• Nutrition · Apr 2018

    Influence of a multidisciplinary protocol on nutritional status at diagnosis in amyotrophic lateral sclerosis.

    • Juan José López-Gómez, Beatriz Torres-Torres, Emilia Gómez-Hoyos, Nieves Fernández-Buey, Ana Ortolá-Buigues, Ángeles Castro-Lozano, Juan F Arenillas-Lara, and Daniel A De Luis-Román.
    • Department of Endocrinology and Nutrition, Clinic University Hospital of Valladolid, Valladolid, Spain; Investigation Institute of Endocrinology and Nutrition, Clinic University Hospital of Valladolid, Valladolid, Spain. Electronic address: Jjlopez161282@hotmail.com.
    • Nutrition. 2018 Apr 1; 48: 67-72.

    ObjectiveThe aim of this study were to understand the influence of a multidisciplinary care protocol in amyotrophic lateral sclerosis (ALS) on the change in the delay of remission to the nutrition specialist and the initial nutritional status.MethodsA cohort study was performed in 43 patients with ALS who were referred to the Nutrition Unit between April 2015 and April 2017. Anthropometric parameters and diagnostic times were collected, and the nutritional status was studied through subjective global assessment (SGA). Patients who were included before (control cohort [NoP]) and after (protocol cohort [P]) a multidisciplinary protocol were compared. The mean age of the participants was 66.79 y (10.86 y). Of the patients, 62.8% belonged to the protocol cohort.ResultsPatients who started the protocol had a lower delay in initial assessment by a nutrition specialist (P:2 [1-6] mo/NoP:12 [10-29] mo; P = 0.03). When the nutritional status was analyzed according to the SGA, more patients who did not initiate protocol were in the state of severe malnutrition (C) (P 22.2% versus NoP 60%; P = 0.01). Entry into the protocol was an independent protective factor of the presence of severe malnutrition at the beginning of the nutritional follow-up (odds ratio, 0.20; 95% confidence interval, 0.03-0.73; P = 0.02).ConclusionsThe implementation of a multidisciplinary protocol in ALS allowed patients to present a lower percentage of severe malnutrition in an initial assessment by the nutrition specialist. This protocol is a protective factor for the presence of malnutrition at the beginning of support.Copyright © 2017 Elsevier Inc. All rights reserved.

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