Canadian Frailty Network (CFN) National Conference Abstracts Contributions from the CFN Trainees

s from all researchers who are engaged with the seriously ill, frail elderly. Authors: John Muscedere1 MD, Sarah Grace Bebenek2 MSc, Denise Stockley PhD2, Laura Kinderman2 PhD, and Carol Barrie1 CPA, CA. 1Canadian Frailty Network, 2Queen’s University. Ultrasound of Thigh Muscle Can Predict Frailty in Elderly Patients S. Salim, L. Warkentin, A. Gallivan, T. Churchill, V. Baracos, R. Khadaroo. University of Alberta, Edmonton, AB, Canada. Background: Sarcopenia, defined as loss of muscle mass and function, has been associated with high morbidity and mortality in patients over 65 years. Yet, it is not part of the routine screening process in geriatric care. Computed tomography (CT) scan has been used as the gold-standard tool to identify sarcopenia. Unfortunately, the high cost, limited availability, and radiation exposure limits the use of CT scans. Thigh muscle ultrasound (US) may provide a feasible diagnostic modality to identify frail older patients. We hypothesize that thigh ultrasound is predictive of frailty and post-operative complications in high-risk elderly patients. Methods: Thirty-eight patients above the age of 65 years referred to Acute Care Surgery service were recruited. Using ultrasound, thigh muscle thickness was standardized to patient height. CT scan images at L3 were analyzed and the skeletal muscle index was calculated. Sarcopenia was defined as skeletal muscle index < 41cm2/m2 for females and <43cm2/m2 or < 53cm2/m2 for males (with BMI 25kg/ m2, respectively). Rockwood Clinical Frailty score (1-3 non-frail, >4 frail) was used to assess patient condition. Results: The mean age of our preliminary study group was 78 ± 8 years and 68% (n=26) were females. Sarcopenia was identified in 69% of the patients via CT. Sarcopenic patients had a greater number of in-hospital complications (48% vs. 16.6% in non-sarcopenic, p=.0001). There was no difference in duration of stay between sarcopenic and non-sarcopenic patients (14 vs. 11 days, p=.06). There were significant differences between sarcopenic and non-sarcopenic females in skeletal muscle surface area (113 ± 9 versus 91 ± 10 cm2, p < .001), and skeletal muscle index (35.2 versus 46.3 cm2/ m2, p< .001). CT scan skeletal muscle index of sarcopenic patients showed significant correlation with frailty score (r2=0.21, p<.05). US of rectus femoris in all females was significantly associated with frailty score (r2=0.19, p=.008). The receiver-operating characteristic (ROC) for thigh ultrasound was not able to distinguish sarcopenic patients (area ROC curve=0.6, p=.8). Conclusion: CT identified sarcopenia was associated with high-risk frail patients. US measured muscle thickness was predictive of frailty but not of CT identified sarcopenia. Validity and Reliability Testing of Two Acute Care Nutrition Support Tools J. McCullough1, H. Keller2, E. Vesnaver3, H. Marcus4, T. Lister5, R. Nasser6, L. Belley7. 1University of Waterloo, Waterloo, ON, Canada; 2Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada; SchlegelUniversity of Waterloo, Research Institute for Aging, Waterloo, ON, Canada; 3Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, Canada; 4Grand River Hospital, Kitchener, ON, Canada; 5Vancouver Island Health Authority, Vancouver, BC, Canada; 6Regina Qu’Appelle Health Region, Regina, SK, Canada; 7Centre hospitalier de l’Université de Montréal, Montreal, QC, Canada. Abstract: Poor food intake is common with patients in acute care, which can affect their recovery. Research describes that many barriers to food intake and poor intake is associated with a longer hospital stay. Thus, identifying problems and intervening as soon as possible is important. The aim of this project was to test the validity and reliability of recently developed tools designed to monitor food intake and barriers experienced by patients. 120 patients over the age of 65 were recruited at four hospitals. Patients reported their food intake for a single meal on the My Meal Intake Tool (M-MIT) and reported mealtime barriers at a single meal on the Mealtime Audit Tool (MAT). Validity of the M-MIT was determined by comparing patient completed M-MIT with food intake estimations conducted by on-site dietitians. Sensitivity (SE) and specificity (SP) for solid food and individual fluid intake (≤ 50% vs. > 50%) was adequate (solids: SE 76%, SP 74%; juice: SE 74.1%, SP 88.1%; coffee/ tea: SE 70.6%, SP 97.0%; milk: SE 64.3%, SP 83.3%). According to the MAT, the mean number of food intake barriers that patients experienced across the four hospitals was 2.93 ± 1.58 out of 18 potential barriers. Some of the most common barriers experienced included: meal tray not looking/smelling appetizing, food not served hot, tray not set up for patient, patient not provided snacks between meals, and the patient being disturbed during the meal. Inter-rater reliability testing of the MAT was conducted at Poor food intake is common with patients in acute care, which can affect their recovery. Research describes that many barriers to food intake and poor intake is associated with a longer hospital stay. Thus, identifying problems and intervening as soon as possible is important. The aim of this project was to test the validity and reliability of recently developed tools designed to monitor food intake and barriers experienced by patients. 120 patients over the age of 65 were recruited at four hospitals. Patients reported their food intake for a single meal on the My Meal Intake Tool (M-MIT) and reported mealtime barriers at a single meal on the Mealtime Audit Tool (MAT). Validity of the M-MIT was determined by comparing patient completed M-MIT with food intake estimations conducted by on-site dietitians. Sensitivity (SE) and specificity (SP) for solid food and individual fluid intake (≤ 50% vs. > 50%) was adequate (solids: SE 76%, SP 74%; juice: SE 74.1%, SP 88.1%; coffee/ tea: SE 70.6%, SP 97.0%; milk: SE 64.3%, SP 83.3%). According to the MAT, the mean number of food intake barriers that patients experienced across the four hospitals was 2.93 ± 1.58 out of 18 potential barriers. Some of the most common barriers experienced included: meal tray not looking/smelling appetizing, food not served hot, tray not set up for patient, patient not provided snacks between meals, and the patient being disturbed during the meal. Inter-rater reliability testing of the MAT was conducted at