Late Breaking Abstracts I 209

(0.3 321.8) mg/L, p = 0.00001. Plasma albumin levels re-mained the same [32.6+5.4 vs 33.0+5.2 g/L, p = 0.183] andother nutritional parameters deteriorated: weight [77.8(36.9 189.9) to 74.7 (37.1 190.7) kg, p < 0.00001]; midarm circumference [30.4+6 to 29.9+6.0 cm, p = 0.007] andcalf circumference [35.8+5.9 to 35.3+6.0 cm, p = 0.011].The CCI was higher in SGA C compared to the other groups[SGA C: 3.5 (1 10); SGA B: 2 (0 8); SGA A: 2 (0 14)]. In-hospital mortality was higher in SGA B and C while 30-daymortality was higher in SGA B.Conclusion: In these Canadian hospitals, the prevalenceof malnutrition is 45%. Although CRP decreased, suggest-ing clinical improvement, nutritional status deterioratedand in-hospital mortality was higher in malnourished.

Disclosure of Interest: None Declared

LB011-SUNPARENTERAL NUTRITION PRESCRIBING PATTERNS INGERMANY: A MEDICAL CHART REVIEW OF 191 PRETERMINFANTSF.X. Liu1, G.M. Prinz2, C. Macahilig2, F. Malinoski2,R.S. Turpin1,3. 1Global Health Economics, BaxterHealthcare, Deerfield, 2Medical Data Analytics,Parsippany, 3Public Policy, Thomas Jefferson Hospital,Philadelphia, United States

Rationale: Parenteral nutrition (PN) is vital for preterminfants (PI) when they are unable to tolerate oral orenteral feeding during their earliest growth period. TheEuropean Society for Clinical Nutrition and Metabolism(ESPEN) has developed guidelines for paediatric PN basedon limited data. This study compared PI parenteralnutrition prescribing patterns in Germany to ESPENguideline recommendations.Methods: An observational retrospective medical chartreview was conducted in early 2011 across Germany.Six neonatologists representing 6 diverse institutionscollected data on 191 PIs. PIs were included if theyreceived PN for �4 days and excluded if they diedwithin 3 days of life, or were transferred to/fromanother facility. Patient demographics, hospitalizationcharacteristics, and PN prescribing patterns were col-lected. PN prescribing patterns were compared with theESPEN guideline recommendations on the intake of aminoacids (AA) and lipids.Results: Data abstracted were from 95 male and96 female PIs with an average gestational age of 31.4weeks (SD, 3.0 weeks) and birth weight of 1518 g (SD,454 g). During the 1st 24 hours of life, 85% of PIsreceived PN. Among those receiving PN, 100% receivedglucose, but only 2% of PIs received the recommendedlevels of lipids and AA. Over the next 6 days, the meanlipid level achieved was 1.6 g/kg/day (recommendedmaximum 4.0 g/kg/day), with a mean AA level achievedof 2.4 g/kg/day (recommended maximum 4.0 g/kg/day).Conclusion: This retrospective chart review providesimportant data on the real-world use of PN amongpreterm infants in Germany. Compared to ESPEN guide-lines, PIs may not receive the recommended levels of AAand lipids, particularly during their 1st 24 hours of life.

Disclosure of Interest: F. X. Liu Other: Employee of BaxterHealthcare, G. M. Prinz Consultant for: Baxter Healthcare,

C. Macahilig Consultant for: Baxter Healthcare, F. MalinoskiConsultant for: Baxter Healthcare, R. Turpin Other: Employeeof Baxter Healthcare

LB012-SUNMANAGING PATIENTS AT RISK FOR DEVELOPINGREFEEDING SYNDROME: CLINICAL WISDOM VERSUSNICE GUIDELINESJ. Edakkanambeth Varayil1,2, S.M. Ali1,2, J.M. Nadeau1,D.G. Kelly1. 1Division of Gastroenterology andHepatology, Mayo Clinic College of Medicine, Rochester,United States; 22nd department of Internal medicine,Charles University in Prague, Faculty of Medicine,Hradec Kralove, Czech Republic

