated with greater muscle mass and handgrip strength (p<0.05). Given the overlapping clinical presentation of malnutrition and sarcopenia, community screening protocols should include combination screening of nutritional status and sarcopenia with appropriate interventions to mitigate risk of adverse health outcomes.

Abstract 14286: Significance of Nutritional Status in Patients With Chronic Limb Threatening Ischemia

Introduction: The nutrition status plays a key role in the pathogenesis of frailty, and is strongly associated with the prognosis of patients with chronic limb-threatening ischemia (CLTI). The Geriatric Nutritional Risk Index (GNRI) is a widely used, simple, and well established nutritional status screening method. The association between the GNRI and wound healing in patients with CLTI has not been established. Hypothesis: We assessed the hypothesis that GNRI is associated with wound healing in patients with CLTI. Methods: We conducted a single-center retrospective analysis for 172 consecutive CLTI patients who were admitted to our hospital from August 2017 to April 2019 (age 70±14 years; men 62.2%). The GNRI on admission was calculated as follows: [14.89 х albumin (g/dL)] + [41.7 х (bodyweight/ideal body weight)]. According to the GNRI values, 4 grades of nutrition-related risk are defined as major risk (GNRI:&lt;82), moderate risk (GNRI: 82 to &lt;92), low risk (GNRI: 92 to 98), and no risk (GNRI: &gt;98). The amputation-free survival (AFS) and the cumulative wound healing rate are calculated by the log-rank test. The receiver operating characteristic curve was used to obtain a cutoff value for wound heal. Cox proportional hazards regression analysis was performed to explore the independent association between the GNRI and wound heal. Results: The follow-up period was 12±6.7 months. The 1-year AFS in no risk, low risk, moderate risk, and major risk groups were 90%, 74%, 66%, and 62%, respectively ( P =0.045). GNRI was significantly associated with WIfI wound score (W1, 95±8.8; W2, 87±8.0; W3, 84±9.3, P &lt;0.001). The 1-year cumulative wound healing rate in no risk, low risk, moderate risk, and major risk groups were 56%, 45%, 37%, and 32%, respectively ( P =0.036). GNRI=95 was selected as cutoff value with maximum discriminative power for wound healing (sensitivity 70%, specificity 60%; Area under the curve, 0.67; 95% confidence interval, 0.59-0.76). GNRI&gt;95 was an independent predictor of wound healing (Hazard ratio, 1.9; 95% confidence interval, 1.0-3.7; P =0.046). Conclusions: The GNRI was significantly associated with AFS and wound healing in patients with CLTI. GNRI=95 is a novel cutoff value to predict wound healing during follow-up.

Screening for nutritional status in the outpatient setting among clinical specialties

Rationale: This cross-sectional study, aimed to determine nutritional status among patients admitted to multiple outpatient specialty clinics, was conducted in collaboration with Turkish Society of Clinical Enteral and Parenteral Nutrition (KEPAN) as an awareness-raising project within the context of World Nutrition Day.

Nutritional Assessment in Gastrointestinal Tumors: News from the 2020 ASCO and ESMO World GI Meetings

Nutritional risk screening and assessment of general nutritional status are of primary importance in the management of gastrointestinal cancers (GIC). Indeed, a major problem in these patients is the involuntary weight loss leading eventually to cachexia. With our review, we aimed at collecting the most recent advances in nutritional assessment of patients with GIC. All the abstracts presented both at the 2020 ASCO and ESMO World GI meetings were considered and a total number of 12 abstracts were selected, reporting colorectal, gastric, esophageal, and pancreatic cancer (PC) series. In some of the analyzed series, pathological conditions such as cachexia and sarcopenia had prognostic significance on clinical outcomes. One abstract reported the results of a phase I trial with the use of a novel interleukin-1-alpha antagonist, bermekimab. Its association with standard chemotherapy in advanced PC brought an improved patients’ performance during treatment. Insufficient attention is paid to the nutritional status of patients with GIC both at screening and during specific cancer treatment. The use of antropometric measurements, together with nutritional assessment tools, may facilitate the clinical evaluation of these patients. Large randomized trials are warranted in order to clarify the real impact of nutritional interventions on clinical outcomes.

