DIAGNOSTIC GROUPS CIE-9 CODEn (At admission) CONUT Changes during Hospital Stay -2, -10,1 LIVER ABSCESS AND SEQUELAE OF CHRONIC LIVER DISEASE PNEUMONITIS DUE TO SOLIDS AND LIQUIDS MALIGNANT NEOPLASM OF BLADDER SECONDARY MALIGNANT NEOPLASM OF RESPIRATORY AND DIGESTIVE SYSTEMS CHRONIC LIVER DISEASE AND CIRRHOSIS MALIGNANT NEOPLASM OF COLON OTHER DISORDERS OF INTESTINE INTESTINAL OBSTRUCTION WITHOUT MENTION OF HERNIA OTHER DISEASES OF ENDOCARDIUM GASTROINTESTINAL HEMORRHAGE PNEUMOCOCCAL PNEUMONIA [STREPTOCOCCUS PNEUMONIAE PNEUMONIA OTHER AND UNSPECIFIED NONINFECTIOUS GASTROENTERITIS AND COLITIS OTHER DISORDERS OF URETHRA AND URINARY TRACT MALIGNANT NEOPLASM OF RECTUM RECTOSIGMOID JUNCTION AND ANUS SECONDARY MALIGNANT NEOPLASM OF OTHER SPECIFIED SITES PNEUMONIA ORGANISM UNSPECIFIED DISORDERS OF FLUID ELECTROLYTE AND ACID-BASE BALANCE OTHER DISEASES OF RESPIRATORY SYSTEM ACUTE KIDNEY FAILURE DIABETES MELLITUS MALIGNANT NEOPLASM OF TRACHEA BRONCHUS AND LUNG ACUTE BRONCHITIS AND BRONCHIOLITIS OTHER DISEASES OF LUNG COMPLICATIONS PECULIAR TO CERTAIN SPECIFIED PROCEDURES OTHER COMPLICATIONS OF PROCEDURES NOT ELSEWHERE CLASSIFIED CHANGES ON NUTRITIONAL STATUS DURING HOSPITAL STAY AND ITS ASSOCIATION WITH THE MOST FREQUENT DIAGNOSES. ESPEN 2011 Congress Authors: A. González-Madroño, F. Rodríguez, G. Fernández, A. Mancha, A. Diaz, J.I. Ulíbarri Clinical Nutrition and Dietetic Unit. Hospital Universitario de la Princesa, Madrid, Spain. RATIONALE: To determine the prevalence of nutritional alert, its evolution during hospital stay and its relation with the most prevalent diagnoses, in the Hospital Universitario de la Princesa of Madrid. METHODS It is a retrospective study which analyzes the MDS databases for three years (with a total of patients) containing information about the diagnosis that has caused the hospitalization (coded as ICD-9) and the total score obtained by the nutritional screening tool CONUT ® (Table 1), which assigns a nutritional alert (low, moderate or high) according to levels of serum albumin, total cholesterol and total lymphocyte count. We selected the 50 most prevalent diagnoses among the patients who had completed these analytical parameters. We compared the results of the first and last CONUT, and created a new variable (CONUT changes during the stay) with the following values: - 2: patients admitted with low alert and discharged with moderate/ high alert - 1: admitted and discharged with moderate/high alert 0: admitted and discharged with low alert +1: admitted with moderate/high alert and discharged with low Diagnoses are ranked according to their prevalence of negative nutritional changes (-2, - 1) during the stay. TABLE I. UNDERNUTRITION ALERT AS EVALUATED BY CONUT ParameterParameter values W ithout deficit With deficit LightModerateSevere Serum albumin * (Score ) ≥ <2.50 (0)(2)(4)(6) Total lymphocytes † (Score ) ≥ <800 (0)(1)(2)(3) Total cholesterol ‡ (Score ) ≥ <100 (0)(1)(2)(3) Interpretation Total score Undernutrition Alert Low AlertModerate AlertHigh Alert RESULTS CORRESPONDENCE Ana González-Madroño Unidad de Nutrición Clínica y Dietética, Hospital Universitario La Princesa C/ Diego de León 62, 28006, Madrid, SPAIN, Tel: , address: CONUT Undernutrition Alert Low Alert n (%) Moderate Alert n (%) High Alert n (%) TOTAL n (%) At admission*16067 (62)7528 (29.1)2301 (8.9)25896 (49.5**) At discharge*7036 (56.9)4175 (33.7)1163 (9.4)12374 (23.7**) TABLE II. PREVALENCE OF UNDERNUTRITION ALERT AS EVALUATED BY CONUT *Patients who had completed the analytical parameters included in the CONUT system. **Percentage of patients who had completed analytical parameters out of all patients admitted to hospital (n=52269). TABLE III. CONUT CHANGES DURING THE STAY CONUT Changes during stay -2*-1*0*0*1*1*TOTAL Nº of patients (%) 1486 (12.10)** 3806 (31)** 5115 (41.60) 1884 (15.30) *As detailed in Methods. **Percentage of patients who had worsen their nutritional status are show in red. CONCLUSIONS CONUT is a very useful tool for screening and monitoring changes on the nutritional alert status during hospital stay. For different reasons half of patients admitted to hospital have not completed the analytical parameters to undergo a nutritional screening during hospital stay. Almost half of the patients (43%) worsen their nutritional alert status during hospital stay. The observed association between certain diagnoses and negative nutritional changes during hospital stay should lead to increased vigilance in those patients with such diagnoses and to promote a better nutritional intervention. REFERENCES CONUT: A tool for Controlling Nutritional Status. First validation in a hospital population. Ulibarri JI, Gonzalez-Madroño A, de Villar NGP et al. Nutr. Hosp. (2005) XX (I) The use of biochemical and immunological parameters in nutritional screening and assessment. A. González Madroño, A. Mancha, F. J. Rodríguez, J. I. de Ulibarri and J. Culebras. Nutr Hosp. 2011;26: AKNOWLEDGMENTS VEGENAT and NUTRICIA. For supporting this project. Gastroenterology diseases Malignat neoplasia Respiratory diseases Kidney diseases