Rationale: Refeeding syndrome can be a devastating com-plication of newly instituted parenteral nutrition (PN).Current guidelines aimed at preventing this potentiallylethal condition are based more on anecdotes thanrandomized controlled trials.Methods: Following IRB approval, a retrospective analysisof the medical records of our patients was conductedfor the period from 2006 2010. Only those patientswho received �7 days of TPN prior to dismissal onhome PN were included in this study. We compared NICE(National Institute of Clinical Excellence) guidelines toour clinical judgment in identifying “at risk” patients.Data were analyzed using SPSS (version 18.0 for Windows,Chicago, IL).Results: Medical records of a total of 269 patientsstarted on home TPN were reviewed for this study.Of this group 69 patients met our inclusion criteria.Based on our clinical judgment, 37 (54%) patients wereconsidered at risk for refeeding syndrome and were givenan appropriate formula. According to NICE guidelinesonly 24 out of the 37 patients would have fulfilledthe criteria for being at risk for developing refeedingsyndrome. On the other hand, our non-risk group hada total of 32 (46%) patients and out of these 17 wouldhave met NICE criteria for being at risk, but as per ourpractice all were started on a normal TPN formula. Nosignificant complications owing to feeding were noted ineither group.Conclusion: Our research shows that there is a significantlack of congruity between clinical judgment and existingNICE criteria in identifying “at risk” patients. Solereliance on the NICE guidelines will not only resultin missing “at risk” patients but may also lead to anunnecessary delay in start of normal TPN in “non-risk”patients and hence should be eschewed.

Disclosure of Interest: None Declared

LB013-SUNDIETARY PATTERN AND COGNITIVE DISORDERS IN A12-YEAR FOLLOW-UP STUDY OF 70 YEAR OLD MENE. Olsson1, B. Karlstrom1, L. Kilander1, T. Cederholm1,P. Sjogren1. 1Uppsala University, Uppsala, Sweden

Rationale: The objective was to study the associationof dietary pattern at age 70 with the 12-year incidenceof Alzheimer’s disease (AD), all-type dementia, andcognitive decline.

210 Late Breaking Abstracts

Methods: Dietary habits in 1138 men aged 70 years oldfrom the Uppsala Longitudinal Study of Adult Men (ULSAM)were determined by a 7-day food record. Predefineddietary scores were used to determine adherence todietary guidelines according to WHO/Healthy Diet In-dicator (HDI), Mediterranean-like diet (MDS) and to acarbohydrate restricted and protein rich diet (CR). Non-adequate reporters of energy intake were identified andonly adequate reporters (n = 564) were included in theanalyses. Medical records were reviewed in order to trackAlzheimer’s disease and all-type dementia. Mini MentalTest (MMT 0 30 p) was performed at the ages of 70 and82 y. Cognitive decline was defined as all-type dementiaor at least 3 points decline in MMT over the 12-y period oran MMT< 25 p at 82 years of age. Cox proportional hazardregression and logistic regression with adjustments wasused to determine risk relations.Results: Over the 12-year period 48, 79 and 105individuals were identified with Alzheimer’s disease, all-type dementia or cognitive decline, respectively. Norelationships for the adherence to any of the dietarypatterns and AD or all-type dementia were found. Forinstance, hazard ratios (95% CI) for all-type dementiaassociated with each SD increment in the dietary scoreswere: 0.93 (0.73 1.19) for HDI; 1.01 (0.77 1.33) for MDS;and 1.12 (0.90 1.39) for CR. However, subsequent andpreliminary analysis indicated that MDS adherence wasnegatively associated with cognitive decline.Conclusion: In this population of 70 year old Swedishmen the dietary pattern had little impact on the riskof AD and all-type dementia, but a high adherence toa Mediterranean-like diet might be associated with areduced risk of cognitive decline.

