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J04 Individualised Nutritional Intervention to Avoid Weight Loss in HD Patients during Hospitalisation
  1. E Roca,
  2. C Méndez,
  3. JM Ruiz
  1. Neuropsychiatry Unit, HD Comprehensive Attention Service, Hospital Mare de Déu de La Mercè, Hermanas Hospitalarias, Barcelona, Spain

Abstract

Background Weight loss is a common feature in HD. Disruptive neuropsychiatric symptoms (aggression, agitation) and dysphagia observed in moderate/severe stages often contributing to and exacerbating feeding problems.

Aim Assess the efficacy of an individualised nutritional intervention to avoid weight lost in HD patients during hospitalisation.

Methods/techniques All HD patients at the Neuropsychiatry Unit are assessed in a comprehensive base within the first 7 days of admission. Nutritional assessment includes weight, height, BMI, Mini Nutritional Assessment (MNA), recent weight loss referred from careers, Determine scale, Dysphagia scale, Barthel scale.

Depending on the initial results, a nutritional alert is activated and a HD hypercaloric diet is provided. If required, nutritional supplements are also provided following indications of the Nutritional Support Service of Vall d’Hebrón General Hospital.

The goal of the intervention is to avoid significant weight loss during admission considering this to be 5% of the initial weight.

Results/outcomes 19 patients consecutively discharged from the Unit during 2013 were included in the retrospective study. 12 men, 7 women; Mean age 51.6 ±. 67 y.; Mean admission duration 144 ± 113.87 d. 84.6% in moderate/advanced stage (TFC III, IV, V). Nutritional characteristics: Mean BMI: 22.26 ± 5.08; Mean MNA total: 14.82 ± 5.97. 10 patients had dysphagia (52.6%), 13 were reported to have weight loss before admission (68.4%). Based on MNA total score, 3 patients had malnutrition, 10 patients were at risk.

13 patients received hypercaloric HD diet (68.4%); 8 of them (42.1%) also received nutritional supplements. The mean weight change was +1.9 kg (±5.25). The number of patients whose weight loss did not exceed 5% of their previous weight was, on average, 94.7%.

Conclusions Malnutrition is a challenge in HD especially in those with added disruptive behaviours or dysphagia.

Our results show that an individualised nutritional program prevents patients from suffering weight loss even if they have dysphagia or experienced weight loss prior to admission.

KeyWords
  • Huntington Disesase
  • nutritional intervention
  • weight loss

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