Translation of the modified NUTRIC score and adaptation to the Greek ICU setting.

BACKGROUND & AIMS: Patients in the intensive care unit are experiencing an increased malnutrition risk. The NUTrition Risk in the Critically ill score (NUTRIC) is a validated tool for the identification of patients that will benefit the most, from nutritional intervention. The aim of the study was twofold, including: 1) to translate and adapt the NUTRIC score in the Greek language for more efficient and comprehensive use among clinicians, and 2) to assess its prognostic performance in a pilot sample. METHODS: The translation process followed standardized steps: 1) initial translation, 2) synthesis of different translations, 3) back -translation to the English language, 4) revision and cultural adaptation of the instrument by an expert committee. A pilot application study was conducted on 80 critically ill patients from three ICUs in Greek hospitals. The NUTRIC score was calculated using the final translated version. RESULTS: The translated score was considered easy to use, fast and comprehensive. No specific corrections were suggested by the expert committee. According to the translated version of the score 56% of the screened patients were classified as of high nutritional risk (score between 5 and 9). Compared to the low - NUTRIC patients, high - NUTRIC patients were older (56.4 ± 16.4 vs. 68.7 ± 12.7 yrs, p < 0.001), had increased APACHE (13.8 ± 6.5 vs. 23.8 ± 6.5, p < 0.001) and SOFA scores (4.7 ± 3.1 vs. 10.4 ± 3.1, p < 0.001) and demonstrated more comorbidities. Elevated 28 -day mortality was observed among high -NUTRIC patients compared to the low - NUTRIC ones (6 vs. 18 patients, p < 0.05). CONCLUSIONS: The Greek version of the NUTRIC score is ready for use among health care professionals employed in intensive care units in Greek speaking countries, aiming to discriminate critically ill patients benefiting from enhanced nutritional support.

An exploratory study of dietary intake patterns among adults diagnosed with cardiovascular risk factors.

The objective of the present exploratory study was to assess compliance with the nutrient recommendations among a convenience sample of adults diagnosed with cardiovascular risk factors in northern Greece and evaluate their dietary intake patterns. Ninety-two people participated in this cross-sectional study. Dietary assessment was carried out using a semi-quantitative food frequency questionnaire. Principal components analysis (PCA) and hierarchical cluster analysis (HCA) were adopted to obtain dietary patterns and classify individuals with similar dietary behaviour. HCA, performed on the factorial scores obtained from PCA, revealed a 4-group interpretable and statistically significant clustering of participants. For all clusters, the mean daily intake for saturated fatty acids was more than 10% of total calories, while the mean sodium intake was above 1500 mg; additionally, a relatively low mean Mediterranean diet score was recorded. Dietary interventions should be considered to raise awareness and expand knowledge on the nutritional and functional benefits of heart-healthy foods.

Percutaneous extraction of transvenous permanent pacemaker/defibrillator leads.

BACKGROUND: Widespread use of cardiovascular implantable electronic devices has inevitably increased the need for lead revision/replacement. We report our experience in percutaneous extraction of transvenous permanent pacemaker/defibrillator leads. METHODS: Thirty-six patients admitted to our centre from September 2005 through October 2012 for percutaneous lead extraction were included. Lead removal was attempted using Spectranetics traction-type system (Spectranetics Corp., Colorado, CO, USA) and VascoExtor countertraction-type system (Vascomed GmbH, Weil am Rhein, Germany). RESULTS: Lead extraction was attempted in 59 leads from 36 patients (27 men), mean ± SD age 61 ± 5 years, with permanent pacemaker (n = 25), defibrillator (n = 8), or cardiac resynchronisation therapy (n = 3) with a mean ± SD implant duration of 50 ± 23 months. The indications for lead removal included pocket infection (n = 23), endocarditis (n = 2), and ventricular (n = 10) and atrial lead dysfunction (n = 1). Traction device was used for 33 leads and countertraction device for 26 leads. Mean ± SD fluoroscopy time was 4 ± 2 minutes/lead for leads implanted <48 months (n = 38) and 7 ± 3 minutes/lead for leads implanted >48 months (n = 21), P = 0.03. Complete procedural success rate was 91.7% and clinical procedural success rate was 100%, while lead procedural success rate was 95%. CONCLUSIONS: In conclusion, percutaneous extraction of transvenous permanent pacemaker/defibrillator leads using dedicated removal tools is both feasible and safe.