Disclosure of Interest: None Declared

LB014-SUNEVALUATION OF NUTRITIONAL STATUS AND ANALYSISOF PARAMETERS SUITABLE FOR DETECTION OFMALNUTRITION IN ONCOLOGICAL PATIENTSH. Plotz1, C. Noe1, R. Kleinschmidt1, A. Dignass1.1Medizinische Klinik 1, Markus-Krankenhaus, Frankfurt,Germany

Rationale: Malnutrition is frequent in oncological patientsand has a significant impact on tolerability and success oftherapy. Different parameters for detection of malnutri-tion were tested in a clinical setting to identify the mostsignificant predictors.Methods: 206 oncologic patients in different stagesof disease were included. Biometric parameters, bio-chemical markers and questionnaires (Subjective GlobalAssessment, SGA and Nutritional Risk Screening, NRS)and bioelectric impedance analysis (BIA) were applied toassess nutritional status.Results: Depending on the singular test system applied,between 8.5% (body mass index, classification indepen-dent of age and sex) and 73.2% (Phase angle of theBIA) of the investigated patients showed malnutrition(SGA: 41.1%, consisting of 26.4% SGA B and 14.4% SGA C).Severe malnutrition (as detected by SGA) was most fre-quent in patients with cancers of the pancreas, stomachand lung, while breast cancer had the smallest impact

on nutritional status. Significant differences betweenpatients with active disease and those in remission werefound in 8 parameters tested. Statistical analyses allowedto identify a small subset of simple parameters whichwere able to detect malnutrition (as defined by SGA andNRS) as reliably as the questionnaires.Conclusion: Application of single parameters yieldswidely varying numbers of patients suffering putativelyfrom malnutrition, and not all parameters showedsignificant detection differences between patients withactive disease and those in remission, although thelatter are much less likely to be in an acute stateof malnutrition. Statistical analyses suggested that afew simple parameters may have the same predictiveperformance for detection of malnutrition as the SGA.

Disclosure of Interest: None Declared

LB015-SUNCAN NEEDLELESS SYSTEMS COMPLETELY PREVENTBACTERIAL INVASION DURING INFUSION LINECONNECTION?

Y. Inoue1. 1Surgery, Kawasaki Hospital, Kobe, Japan

Rationale: Needless systems are used to prevent micro-bial invasion through connection between a catheter andinfusion line. It has been simply considered that the use ofthese systems can prevent microbial invasion and reducethe incidence of catheter-related blood stream infection.Methods: We conducted three experiments on eight typesof connection systems:1. After bacteria were applied to female connectors

following 120-hour connection, whether or not theconnecting male connectors would cause bacterialinvasion of the device was examined (long-termconnection test; n = 20).

2. Whether or not the connecting male connectorsunder contaminated conditions would cause bacterialinvasion of the device was examined (male connectorcontamination test: n = 20).

3. After the connection operation was repeated 70times, bacteria were applied to the female connectorsand the disinfection maneuver was performed. Then,whether or not the connecting new male connectorswould cause bacterial invasion of the device wasexamined (female connector endurance test: n = 20).

Results: The long-term connection test showed bacterialinvasion of all the devices, except two of them, andsome devices showed a bacterial invasion rate of 60%. Themale connector contamination test revealed no bacterialinvasion in three types of devices, but bacterial invasionrates of 60% and 100% were observed for some otherdevices. In the female connector endurance test, thebacterial invasion rates for all devices, except three ofthem, were 5% to 45%. Modified piggyback system wasthe only system that showed no bacterial invasion in thethree experiments.Conclusion: If needleless systems are not used carefully,microorganisms can invade the systems. Therefore,thorough sterilization management for the entire infusionsystem needs to be conducted without overestimating thesafety of catheter devices.

Disclosure of Interest: None Declared