The association between nutrient intake, nutritional status and physical function of community-dwelling ethnically diverse older adults

BackgroundThere are limited longitudinal data regarding nutrient intake, nutritional status and physical function in community-dwelling ethnically diverse older adults. This study explored these variables and their relationship at baseline (n = 100) and 8-months’ follow-up (n = 81) among community-dwelling ethnically diverse older adults (≥60 years) in Birmingham, United Kingdom.MethodsMultiple-pass 24-h dietary recalls and the Mini Nutritional Assessment-Short Form assessed nutritional intake and status, respectively. Short Physical Performance Battery (SPPB) and handgrip strength measured physical function. Linear and multinomial regressions were used to predict relationships between physical function, nutritional status and nutrient intake.ResultsComplete data were collected at baseline (n = 100) and 8-months’ follow-up (n = 81). Mean (SD) age was 70 (8.1) years (60% male), with 62% being obese. Statistically significant decreases in intakes of vitamin B6, vitamin B1, iron, folate, and magnesium occurred over time. Daily intake of all micronutrients except vitamin B12, phosphorus and manganese were below the Recommended Nutrient Intakes (RNI). SPPB (Z = -4.01, p < 0.001) and nutritional status (Z = -2.37, p = 0.018) declined over time. Higher SPPB scores at baseline (OR = 0.54 95% CI 0.35, 0.81) were associated with a slower decline in nutritional status.ConclusionThe observed declines and inadequate nutrient intakes in the absence of weight loss in just 8 months may pose serious challenges to healthy ageing, identifying an urgent need to re-evaluate and tailor appropriate dietary advice for this population. Additionally, the associations of nutrition and physical function observed in this study serves as an essential resource to design and implement community/faith-based interventions targeting early screening of nutritional status and physical function to ensure most older adults are assessed and treated accordingly.

Bioelectrical Impedance Analysis to Increase the Sensitivity of Screening Methods for Diagnosing Cancer Cachexia in Patients with Colorectal Cancer.

Background Currently used methods for detecting and monitoring cancer cachexia (CC) are not sensitive enough. In this field, there is a need to implement new instruments into clinical practice. Objective Determining the usefulness of bioelectrical impedance analysis (BIA) for detecting and monitoring CC in patients with colorectal cancer (CRC). Methods 158 people were invited to the study (70 from CRC and 88 controls). Their body composition was determined using BIA, and their nutritional status was determined according to NRS 2002, SGA, and BMI criteria. For statistical data analysis, Student's t-test, Mann–Whitney U test, and AUC ROC were used. Results Men with CRC stage I had higher values of FMI, SMMI, and ECW/TBW (p < 0.05) than in stages II–IV, and women with CRC stage I had higher values of FMI, FFMI, and FM/FFM than in the group of stages II–IV (p < 0.05). The ability of FFMI to detect malnutrition relative to SGA was low (sensitivity: women 40%, men 40% and specificity: women 74%, men 70%). Conclusions SGA and NRS 2002 scales are dynamic and consider changes in nutritional status over time, while BIA is static and does not consider these changes. Therefore, BIA is not a good tool for screening nutritional status. BIA successfully identifies differences in body composition depending on cancer stage and advancement of CC. Therefore, after the diagnosis CRC, just to monitor the disease advancement and state of CC, it is worth comparing the results of periodically repeated BIA.

Malnutrition in Chronic Pancreatitis: Causes, Assessment Methods, and Therapeutic Management.

Purpose In recent years, more and more emphasis has been placed on early diagnosis and adequate treatment of malnutrition in the course of chronic diseases (CP). One of these diseases is chronic pancreatitis in which malnutrition may develop as a consequence of abdominal pain, vomiting, diarrhea, and alcohol abuse. The aim of this review paper is recognized if we can improve the nutritional status of patients with CP. Methods This paper is based on systematic literature review according to the PubMed. Results One of the most important problems is lack of “gold standard” in screening of nutritional status in patients with CP, especially in outpatient clinics. Another problem is preventing malnutrition in these patients and beginning treatment already at significant stages of disease. To prevent malnutrition you must first recognize the causes of malnutrition in CP, adequately assess its severity using one of available questionnaires and then apply the appropriate therapeutic management. At each visit, remember to assess the nutritional status of the patient, including laboratory markers and anthropometric measurements. Patients should be advised to stop smoking and drinking alcohol and to use adequate enzyme supplementation. Conclusion Patients with CP should be led by a team of gastroenterologist, diabetologist, and psychologist and consulted by a dietitian, specialist of pain treatment, and surgeon.

