Liver and gastrointestinal tract II 125

(BW) depending on compliance and to identify residentcharacteristics associated with compliance.Methods: 42 nursing home residents at risk of malnu-trition (MN) (87±6 y, 88% &) received 2×125 ml dailyof a nutrient- and energy-dense ONS (2.4 kcal/ml) for12 weeks as part of a controlled intervention trial.Intake was documented daily by nursing staff (ml/d),compliance calculated as percentage of the providedamount. Poor and good compliance was defined as �30%and �80%. BW was measured at baseline and after12 weeks. BW differences were analyzed by t-test,correlation to compliance by Spearman’s coefficient.Associations of compliance with mobility, level of care,dementia, depression, appetite, MN according to MNA(Mini Nutritional Assessment), feeding assistance andgastrointestinal complaints (GIC) were assessed by Chi2-test.Results: Median ONS intake was 438 (Q1 141; Q3 519)kcal/d. 71.4% consumed at least half of the providedamount. Compliance was good in 35.7% and poor in28.6%. BW change was significantly higher in subjectswith good vs poor compliance [+3.0 (+2.1; +3.8) kg vs0.2 ( 2.2; +1.6) kg; p < 0.001] and correlated with the

compliance (r = 0.69; p < 0.001). Good compliance wasmore prevalent in malnourished compared to residentsat risk and well-nourished (69.2 vs 23.1 vs 0.0%; p < 0.05).Poor compliance was more frequent in immobile vs mobile(45.0 vs 14.6%; p < 0.05) and in residents with GIC vsno complaints (50.0 vs 17.9%; p < 0.05). There was norelation to other characteristics.Conclusion: Poor compliance reduces positive effects ofONS on BW. As limiting factors we identified GIC andimmobility. Contrary, low MNA scores seem to contributeto a better adherence to ONS. To enhance the efficiencyof ONS these aspects need to be focused.

Disclosure of Interest: I. Stange Grant/Research Support from:The study was supported by Pfrimmer Nutricia, Germany, Y. Liao:None declared, K. Poschl: None declared, M. Bartram: Nonedeclared, C. Sieber: None declared, D. Volkert: None declared

PP262IMPLEMENTATION OF THE TUBE FEEDING RATIONALUSE IN PATIENTS WITH OROPHARYNGEAL DYSPHAGIA’SSUSPECTM.J. Alvarez1, M.J. Rodriguez1, R. Asbaugh1,V. Rodriguez1, R. Garriga1, I. Gonzalo1, B. Calderon1,A. Munoz1. 1Endocirnología y Nutricion. Unidad deNutricion, Hospital Universitario Principe de Asturias,Alcala de Henares, Madrid, Spain

Rationale: Dysphagia oropharyngeal (DOP) is a frequentsymptom (30 82%) in patients with neurological disease,head and neck cancer and frail older people. TheVolume Viscosity Test (VVT) is an efficient tool to clinicalbedside assessment to optimize the use of the tubefeeding. The aim of this study is to demonstrate that thesystematic use of VVT improves the tube feeding rationaluse in patients with DOP and saves cost.Methods: Patients with DOP’s clinical suspect and enteralnutrition indication were assessed with the VVT. Toevaluate efficacious and safe swallow (blus propulsion,swallow response, laryngeal closure), before the tube

feeding placement, the nurse of the nutrition supportteam made swallowing assessment without boluses andVVT with 3 20 ml liquid, nectar and pudding boluses. Thedirect cost was calculated with the necessary elements ofenteral nutrition care, natural diet and oral supplements(OS) prices.Results: 217 patients (97 Female and 120 Male), age: 73.5(22 96) years; 82.9% with neurological disease, 15.3% frailolder people without identified neurological disease, and1.8% with problems related with head and neck cancertreatment. We identified 188 patients with DOP. Only25 patients needed feeding tube and 163 ate a texturemodified diet (liquids, nectar and pudding accord to theresults). In this group, 68% of the patients needed OS.The mean cost of the tube feeding, texture modified dietwith OS and texture modified diet per day was 14.4€ vs10.58€ vs 9€ respectively.Conclusion: Due to the systematic use of VVT as atool for clinical bedside assessment of DOP, an elevatedpercentage of patients could ate a texture modified dietinstead of the enteral tube feeding. In fact, the cost ofthe nutritional care was reduced between 26% and 37.5%in a 68% of patients.

Disclosure of Interest: None declared

Liver and gastrointestinal tract II

PP263SURVIVAL RATE AND RISK FACTORS FOR DEATH ONHOME PARENTERAL NUTRITION (HPN) FOR INTESTINALFAILURE (IF)

F. Joly1, M. Staun1, C. Cuerda1, D.G. Kelly1, S. Klek1,G. Wanten1, C. Jonker1, L. Santarpia1, D. BoggioBertinet1, J. Baxter1, L. Chicharro1, C. Pazzeschi1,N. Virgili1, A. Van Gossum1, L. Pironi1. 1Home ArtificialNutrition and Chronic Intestinal Failure Working Groupof ESPEN, Bologna, Italy

Rationale: A high risk of death related to the underlyingdisease is a criteria for patient referral for intestinaltransplantation. In order to investigate this issue, amulticenter, retrospective, questionnaire-based, 5 yearfollow up was performedMethods: Adult patients who started HPN for benign IFbetween January 2000 and December 2004 were enrolled.Demographic and underlying disease characteristics werecollected from patients’ records. End of the follow upwas: weaning-off HPN, intestinal transplantation, deathon HPN or 5 years of HPN. Statistics by Kaplan-Meieranalysis and Logistic Regression.Results: The 5-year outcome of the 342 who wereevaluated was: weaned-off HPN 29.5%, intestinal trans-plantation 2.8%, deceased on HPN 23.7%, alive on HPN43.0%. The survival rate was: 88%, 77%, 64% and 39%in age decades at starting HPN �30, 31 50, 51 70 and>70 years (P< 0.001), respectively; 72%, 65% and 53% incauses of intestinal failure, short bowel, motility disorderand extensive mucosal disease, respectively (P= 0.092);82%, 80%, 67%, 64% and 56% in underlying diseases,Crohn’s, pseudo-obstruction, radiation enteritis, post-surgical complication, and other diseases, respectively