Læknablaðið : fylgirit - 03.01.2017, Blaðsíða 42

X V I I I V Í S I N D A R Á Ð S T E F N A H Í
F Y L G I R I T 9 1
42 LÆKNAblaðið/Fylgirit 91 2017/103
regression used to identify prognostic factors of survival. Median follow-
-up was 31 months.
Results: 693 operations were performed on 655 individuals (52% females);
523 lobectomies (76%), 84 pneumonectomies (12%) and 86 sub-lobar
resections (12%). Adenocarcinoma (76%) and squamous cell carcinoma
(28%) were the most common histology types. The mean age increased
from 63 to 66 yrs. in 1991-1994 to 2011-2014, respectively (p<0.001), and
the proportion of stage I+II tumors from 74% to 87% in the same periods
(p=0.01), with no change in incidental diagnosis (33%) (p=0.80). Both 1
and 3-year survival increased significantly from 1991-1994 to 2011-2014
(p=0.003); 69% to 91% at 1-year and from 43% to 72% at 3 yrs. Independant
prognostic factors for mortality were advanced TNM-stage (HR=1.38) and
age (HR=1.03), ischemic heart disease (HR=1.25) and year of treatment,
with most favorable survival seen in 2011-2014 (HR=0.51; 95% CI=0.33-
0.80; P=0.003).
Conclusion: Survival of patients operated for NSCLC has improved sign-
ificantly in Iceland. This is not explained by increased incidental detection
or number of patients diagnosed in lower stages. Improved preoperative
staging and fewer understaged patients may contribute to this result.
E 117 Hemispatial neglect: Clinical course and sensitivity of
diagnostic tasks
Marianne E. Klinke1, Haukur Hjaltason2, Guðný B. Tryggvadóttir3, Helga
Jónsdóttir1
1Faculty og Nursing, School og Health Sciences, 2Neurological Department, Landspitali, 3The
Social Science Research Institute, University of Iceland
marianne@hi.is
Objectives: Describe (i) the course of clinical symptoms in stroke patients
with moderate to severe hemispatial neglect (HN) from acute setting to
home, (ii) the sensitivity of clinical diagnostic tasks over time, and (iii)
agreement between the researcher’s and patients’ HN assessment.
Methods: Prospective longitudinal study. Out of 79 consecutive patients
with HN after a first right hemisphere stroke we included 23 patients
with moderate/severe HN. The Catherine Bergego Scale (CBS) was used
as a benchmark for HN and to measure agreement between the rese-
archer’s and patients’ HN assessment. Diagnostic HN tasks included star
cancellation, line crossing, line bisection, fluff test, figure copying, and
clock drawing. Data were collected at; t1: sub-acute stroke, t2: during
rehabilitation, and t3: after discharge.
Results: (i) HN improved over time but 20 still had symptoms at t3, four
continued to be severely affected. Frequent concomitant challenges inclu-
ded paralysis, impaired skin sensation, visual deficits, and extinction. (ii)
Combining the star cancellation and figure copying yielded the highest
sensitivity at all time-points. (iii) Patients’ HN scores differed from the res-
earcher’s at t1. The difference was insignificant at t3. Nevertheless, eight
patients rated themselves as more affected by HN than the researcher did,
and two patients considerably overestimated their abilities.
Conclusion: This study is the first to include only patients with moderate
to severe HN at baseline and to show their concomitant stroke challenges.
HN persisted to some degree in most patients. The star cancellation and
figure copying were superior test combinations to detect HN at all time-
points.
E 118 Malnutrition in patients with COPD; association with lung
function and length of hospital stay
Áróra Ingadóttir1,2, Anne M. Beck3, Christine Baldwin4, Ólöf G. Geirsdóttir1,5, Alfons
Ramel1, Þórarinn Gíslason6, Ingibjörg Gunnarsdóttir1,2
1Unit for Nutrition Research, Landspitali University Hospital & Faculty of Food Science and
Nutrition, University of Iceland, 2Department of Clinical Nutrition, Landspitali University
Hospital, 3Department of Nutrition and Health, Faculty of Health and Technology,
Metropolitan University College, Copenhagen N, 4Division of Diabetes and Nutritional
Sciences, King’s College London, 5The Icelandic Gerontological Research Center, Landspitali
University Hospital & University of Iceland, 6Faculty of Medicine,University of Iceland, and
Department of Respiratory Medicine and Sleep, Landspitali University Hospital
aroraros@lsh.is
Introduction: Diagnosis criteria of malnutrition were proposed by the
European Society for Clinical Nutrition and Metabolism (ESPEN) in
2015. The aims of this study were to compare the prevalence of malnut-
rition using a validated screening tool and new criteria proposed to
ESPEN in patients with COPD, and to assess the ability of different
components of the ESPEN criteria to predict lung function and length
of stay (LOS).
Methods: Subjects were COPD patients (n=121) admitted to Landspitali
in the period March 2015- March 2016. Patients were screened for risk of
malnutrition using Icelandic screening tool (ISS). Body composition was
measured with a bioelectrical impedance analyser (BIA). Lung function
was measured with spirometry.
Results: In total, 36.4% of the patients were at risk of malnutrition using
the ISS. The prevalence of malnutrition according to the ESPEN criteria
was 20.7%. FEV1% of predicted was significantly lower in subject with
BMI below age related cut off (mean 37.2 ± 17.3 vs. 49.6 ± 21.3, p=0.006).
Significantly lower FEV1% of predicted was seen in subjects with low fat
free mass index (FFMI) (mean 35.6 ± 21.9 vs. 50.1 ± 18.9, p=0.001). There
was a trend towards longer LOS in subjects with low FFMI (median 10.0
vs. 8.0, p=0.067).
Conclusion: Our study is the first to describe the prevalence of malnut-
rition in hospitalized COPD patients using the ESPEN criteria from
2015. It might be suggested that age related BMI and FFMI should be
used as an independent criteria for diagnosis of malnutrition in COPD
patients.
E 119 Parameters affecting ACL loading at two time points of early
stance of dynamic task performance
Haraldur B. Sigurðsson1, Þórarinn Sveinsson2, Kristín Briem2
1Faculty of Medicine, University of Iceland, 2Department of Physical Therapy, University of
Iceland
harbs@hi.is
Introduction: Anterior cruciate ligament (ACL) injuries most commonly
occur during the first 100ms of stance during dynamic activities, during
which two discrete events of biomechanical significance are seen: the
first peak vertical ground reaction force (vGRF) and the peak negative
sagittal plane power (SPP). Little is known about how biomechanical data
compare between these two timeframes. The purpose of the study was to
contrast variables associated with ACL injury risk during each instance.
Methods: 125 athletes aged 9-11 year old were recruited from local sports
clubs. Their movements were recorded while they performed cutting
maneuvers to the right and left, using an 8 camera Qualisys system and
two AMTI force plates. Statistical analyses contrasting data at the two
instances were performed using the paired samples t-test, and correlation
coefficients used to analyze associations between relevant variables.
Results: The first peak vGRF occurred at a mean (SD) of 45ms (15ms)
after initial contact and the peak negative SPP at 80ms (45ms). Significant