1. DIAGNOSTIC GROUPS CIE-9 CODEn (At admission) CONUT Changes during Hospital Stay -2, -10,1 LIVER ABSCESS AND SEQUELAE OF CHRONIC LIVER DISEASE 57217278.921.1 PNEUMONITIS DUE TO SOLIDS AND LIQUIDS 50723377.722.3 MALIGNANT NEOPLASM OF BLADDER 18814870.429.6 SECONDARY MALIGNANT NEOPLASM OF RESPIRATORY AND DIGESTIVE SYSTEMS 19717666.233.8 CHRONIC LIVER DISEASE AND CIRRHOSIS 57126964.335.7 MALIGNANT NEOPLASM OF COLON 15323862.937.1 OTHER DISORDERS OF INTESTINE 56915162.337.7 INTESTINAL OBSTRUCTION WITHOUT MENTION OF HERNIA 56015261.338.7 OTHER DISEASES OF ENDOCARDIUM 42431856.843.2 GASTROINTESTINAL HEMORRHAGE 57818956.843.2 PNEUMOCOCCAL PNEUMONIA [STREPTOCOCCUS PNEUMONIAE PNEUMONIA 48135756.243.8 OTHER AND UNSPECIFIED NONINFECTIOUS GASTROENTERITIS AND COLITIS 55822754.845.2 OTHER DISORDERS OF URETHRA AND URINARY TRACT 59973054.545.5 MALIGNANT NEOPLASM OF RECTUM RECTOSIGMOID JUNCTION AND ANUS 15414053.946.1 SECONDARY MALIGNANT NEOPLASM OF OTHER SPECIFIED SITES 19812852.847.2 PNEUMONIA ORGANISM UNSPECIFIED 486113352.247.8 DISORDERS OF FLUID ELECTROLYTE AND ACID-BASE BALANCE 27623051.648.4 OTHER DISEASES OF RESPIRATORY SYSTEM 51934150.749.3 ACUTE KIDNEY FAILURE 58422147.752.3 DIABETES MELLITUS 25034247.452.6 MALIGNANT NEOPLASM OF TRACHEA BRONCHUS AND LUNG 16226744.655.4 ACUTE BRONCHITIS AND BRONCHIOLITIS 46621044.155.9 OTHER DISEASES OF LUNG 51841143.156.9 COMPLICATIONS PECULIAR TO CERTAIN SPECIFIED PROCEDURES 99629440.759.3 OTHER COMPLICATIONS OF PROCEDURES NOT ELSEWHERE CLASSIFIED 99813840.659.4 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 52269 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 ) ≥3.503.00-3.492.50-2.99<2.50 (0)(2)(4)(6) Total lymphocytes † (Score ) ≥16001200-1599800-1199<800 (0)(1)(2)(3) Total cholesterol ‡ (Score ) ≥180140-179100-139<100 (0)(1)(2)(3) Interpretation Total score0-45-89-12 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: 34 915 202 401, E-mail address: ana_madrono@yahoo.com 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) 12291 *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) 38-45. 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;26:594-601. AKNOWLEDGMENTS VEGENAT and NUTRICIA. For supporting this project. Gastroenterology diseases Malignat neoplasia Respiratory diseases Kidney diseases http://blog.conut.es