PD003 - ULTRASOUND-DERIVED CUTOFFS FOR NUTRITIONAL ULTRASOUND® TO DETECT MALNUTRITION AND PREDICT MORTALITY IN HOSPITALIZED PATIENTS AT NUTRITIONAL RISK. DRECO STUDY

PD003

ULTRASOUND-DERIVED CUTOFFS FOR NUTRITIONAL ULTRASOUND® TO DETECT MALNUTRITION AND PREDICT MORTALITY IN HOSPITALIZED PATIENTS AT NUTRITIONAL RISK. DRECO STUDY

G. M. OLVEIRA FUSTER^1,* on behalf of DRECO STUDY GROUP , D. De Luis Román², J. M. GARCIA-ALMEIDA³, G. GUZMAN-ROLO⁴, D. BELLIDO⁵ on behalf of M García-Olivares, JJ. López-Gómez, Y García-Delgado, P Guirado-Peláez, A Zabalegui, C Porca, Montserrat Gonzalo, María Maíz, CM Alzás, A Bielza, JM Guardia, LA. Calles, AJ. Martínez, I Prior-Sánchez, M González-Pacheco, MG Rodríguez-Carnero, M Civera, I

¹ENDOCRINOLOGY AND NUTRITION, HOSPITAL REGIONAL UNIVERSITARIO DE MÁLAGA, MALAGA, ²ENDOCRINOLOGY AND NUTRITION, HOSPITAL CLINICO UNIVERSITARIO VALLADOLID, VALLADOLID, ³ENDOCRINOLOGY AND NUTRITION, HOSPITAL VIRGEN DE LA VICTORIA , MALAGA, ⁴ABBOTT NUTRITION, MADRID, ⁵ENDOCRINOLOGY AND NUTRITION, Complejo Hospitalario de Ferrol, A CORUÑA, Spain

Rationale: The DRECO study is a nationwide, prospective, multicentre cohort designed to evaluate the clinical utility of ultrasound (US) for detecting malnutrition in hospitalised patients at nutritional risk and to establish sex-specific diagnostic cut-offs.

Methods: Patients at nutritional risk (MUST), underwent a comprehensive morphofunctional assessment (handgrip strength, BIA and TUG test, and rectus femoris ultrasound. ROC)curve analyses were performed to determine  cut-offs for malnutrition according to GLIM criteria. Survival analyses with multivariable adjustment were used to assess 6-month mortality.

Results: 932 patients were evaluated (59% men; mean age 58.7 ± 16.3 years). Malnutrition was identified in 88.3% of patients (41.3% moderate and 47.0% severe), with no significant differences between sexes. Patients with moderate and severe malnutrition showed significantly lower BIA, ultrasound, and functional parameters compared with well-nourished individuals (p < 0.001).  Rectus femoris cross-sectional area (CSA) and Y-axis thickness were significantly correlated with BIA parameters and functional measures.  Optimal ultrasound cut-offs were: CSA < 4.00 cm² and Y-axis < 13.1 mm in men, and CSA < 2.98 cm² and Y-axis < 9.73 mm in women. During the 6-month follow-up, mortality increased progressively with malnutrition severity (4.6% well-nourished, 10.6% moderate and 18.9% severe malnutrition; p < 0.001). Patients with CSA or  Y-axis thickness above the sex-specific cut-off had a reduced risk of death (HR 0.54; 95% CI 0.37–0.79  and HR 0.28; 95% CI 0.17–0.47, respectively ).

Conclusion: Malnutrition is highly prevalent among hospitalised patients identified as being at nutritional risk. The ultrasound assessment of the rectus femoris adds clinically relevant and complementary information to the morphofunctional evaluation.

Disclosure of Interest: G. M. OLVEIRA FUSTER: None declared, D. De Luis Román: None declared, J. M. GARCIA-ALMEIDA: None declared, G. GUZMAN-ROLO Other: EMPLOYED ABBOTT NUTRITION , D. BELLIDO: None declared