P820 - WHEN IS THE OPTIMAL GOLDEN TIME TO APPLY ENTERAL TUBE FEEDING FOR PATIENTS WITH AMYOTROPHIC LATERAL SCLEROSIS? : FOCUS ON DYSPHAGIA PATIENTS AT THE TIME OF DIAGNOSIS

P820

WHEN IS THE OPTIMAL GOLDEN TIME TO APPLY ENTERAL TUBE FEEDING FOR PATIENTS WITH AMYOTROPHIC LATERAL SCLEROSIS? : FOCUS ON DYSPHAGIA PATIENTS AT THE TIME OF DIAGNOSIS

E. Kim^1,2,*, Y. Kim³

¹Nutrition Support Team, ²Nursing, Seoul National University Hospital, ³Nutrition Care, SMG-SNU Boramae Medical Center, Seoul, Korea, Republic Of

Rationale: This study aimed to investigate the characteristics of the patients who were already dysphagia at the time of diagnosis of amyotrophic lateral sclerosis (ALS), and to evaluate the nutritional strategies at the time of transition from oral to enteral nutrition (EN) after diagnosis.

Methods: This retrospective study collected date from 108 patients who received nutritional care from the nutrition support team between January 2018 and December 2023. Demographic date, feeding tube insertion timing, and ALS functional rating scale-revised (ALSFRS) score were collected. Nutritional status was evaluated using the body mass index (BMI) and Global Leadership Initiative on Malnutrition (GLIM) criteria.

Results: Patients with dysphagia at diagnosis (16.7%, mean age 69.2 years) required feeding tube earlier (8.3 months vs. 17.1 months) and lost more weight (19.0% vs. 11.5%) than those without dysphagia (83.3%, mean age 64.0 years). In dysphagia group, the period from diagnosis to assessment with ALSFRS dysphagia score 3 was 6.2 months, while ALSFRS dysphagia score 2 was 15.2 months. Only 13.9% underwent early feeding tube insertion before the onset ALSFRS dysphagia score 3, while 43.0% were delayed until ALSFRS dysphagia score 2. Nutritional status at the time of feeding tube insertion, assessed using the GLIM criteria, was as follows; severe malnutrition 53.7% (n=53), moderate malnutrition 25.9% (n=28) and well-nourished 20.4%(n=22).

Conclusion: Patients with dysphagia at the time of diagnosis had a shorter duration until feeding tube insertion and suffer from weight loss. Therefore, for patients with dysphagia, regardless of whether oral intake is possible, it is recommended to consider EN earlier than the current recommended period before their nutritional status worsens.

Disclosure of Interest: None declared