ESPEN 2020 Abstract Submission
Topic: Nutritional assessment
Abstract Submission Identifier: ESPEN20-ABS-1599
MALNUTRITION, SARCOPENIA AND THEIR COMBINATION IN POLYMORBID HOSPITALIZED PATIENTS ARE ASSOCIATED WITH A WORSE EVOLUTION OF HOSPITALIZATION AND A WORSE QUALITY OF LIFE
M. D. Ballesteros-Pomar*, 1, L. Gajete Martin 1, B. Pintor de la Maza 1, A. Hernández Moreno 1, D. E. Barajas Galindo 1, E. González Arnáiz 1, L. González Roza 1, I. Cano Rodriguez 1
1Endocrinology and Nutrition, COMPLEJO ASISTENCIAL UNIVERSITARIO DE LEÓN, Leon, Spain
Rationale: The GLIM and EWGSOP2 criteria have recently been proposed for the diagnosis of malnutrition and sarcopenia. The presence of any of them, and their combination (Malnutrition-sarcopenia syndrome, MSS) can mean worse evolution during hospitalization.
Methods: Observational prospective cohort study conducted in adult patients admitted to the Internal Medicine Department of the Hospital de León, from March to September-2019. All the patients giving written consent form were included and the study was approved by the Local Research Ethics Committee. Body composition was assessed using electrical bioimpedance (Akern BIA 101®) and hand grip strength using Dynx® electrical dynamometer. The presence of malnutrition was determined by GLIM criteria (using appendicular skeletal muscle mass index <7 or <5.5 kg/ m2 in men or women respectively or calf circumference <31 cm as a criterion of low muscle mass) and sarcopenia according to the criteria of the EWGSOP2. Data are expressed as medians (interquartile range) as normality was not confirmed, and compared using Mann Whitney's U-test or Chi square test.
Results: 200 patients, 50% male, with age of 71.5 (16.5) years and a Charlson comorbidity score (CCS) of 3.8 (2.6) (68%>3) were included. 38% presented only GLIM criteria of malnutrition, 7% only probable/confirmed sarcopenia according to EWGSOP2 and 26% coexistence of both. The table summarizes the results of the variables studied. In the multivariate model, adjusting for age, sex, and CCS, GLIM was not significantly associated with length stay (LOS), quality of life, readmissions, or mortality, but EWGSOP2 and MSS were associated with poorer quality of life, mortality (OR8.2, p = 0.006 for sarcopenia and OR 6.8, p = 0.01 for MSS) and readmissions (OR2.3, p = 0.030 for sarcopenia).
|
GLIM |
p |
EWGSOP2 |
p |
MSS |
p | |||
|
|
No |
DRM |
|
No |
Sarcopenia |
|
No |
MSS |
|
|
Age |
72.9 (19.6) |
77.2(20.2)
|
0.035 |
69.7(24.3) |
82.9(11.6) |
p<0.001 |
70.7(22.8) |
82.8(10.8) |
<0.001 |
|
Charlson comorbidity score |
3.0(4.0) |
4.5(4.0) |
0.013 |
3.0 (4.0) |
5.0(2.0) |
<0.001 |
3.0 (4.0) |
5.0(2.0) |
<0.001 |
|
LOS (days) |
6.0(7.0) |
7.0(7.0)
|
0.704 |
6.0(6.0) |
8.0(9.0) |
0.011 |
6.0(6.0) |
8.0(9.0)
|
0.041 |
|
Quality of life (EuroQoL analogic visual scale) |
50.0 (31.0) |
50.0 (24.0)
|
0.053 |
60.0(30.0) |
50.0(20.0) |
<0.001 |
52.5(30.0) |
45.0(20.0) |
<0.001 |
|
Deaths (%) |
1.4% |
9.4%
|
0.028 |
1.5% |
16.7% |
<0.001 |
2% |
19.2% |
<0.001 |
|
Readmission (%) |
27.8% |
34.4% |
0.337 |
26.9% |
42.4% |
p=0.027 |
28.4% |
42.3% |
0.064 |
Conclusion: The diagnosis of sarcopenia, based on function, seems to have a higher prognostic value than that of isolated malnutrition.
Disclosure of Interest: None Declared
Keywords: malnutrition