Nutritional Status in Patients with Esophageal Cancer Receiving Chemoradiation and Assessing the Efficacy of Usual Care for Nutritional Managements.

Background:Malnutrition is prevalent in esophageal cancer patients which affects cancer prognosis. The purpose of this study was a comprehensive assessment of nutritional status during Chemoradiation (CRT). Methods:Newly diagnosed adults with esophageal cancer were recruited for this study. Patient-Generated- Subjective Global Assessment (PG-SGA), anthropometric indices, body composition, dietary intake, laboratory tests, and nutritional-related complications were assessed before, after, and 4 to 6 weeks after CRT. Results:Seventy-one cases were enrolled. The mean age was 66.8±12 years. Patients’ mean weight loss was 2.42±2.4 kilograms during treatment. A significant reduction observed in mean MUAC (26.68±4.9 vs. 25.42±5.1 cm), fat mass percentage (24.11±11.8 vs. 22.8±12.5), fat free mass index (16.87±2.4 vs. 16.47±2.6 kg/m2) and hand grip strength (43.2±19 vs. 36.1±20 kg) during CRT (all p-values <0.0001). We had also a non-significant change in mean energy intake (19.5±11 vs. 18.3±11 kcal/kgw. day) and protein intake (0.56±0.4 vs. 0.66±0.5 g/kgw.day) during CRT. In our assessment before, immediately after and 4-6 weeks following CRT, we recorded energy intake insufficiency in 55.7%, 58.7% and 27.3% and protein intake inadequacy in 89.8%, 89.1% and 72.7% of cases, respectively. The most common complications were dysphagia (56.7%), anorexia (25%), and constipation (47.9%) at admission. Dysphagia improved in some cases (42%), but anorexia (35%), early satiety (25%), Esophagitis (25%), dysosmia (21%) and dysgeusia (17%) were increased as CRT complication. yet, 25% of patients had dysphagia and 34.4% had constipation 4-6 weeks after CRT. The twelve-months mortality was significantly associated with lower BMI after CRT, primary PG-SGA score, weight loss, BMI<18.5, MUAC, physical performance, living in rural or urban areas, addiction. Conclusion:Our study demonstrated a high prevalence of malnutrition among esophageal cancer patients which worsened during Chemoradiotherapy. Our findings warrant early screening and monitoring of nutritional status and effective nutritional interventions with symptoms management during treatment in these patients.

Assessment of Two Nutritional Screening Tools in Hospitalized Children.

Aim: to evaluate validity and concordance of Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) and Screening Tool for Risk On Nutritional status and Growth (STRONGkids) screening tools for assessment of nutritional risk in pediatric inpatients. Methods: Prospective longitudinal observational multicenter study in children aged 1 month or older admitted as inpatients. Weight, height, cause of admission, demographic data, length of stay, and nutritional interventions were recorded. STAMP and STRONGkids were applied within the first 72 h of admission. Anthropometric measurements were recorded again 12–18 months after admission. Results: Eighty-one patients with median age of 4.1 years completed the study. Agreement between tools was moderate (κ = 0.47). STAMP had a greater tendency to classify patients as high risk (12.3% vs. 2.5%). Both tools showed very weak correlation with height for age. All undernourished patients at the beginning and the end of the study were classified as medium or high risk by STAMP and STRONGkids (100% sensitivity), although specificity was below 50% in all cases. There were no differences in length of stay based on nutritional risk with any of the tools. Conclusions: STAMP and STRONGkids demonstrated moderate agreement, with high sensitivity but low specificity for the diagnosis of undernutrition. Further studies are required to analyze cost-effectiveness of these tools and nutritional interventions derived from them.

