Department, Laikon General Hospital, National and Kapodistrian University of. Athens ... the level of adherence to the Mediterranean diet in a sample of patients.
176
Abstracts / Clinical Nutrition ESPEN 24 (2018) 173e190
Department, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece Background & aims: Poor nutritional intake is a common problem in patients with hematologic diseases. Recurrent infections and chemotherapy complications are some of the possible causes. Malnutrition is correlated to slow recovery, prolonged hospitalization, and higher mortality. Audits about the nutritional support of hospitalized patients may detect significant failures in patient care and help towards the correct application of the international guidelines. This study was a prospective observational audit on hospitalized patients with hematologic diseases to investigate their nutritional status and whether they received the appropriate nutritional support was performed Methods: 122 consecutive patients with hematologic diseases admitted from March 31, 2016 to June 8, 2016 in two Hematologic Units of a Tertiary University Hospital in Athens, Greece were included. A questionnaire based on the Malnutrition Universal Screening Tool (MUST) with additional questions on demographic, somatometric and medical data was completed. The questionnaire was applied by 6th-year medical students to all patients within 48 hours of admission. Patients were classified as high, intermediate, and low-risk per the MUST score and were reassessed at predefined intervals. During reassessment, food intake and the nutritional interventions (nutritional supplements, enteral or parenteral nutrition) applied were also recorded. Results: Ninety-three patients were included in the final analysis (5 refused to participate, 22 were excluded due to short-term hospitalization, 2 were absent during reassessment). Forty-one (38%) patients had a MUST score 2 (high risk) but none of them received nutritional supplements. One patient was supported with parenteral nutrition. Conclusions: Our audit revealed a lack of nutritional support of the hospitalized patients. A presentation of the results to the involved health professionals was organized the possible causes (lack of sensitization of the staff, high regimen cost, shortness of staff) were illustrated. Proposals to change the current situation were made. A re-audit was programmed and is in progress. Disclosure of interest: None declared. ADHERENCE TO THE MEDITERRANEAN DIET AND METABOLIC PARAMETERS IN PATIENTS WITH CHRONIC KIDNEY DISEASE STAGE 5 Kalliopi-Anna Poulia 2, Chrysanthi N. Olivia Papageorgiou 1, 1 1 Skalioti , Christina Melexopoulou , Alexandros Kokkinos 3, Despoina Perrea 4, Ioannis N. Boletis 1. 1 Nephrology Department and Renal Transplantation Unit, Laiko Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece; 2 Department of Nutrition and Dietetics, Laiko General Hospital of Athens, Athens, Greece; 3 First Department of Propaedeutic and Internal Medicine, Laiko General Hospital Athens, University Medical School, Athens, Greece; 4 N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece Background & aims: Mediterranean diet has been associated with lower risk of cardiovascular disease and cancer. Dietary restrictions often imposed to patients with Chronic Kidney Disease (CKD) stage 5 leads to lower adherence to this dietary pattern, due to the limited allowance in the consumption of foods of plant origin. The aim of this study was to evaluate the level of adherence to the Mediterranean diet in a sample of patients with CKD stage 5. Methods: Fifty patients (33 men), 24 undergoing hemodialysis (HD) and 26 under peritoneal dialysis (PD) were consecutively enrolled in the study. Body mass Index (BMI) based on dry body weight was calculated and a semi quantitative food frequency questionnaire was completed in order to evaluate the adherence to the Mediterranean diet by the Mediterranean Diet Score (MedDietScore). Data from the medical history of the patients were also recorded, namely the years in dialysis, medications and biochemical analyses. Results: According to our analysis our patients (Mean age 54.4 ± 17.7 years, BMI 25.5 ± 3.87 kg/m2, average duration of dialysis 6.6 ± 7.1 years) had medium level of adherence to the Mediterranean diet (MedDietScore 30 ± 3.27). No statistical significant differences were detected between sexes and between HD and PD patients. MedDietScore was negatively
associated with age (0.354, p ¼ 0.016) but it was not significantly associated with the levels of phosphate, potassium and albumin. Conclusions: The patients in our study had similar level of adherence to the Mediterranean Diet with the general population. Adhering to this dietary pattern did not had a significant impact on the metabolic profile of these patients. Disclosure of interest: None declared. POSTOPERATIVE C-REACTIVE PROTEIN TO ALBUMIN RATIO AS A DIAGNOSTIC TOOL FOR PREDICTING COMPLICATIONS AFTER ABDOMINAL SURGERY Dimitrios Karayiannis 1, Zoi Bouloubasi 1, Aristea Baschali 1, Dimitrios Eleni Daskalaki 2, Vassilis Kalatzis 2, Sotirios Constantinou 2, Voulgaris 2, Constantinos Botsakis 2, Dimitrios Magganas 2, Vasileios Vougas 2. 1 Department of Clinical Nutrition, Evangelismos General Hospital, Athens, Greece; 2 1st Department of Surgery & Transplant Unit, Evangelismos General Hospital, Athens, Greece Background & aims: The ratio of C-reactive protein to albumin, as a prognostic score, is associated with outcomes in patients with various types of cancer. The diagnostic accuracy of the CRP/albumin ratio has not been assessed in abdominal surgery for predicting postoperative complications. The aim of this retrospective study was to evaluate the prognostic significance of the ratio of C-reactive protein to albumin (CRP/ALB ratio) on day 3 in patients who undergo abdominal surgery. Methods: A total of 214 patients undergoing major abdominal surgery between May 2012 and June 2015 were eligible for this study. Uni- and multivariate analyses were performed to identify risk factors for postoperative complications. Receiver operating characteristic curves were developed to examine the cutoff values and diagnostic accuracy of the CRP/ albumin ratio and postoperative CRP levels. Results: Among all the patients, 72 (33.6%) were reported to have postoperative complications. The CRP/albumin ratio was an independent risk factor for complications (OR 2.37; 95% CI 1.46e4.25; P < 0.001), and the cutoff value was 2.0, which had a higher area under the curve compared to CRP on postoperative day 3 (AUC 0.721 vs 0.656). The CRP/albumin ratio also had a higher positive predictive value than CRP levels on postoperative day 3. Patients with CRP/albumin 2.0 suffered more postoperative complications (49.3% vs 22.1%, P < 0.05), longer length of hospital stay (postoperatively) (9 (5e42) vs 5 (3e65) days, P < 0.05), and increased surgical site infections (SSIs) (21.1% vs 4.8%, P < 0.001) than those with CRP/albumin
