PTU-146 The use of diet diaries and a gastric accommodation test prior to hospital discharge for predicting intake after discharge following upper gastrointestinal surgery

Introduction Patients undergoing upper gastrointestinal surgery are often malnourished and following hospital discharge eat poorly despite dietetic input. The 'slow satiety' drinking test has been used to assess impaired gastric accommodation in functional dyspepsia. We examined if a drinking test done along with a 2 day diet diary could predict dietary intake post hospital discharge. Method Prior to discharge, patients undergoing an oesophagectomy or total gastrectomy for cancer completed a 2 day dietary diary and underwent a gastric accommodation test. The accommodation test comprised of drinking 20 ml/min of polymeric sip feed until they felt comfortably full. After hospital discharge patients completed 2 day dietary diaries at 3, 6 and 12 weeks. The diaries were analysed using Dietplan 6 and tabulated. We calculated energy intake as absolute intake (Kcal) and% of calculated requirement (using the Harris-Benedict formula). The accommodation tests (volume of feed and time taken) were correlated (Pearson's) with energy intake at hospital discharge. The accommodation test results and energy intake at hospital discharge were also correlated with energy intake at 3, 6 and 12 weeks post discharge. Results 28 patients (22 men), median age 66 (IQR: 60-74), were recruited (Oesophagectomy = 18 Gastrectomy 10). There was no correlation between the accommodation test and actual energy intake or% of required energy intake at hospital discharge. Abstract PTU-146 Table 1 Accommodation test Energy (Kcal) intake as% of calculated requirements --- Volume (ml) Time (min) Discharge 3 weeks 6 weeks 12 weeks --- 106 (72, 140) 389 (244, 534) 66 (58, 74) 78 (69, 87) 79 (71, 88) 90 (77, 102) Correlation coefficient 0.34 0.43 0.40 P value 0.078 0.023 0.034 Dietary energy intake (Kcal) at hospital discharge did not correlate with post discharge energy intake, but when expressed as a% of calculated requirements there was a correlation at 6 and 12 weeks. The volume of feed consumed and time taken to drink the sip feed for the accommodation test did not correlate with post discharge dietary intake. Conclusion Energy intake at hospital discharge was modest and increased slowly to reach 90% of requirements at 12 weeks. There was only a weak correlation between dietary records done just prior to hospital discharge and those done at 6 and 12 weeks. There was no correlation between the gastric accommodation test and post discharge dietary intake. Neither the gastric accommodation test or