Birth weight influence and maternal nutritional status in student’s body composition

Objective: This paper aims to evaluate birth weight and maternal nutritional status in children’s body composition aging from 7 to 9 years old. Methods: Transversal study composed of collecting interviewee’s socio economic and anthropometrical variables in which 41 children and their mothers were evaluated in the city of Picos in Piaui state. The following mother’s anthropometrical parameters were investigated: weight, height, and waist circumference. In addition, the following student’s anthropometrical variables were collected: born and current weight, height, waist circumference (WC), arm circumference (AC), subscapular skinfold (SS), and triceps skinfold (TS). Results: Birth weight relates positively and significantly with some anthropometrical variables of children, such as: waist circumference (WC; p=0.02), arm circumference (AC; p=0.03), subscapular skinfold (SS; p=0.02), and percentage of body fat (%BF; p=0.05). A statistically positive correlation between children’s current weight and mother’s current weight (p=0,04) was observed. Besides, a lower, but more significant inverse correlation between mother’s height and variables referring to children’s body composition was found. Conclusion: The following paper suggests that born weight correlates with children’s current bodily composition and that, no matter what the born weight is, mother’s weight is relevant to the children’s current weight, demonstrating the importance of continuous screening of nutritional status between mother and children.

Prevalence of Anemia and Its Associated Factors in Antiretroviral-Treated HIV/AIDS-Positive Adults from 2013 to 2018 at Debre Berhan Referral Hospital, Ethiopia.

Introduction. Anemia was defined as a hemoglobin level of less than or equal to 13.9 g/dl for male and less than or equal to 12.2 g/dl for female adults. It is one of the most common hematological abnormalities in people living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and is a determining factor for disease progression and death. Among the countries in sub-Saharan Africa, Ethiopia is one of the most affected nations by HIV. Therefore, this study aimed to assess the prevalence of anemia and its associated factors among HIV-positive adults that had received antiretroviral treatment (ART) at Debre Berhan Referral Hospital. Methods An institution-based, descriptive, cross-sectional study was conducted involving 263 adults with HIV/AIDS that had undergone ART at Debre Berhan Referral Hospital, Ethiopia. Data were collected from patient charts using systematic sampling with a pretested data extraction tool and entered using EpiData 3.1. Variables having a p value ≤0.25 in the bivariate were fitted to a multivariable regression model with a 95% confidence interval. p value ≤0.25 in the bivariate were fitted to a multivariable regression model with a 95% confidence interval. Results Among the 263 HIV-positive patients, 237 (90.11%) were included in the final analysis. The overall prevalence of anemia was 26.2%. Factors that were significantly associated with anemia were past opportunistic infections, patients being in WHO clinical stage III and IV, and a BMI <18.5. Conversely, those patients who took anti-TB medication were less likely to have anemia. Conclusion Our study shows that the severity of anemia among HIV/AIDS patients that had undergone ART is lower than most studies conducted in Ethiopia. We also found that opportunistic infection, WHO clinical staging, anti-TB treatment, and low BMI were significantly associated with anemia. Therefore, routine screening of patient nutritional status and opportunistic infections may be useful in predicting and controlling anemia in HIV/AIDS patients.

Malnutrition risk and hospital-acquired falls in older adults: A cross-sectional, multicenter study.

AimTo assess the relationship of malnutrition risk and in‐hospital falls in a patient group of older hospitalized patients (65–79 and ≥80 years).MethodsA cross‐sectional, multicenter, point‐prevalence study was conducted in 68 Austrian hospitals with 3702 hospitalized older patients. The relationship between malnutrition risk and falls was analyzed using univariate and multivariate binary logistic regression analyses. Data were analyzed separately for two age groups, patients were aged 65–79 years (n = 2320) and ≥80 years (n = 1382).ResultsPrevalence of hospital‐acquired falls was 5.2%, and prevalence of risk of malnutrition was 24.3% (Malnutrition Universal Screening Tool) and 16.2% (definition using body mass index and weight loss). The univariate analysis showed significant associations of malnutrition risk and in‐hospital falls for patients aged ≥80 years (odds ratio 2.1; 95% confidence interval 1.2–3.6) but not for patients aged 65–79 years. The multivariate logistic regression analysis did not show significant associations between malnutrition risk and hospital‐acquired falls.ConclusionsThe results of this study show that malnutrition risk is a predictor for in‐hospital falls in very old patients (≥80 years). In this patient group, the screening and assessment of nutritional status as well as nutritional interventions for the prevention/treatment of malnutrition risk should be considered as one important factor for successful fall prevention. Studies are necessary to assess the effect of nutritional interventions as part of a multifaceted fall‐prevention program. Geriatr Gerontol Int 2020; 20: 348–353.

