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Purpose: Controlling nutritional status (CONUT) is a simplified yardstick for the nutritional assessment of undernourished inpatients. For the effective screening of undernourished inpatients with test data, we thoroughly explored the clinical validity of a modified CONUT method.
Methods: We measured the total cholesterol (T-Cho) of subjects. We came up with a modified CONUT method, whereby T-Cho for which there were more requests from inpatients would be included, whereas T-Cho for which the requests were fewer would be excluded. We determined the degree of concordance with regard to the nutrition level between the modified CONUT method and the conventional CONUT method. We also determined correlations between the scores achieved using these methods.
Results: The measured T-Cho rate was 15.4%. The degree of concordance with regard to the nutritional level between the modified CONUT method and the conventional CONUT method was κ = 0.778. The Spearman coefficient between the score of the modified CONUT method and that of CONUT method was rs = 0.942.
Conclusion: The correlation between scores and degree of concordance with regard to the nutritional level between the modified CONUT method and the conventional CONUT method were favorable. It was suggested that the modified method would presumably be as useful as the conventional CONUT method for the screening of undernourished inpatients. Using hemoglobin (Hb), for which requests are higher than T-cho from inpatients, the modified CONUT method makes it possible to nutritionally screen a greater number of inpatients.

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Purpose:To determine whether our ICU nutritional support protocol, which was operated by multioccupational nutrition support team (NST) members, improves feeding practices and reduces mortality in ICU patients.
Methods:We retrospectively reviewed nutritional management in patients who were admitted to our ICU for longer than two weeks. We compared the results obtained before and after introducing the protocol.
Results:We enrolled 127 patients in the before group and 103 patients in the after group, respectively. As a nutritional evaluation, albumin of 4 weeks later (3.3g/dL vs 3.6g/dL), prealbumine of 3 weeks later (16.9mg/dL vs 20.7mg/dL) were significantly improved. The day of starting enteral nutrition was significantly earlier (3.9±4.2 days vs. 1.8±0.4 days; p=0.038), and the ratio of patients starting early enteral nutrition within 48 hours was significantly higher 35.4% vs. 53.4%; p=0.008).ICU length of stay or ICU discharge mortalityshowed tendency to improve (22.6±11.5 days vs 20.8±7.3 days; p=0.15, 16.5% vs 8.7%; p=0.059). Multiple regression analysis showed that protocol implementation was independently associated with the ratio of starting early enteral nutrition within 48 hours (odds ratio, 2.16; 95% confidence interval [CI], 1.17-3.99; p=0.013).
Conclusions:Introducing ICU nutritional support protocol promoted early enteral nutrition, greater nutritional adequacy and improvement of nutritional laboratory data of patients admitted to the ICU for longer than two weeks.

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Aim: Body weight (BW) is the most basic parameter for calculating the quantity of nutrition to be given in nutritional care. However, it is very difficult to determine the BW in dysstatic elderlies. We therefore tried to estimate the BW based on parameters that are easy to measure at the bedside.
Subjects & method: One hundred twenty one dysstatic person, 65 years or older, who agreed to participate this study, were enrolled. These include the inpatients of Ibaraki Seinan Medical Center Hospital and the residents of the elderly nursing home in Ibaraki prefecture. Actual BW (aBW), height (6-point method:HT-6), tibial length (TL), knee height (KH), and abdominal circumference (Ab-C) were measured. The formula to estimate BW was obtained by using multiple regression analysis, where objective variable as aBW, with the explaining variables as age, gender, Ab-C and any one of the following: TL, HT-6, or KH.
Result: Results indicated BW could be calculated via the following formula based on TL: BW(kg)=-15.8-3.53× gender [male(1), female(2)] -0.106× age +0.743× Ab-C(cm) +0.530× TL (cm). This formula showed a correlation of r=0.905. High correlations were also found when HT-6 or KL was used instead of TL.
Conclusion: Even in the dysstatic elderly, a practical BW could be estimated via measurements that can easily obtained at the bedside, specifically Ab-C combined w ith TL or KH.

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[in Japanese]

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