Authors (including presenting author) :
EKH Luk(1), THY Ting(1), PYP Yau(2), KCT Li(3), RSK Lo(3)
Affiliation :
(1) Department of Dietetics, Shatin Hospital, Hong Kong, China, (2) Department of Dietetics, Prince of Wales Hospital, Hong Kong, China, (3)Department of Medicine, Shatin Hospital, Hong Kong, China
Introduction :
Patients under palliative care, such as patients with advanced cancers, end-stage renal failure and chronic pulmonary obstructive disease, are prone to malnutrition risk. Poor nutritional status is related to more inferior quality of life, increased complications and increased mortality.
Objectives :
To understand the service gaps and introduce service improvement measures, we investigate the prevalence of malnutrition risk and its relationship with nutritional intake and clinical outcomes such as length of stay (LOS) and mortality in patients under palliative care at the Shatin Hospital.
Methodology :
Electronic inpatient has been applied for the Dietetics service since 2017. Patient information on nutrition assessment was entered into Clinical Management System (CMS) for record-keeping purposes. The records of 534 patients under palliative care who had seen a dietitian during the admission period from 1 January 2020 to 31 December 2020 were retrieved from the Clinical Data Analysis and Reporting System (CDARS). The prevalence of malnutrition risk, dietary intakes, length of stay and mortality were compared between the low malnutrition risk and at-risk groups (medium and high-risk groups).
Result & Outcome :
The prevalence of malnutrition risk in the 534 cancer patients was 86.3% (both medium and high-risk patients). The LOS of the low-risk group is significantly longer than the at-risk group (19.8 ± 18.1days vs 25.9 ± 36.1days, p<0.05). The mortality of patients with the at-risk group was significantly higher than the low-risk group (29.0% vs 17.8%, OR 1.89, p<0.05). The energy and protein intake records were available in 224 patient records. The mean intake of energy and protein for the at-risk group is 728kcal and 32g protein per day, respectively, which met 47% and 50% of the requirements. Enhancement measures implemented include 1. Introduce new nutrition products to enhance treatment effectiveness 2. Introduce “Top Up” nutrition products and re-activate high protein high energy diet to provide safe, timely and efficient nutrition care at ward level 3. Optimize patient meal portion size to ensure an equitable of care is provided.
