C. De Caprio

TIME TREND PREVALENCE OF ARTIFICIAL NUTRITION COUNSELLING IN A UNIVERSITY HOSPITAL

OBJECTIVES The negative effects of malnutrition on the prognosis of hospitalized patients are well documented; however, less known is the awareness and knowledge of health care professionals about this complication. The aim of this study was to evaluate the trend of the requests for nutritional consultation in years and the prescription of artificial nutrition (AN), for adult patients at a university hospital in southern Italy in the years 2004, 2008, 2012, and 2016 to assess the progress of medical teams concerning awareness of hospital malnutrition. METHODS This was a retrospective study that evaluated the time trend of nutritional consultation requests and related prescription of AN, for adult patients at a university hospital in southern Italy in the years 2004, 2008, 2012, and 2016. Of 112 233 inpatients, 2505 received a nutritional consultation with the prescription of AN. RESULTS The number of patients on AN increased from 507 of 33 240 (1.52%) in 2004 to 730 of 29 195 (2.5%) in 2008 (P < 0.001), remaining almost stable in 2012 and 2016. The request for AN was quite equally distributed between surgical (51.5%) and medical wards (48.5%), with a prevalence among patients with oncologic diseases (806 patients [65.6%]). As for nononcologic diseases, 20.4% involved the gastrointestinal tract and 6.3% the nervous system. Throughout the 12 y of observation, parenteral nutrition was the main prescribed support (59.8%) followed by oral nutritional supplements (26.1%) and enteral nutrition (9.3%). Mean nutritional intervention duration was 11 d (±10.8 d). CONCLUSIONS The request of AN for hospitalized patients increased over time, probably owing to improved medical consciousness of the potential risks for malnutrition and the availability of a specialized clinical nutrition team.

Screening for sarcopenia in obesity

Sarcopenia is a progressive and generalized loss of skeletal muscle mass (SM) and function which can also be found in obese adults. The aim of the study was to evaluate the prevalence of sarcopenia in 1 245 obese women (18 – 67 years, weight 114.7±24.5 kg; BMI 44.1±9.2; fat mass 49.0±6.2%) from Southern Italy. Body composition was evaluated by bioimpedance analysis (BIA) and SM calculated by using Janssens equation; therefore the sex-specific cut-off points of percentage skeletal muscle index were used. The whole population was divided in two age groups: A (18-40 years; n. 808; weight 115.4±23.5 kg; BMI 43.8±8.8 kg/m2) and B (41-67 years; n. 438; weight 113.4±26.3 kg; BMI 44.8±9.9 kg/m2). In all the sample there was 2.7% moderate and 0.6% severe sarcopenia; in group A, 1.9% moderate and 0.6% severe sarcopenia whilst in group B 4.3% moderate and 0.7% severe sarcopenia. The results of our study suggest that, based on a screening examination by BIA, moderate/severe sarcopenia can be detected in an unselected middle-aged obese population. Further studies are required to clarify the diagnosis with functional tests.