LB014 - SPECIALIST DIETITIAN INPUT CAN IMPROVE PATIENT OUTCOMES & IDENTIFY PATIENTS WHO NEED MORE INTENSIVE INTERVENTION

LB014

SPECIALIST DIETITIAN INPUT CAN IMPROVE PATIENT OUTCOMES & IDENTIFY PATIENTS WHO NEED MORE INTENSIVE INTERVENTION

K. Weatherby^1,*, T. Nyirenda¹, S. Moreea¹

¹Bradford Teaching Hospital Foundation Trust, Bradford, United Kingdom

Rationale: Screening & assessment of patients with decompensated liver disease is key to identify sarcopenia & prevent the associated morbidity, mortality & poorer quality of life. We evaluated our Specialist Liver Dietitian’s proactive service with day case paracentesis patients, to see if it improved anthropometric measures (AM) & overall outcomes.

Methods: A retrospective audit was done between Sept 23 & Aug 24 on the day case paracentesis unit. AM included Hand Grip Strength (HGS) & Mid Upper Arm Circumference (MUAC). Number of dietetic interventions & dietetic education topics were recorded. The 4 main topics discussed were 2-3 hourly meal pattern, high protein sources, late evening supper & exercise. Data was excluded if only initial AM was obtained.

Results: 116 drains were carried out on 31 patients. Of these, 19 (61.3%) patients received dietetic input, averaging 2.9 dietetic episodes/patient (14M, age range 35-84, mean 58.5; 5F, age range 30-73, mean age 60). Average time between pre & post AM was 6.8 months. Sarcopenia was identified in all 19 patients & all required oral nutrition supplements (ONS).

Pre & post HGS measures were taken on 16 patients (84.2%). HGS increased on average by 2.9kg. Pre & post MUAC was taken on 13 patients (68.4%). MUAC increased on average by 2cm. Patients with above average HGS & MUAC had more favourable outcomes; 1 listed for transplant, 1 TIPPS & 3 diuretic controlled ascites. Decreasing AM led to unfavourable outcomes; 2 mortalities, 1 rocket drain, 1 ongoing decompensation. No patients who showed improved AM died within 3 months of audit completion.

Conclusion: Identifying patient with decreasing AM allows dietitians to provide more intensive dietetic treatments. All patients needed tailored nutritional education & ONS therefore specialist dietetic input is essential within this patient group.

Disclosure of Interest: None declared