Use of Mid-Upper Arm Circumference (MUAC) to Predict Malnutrition among Sri Lankan Schoolchildren.

The double burden of malnutrition (under- and overnutrition) is a serious public health issue in childhood. The mid-upper arm circumference (MUAC) is a simple tool for screening nutritional status, but studies of the optimal cutoff to define malnutrition are limited. This study aimed to explore the prediction of malnutrition by MUAC in Sri Lankan schoolchildren. The participants were 538 students (202 boys, 336 girls) aged 5–10 years. Spearman’s rank correlation was calculated for MUAC and both body-mass-index-for-age z-score (BAZ) and height-for-age z-score (HAZ). Receiver operating characteristic (ROC) analysis was conducted to assess the ability of MUAC to correctly classify malnutrition, after stratifying for age and birth weight. MUAC correlated significantly with BAZ (r = 0.84) and HAZ (r = 0.35). The areas under the ROC curve for thinness, overweight, obesity, and stunting were 0.88, 0.97, 0.97, and 0.77, respectively. The optimal MUAC cutoff values for predicting thinness and stunting were 167.5 mm and 162.5 mm, respectively; the optimal cutoffs for predicting overweight and obesity were 190.5 mm and 218.0 mm, respectively. These cutoffs differed after stratification by age group and birth weight. Our results confirm MUAC to be a useful tool for monitoring growth in schoolchildren.

Assessment of Body Composition and Nutritional Risks in Young Ballet Dancers - The Bioelectrical Impedance Analysis.

BackgroundYoung ballet dancers are at risk of health issues associated with altered nutritional status and of relative energy deficiency in sport compared to the general population.AimTo evaluate the nutritional status and body composition in ballet dancers.Materials and methodsThe study group consisted of 40 young ballet dancers (mean age 19.97 years). Height and weight were measured and body mass index was calculated in all subjects (mean BMI value 19.79 kg/m2, SD: 2.051). Body composition was estimated using the bioelectrical impedance method.ResultsThe dancers’ fat-free mass was 47.33 kg (SD: 5.064) and, on the average, body fat represented the 15.92% (SD: 16.91) of their body weight.ConclusionsBallet dancers, who usually show significantly lower BMI values compared to the general population, also displayed body fat values under the suggested range. Some screening for altered nutritional status should be performed. In addition, education programs should be recommended in young ballet dancers, in order to inform about energy and nutrition requirements for health and training and to prevent malnutrition-related problems.

P2607Quick nutritional assessment and prognosis in outpatients with heart failure with mid-range ejection fraction

Abstract Background Nutritional status is an important prognostic factor in patients with heart failure (HF) beyond body mass index, although its prognostic value in patients with mid-range left ventricular ejection fraction (HFmrEF) is not completely elucidated. In a pilot study we observed that the Mini Nutritional Assessment Short Form (MNA-SF) was the best approach for the screening of nutritional status in HF outpatients over others screening tools. Purpose To assess the prognostic role of malnutrition or risk of malnutrition in HFmrEF outpatients after the implementation of the MNA-SF screening tool in a routine way in a multidisciplinary HF. Methods The MNA-SF screening tool was administered during the global nurse evaluation of patients. The scoring ranges from 0 to 14, being 0 to7 as malnutrition status, 8 to 11 as at risk of malnutrition and 12 to 14 as normal nutritional status. For the present study those patients with malnutrition and at risk of malnutrition were merged and considered abnormal nutritional status. All-cause death was the primary end-point. Univariate and multivariate (backward conditional stepwise) Cox regression analyses were performed. Results Since October 2016 to November 2017, 153 HFmrEF patients were studied (mean age 68.8±11.7 years, 72.5% men, body mass index 28.4±4.4, LVEF 44% ± 3, NYHA class I 5.9%, II 86.3%, and III 7.8%). According to the MNA-SF 25 patients were (16.3%) fulfilled criteria of malnutrition (4) or where at risk of malnutrition (21). During a mean follow-up of 17.4±6.1 months, 23 patients died (15%). In the univariate analysis, nutritional abnormal status was significantly associated with all-cause death (HR 2.93 [1.23–7], p=0.02). In the multivariate analysis which included age, sex, NYHA functional class, body mass index, ischemic aetiology of HF and years of duration of HF, abnormal nutritional status remained significantly associated with all-cause mortality (HR 3.64 [1.39–9.54], p=0.009), together with NYHA functional class (HR 7.93 [2.69–23.4], p&lt;0.001) and years of HF duration (HR 1.10 [1.04–1.16], p=0.001). Conclusions Nutritional status assessed with the screening MNA-SF was an independent predictor of all-cause death in ambulatory patients with HFmrEF – beyond BMI – together with NYHA functional class and HF duration.

Current nutritional status assessment tools for metabolic care and clinical nutrition.

The aim of this report is to critically review existing questionnaires and tools to assess nutritional status in different populations and pathological conditions. A total of 16 instruments to evaluate nutritional status were recorded, which were based on anthropometrical determinations, biochemical markers, clinical examinations and subjective questionnaires, depending on the nutritional assessment focus, involving different concepts: screening of the risk, diagnosis and severity of malnutrition, as well as the consequences of undernutrition or overnutrition. A variety of questionnaires, equations and tools were found with ability to assess nutritional status for metabolic care or clinical nutrition purposes, but apparently there is no optimal, universal and reliable nutritional status screening system for all metabolic conditions. Novel assessment instruments should provide high sensibility and specificity, be precise and reliable as well as inexpensive and simple, in order to avoid the additional burden of excessive loads of costs, work and time while dynamically overcoming the influence of disease diversity.

Application of STRONGkids to screen infants with lower respiratory tract infection and its possible influence on clinical outcome

Objective To investigate the incidence of nutritional risk in infants with lower respiratory tract infection, and to compare the effects of different nutritional risks on clinical outcomes, and to provide evidence for clinical nutritional management of infantile lower respiratory tract infection. Methods Infants and young children with lower respiratory tract infection who were hospitalized in our hospital from January 2013 to March 2016 were selected as subjects. Nutritional risk screening was performed using the Nutritional Status and Growth Risk Screening Tool (STRONGkids). Results A total of 957 infants with lower respiratory tract infections were included in the study. The incidence of high nutrition risk and low and medium nutritional risk were 17.6% and 82.4%, respectively. The clinical cure rate was 68.5% and 71.4% respectively. The children with pneumonia and bronchitis had high nutritional risk. The incidence rates were 20.60% and 4.87%, respectively, and the difference was statistically significant (χ2=25.52, P=0.000). Time-effect single factor analysis (Kaplan-Meier method): The hospitalization time for infants with low nutritional risk and high nutritional risk was 9.3(0.3) d and 13.3(1.0) d, respectively. The difference between the two groups was statistically significant. (χ2=28.33, P=0.000), the total hospitalization expenses were 5 653.5(224.8) yuan and 10 079.5(1 755.8) yuan respectively. The difference between the two groups was statistically significant (χ2=4.47, P=0.034). Multivariate COX regression analysis: High nutritional risk was a risk factor for hospitalization of hospitalized infants with lower respiratory tract infection (RR=1.57, P=0.024). Conclusion There is a high incidence of high nutritional risk in infants with lower respiratory tract infection. Compared with children with low and moderate nutritional risk, the hospitalization time is longer, the hospitalization cost is increased, and the clinical cure rate is lower, which is the risk of clinical outcome. factor. Therefore, it is necessary to conduct nutrition risk screening for infants with lower respiratory tract infections, and provide a theoretical basis for clinical nutrition evaluation and nutritional intervention. Key words: Respiratory infections; Infants; Nutritional status and growth risk screening tools