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Subjective Global assessment as a Pre-Operative nutrition Status Screening Tool for Head and Neck Cancer Patients of a Tertiary Health Care Setting

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Journal of Cancer Therapy 2022年第8期13卷 539-548页

作者： Snany Surendran Uma V. Sankar Santhoshkumar Nochikkattil Reena Cheekapravan Narayanankutty Warrier Sajith Babu Department of nutrition Oncology MVR Cancer Centre & Research Institute Kozhikkode India Department of Clinical Research MVR Cancer Centre & Research Institute Kozhikkode India Department of Head and Neck Surgical Oncology MVR Cancer Centre & Research Institute Kozhikkode India Department of Clinical nutrition & Dietetics Malabar Cancer Centre Kannur India Department of Medical Oncology MVR Cancer Centre & Research Institute Kozhikkode India Department of Head and Neck Surgical Oncology Malabar Cancer Centre Kannur India

Introduction: In India, 57% of patients with head and neck cancers are documented with nutritional compromise. Active nutritional support has been shown to improve outcomes and reduce the cost of treatment in severely malnourished patients. The assessment of nutritional status should be a priority when initiating medical nutrition therapy. We evaluated the agreement between Subjective and Objective evaluation of pre-operative nutrition status of head and neck cancer patients in a tertiary cancer centre. Methods: Two hundred and thirty seven head and neck cancer patients who underwent surgery were eligible. The patients included both males (147) and females (90) with age varying between 23 - 88 years. All patients were screened for pre-operative nutrition status objectively as well as subjectively. The association of pre-operative SGA scores (A, B and C) subjectively, and PNS score (0, 1, 2) objectively were tested for statistical significance. Results: The cancer sites included tongue in 82, buccal mucosa in 30, thyroid in 28, alveolus in 18, glottis in 10, RMT in 10, nasal cavity in 9, FOM in 8. The pre-operative nutrition status based on subjective scores are A in 156 (65.8%), B in 75 (32%) and C in 6 (2.5%). The objective parameters obtained on the basis of BMI, % weight loss, PNI and S. albumin values are PNS 0 in 161 (67.9%), PNS 1 in 71 (30%) and PNS 2 in 5 (2.1%) patients. As the kappa coefficient p-0.56, there is moderate agreement between the pre-operative nutrition status subjectively as well as objectively. Conclusion: Subjective global assessment is a simple and inexpensive way to screen the pre-operative nutrition status when compared to the other objective assessment tool. SGA has moderate agreement with expensive and complicated objective assessment tools. So it can be a reliable tool for assessing the pre-operative nutrition status.

关键词： Subjective Global assessment nutrition assessment Head and Neck Cancer

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nutritional status in relation to lifestyle in patients with compensated viral cirrhosis

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World Journal of Gastroenterology 2012年第40期18卷 5759-5770页

作者： Fumikazu Hayashi Chika Momoki Miho Yuikawa Yuko Simotani Etsushi Kawamura Atsushi Hagihara Hideki Fujii Sawako Kobayashi Shuji Iwai Hiroyasu Morikawa Masaru Enomoto Akihiro Tamori Norifumi Kawada Satoko Ohfuji Wakaba Fukusima Daiki Habu Department of Medical nutrition Graduate School of Life ScienceOsaka City University Department of Hepatology Graduate School of MedicineOsaka City University Department of Hepatology Graduate School of MedicineOsaka City UniversityOsaka 545-8585Japan Department of Public Health Graduate School of MedicineOsaka City University

AIM:To assess the nourishment status and lifestyle of non-hospitalized patients with compensated cirrhosis by using noninvasive ***:The subjects for this study consisted of 27 healthy volunteers,59 patients with chronic viral hepatitis,and 74 patients with viral cirrhosis,from urban *** assessed the biochemical blood tests,anthropometric parameters,diet,lifestyle and physical activity of the patients.A homeostasis model assessment-insulin resistance(HOMA-IR) value of ≥ 2.5 was considered to indicate insulin *** measured height,weight,waist circumference,arm circumference,triceps skin-fold thickness,and handgrip strength,and calculated body mass index,arm muscle circumference(AMC),and arm muscle area(AMA).We interviewed the subjects about their dietary habits and lifestyle using health assessment computer *** surveyed daily physical activity using a *** and multivariate logistic regression modeling were used to identify the relevant factors for insulin ***:The rate of patients with HOMA-IR ≥ 2.5(which was considered to indicate insulin resistance) was 14(35.9%) in the chronic hepatitis and 17(37.8%) in the cirrhotic ***(%)(control vs chronic hepatitis,111.9% ± 10.5% vs 104.9% ± 10.7%,P = 0.021;control vs cirrhosis,111.9% ± 10.5% vs 102.7% ± 10.8%,P = 0.001) and AMA(%)(control vs chronic hepatitis,128.2% ± 25.1% vs 112.2% ± 22.9%,P = 0.013;control vs cirrhosis,128.2% ± 25.1% vs 107.5% ± 22.5%,P = 0.001) in patients with chronic hepatitis and liver cirrhosis were significantly lower than in the control *** strength(%) in the cirrhosis group was significantly lower than in the controls(control vs cirrhosis,92.1% ± 16.2% vs 66.9% ± 17.6%,P nutrition intake and amounts of carbohydrates,protein and fat were not significantly different amongst the *** activity levels(kcal/d)(control vs cirrhosis,210 ± 11

关键词： Hepatitis C virus Insulin resistance Livercirrhosis nutrition assessment Obesity Lifestyle Ex-ercise

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Handgrip Strength as a Predictor of nutritional Status in Chinese Elderly Inpatients at Hospital Admission

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Biomedical and Environmental Sciences 2017年第11期30卷 802-810页

作者： ZHANG Xin Sheng LIU Ying Hua ZHANG Yong XU Qing YU Xiao Ming YANG Xue Yan LIU Zhao LI Hui Zi LI Feng XUE Chang Yong Department of nutrition Chinese PLA General Hospital Department of nutrition Chinese PLA General Hospital of Rocket Forces

Objective To assess nutritional status and define gender-and age-specific handgrip strength（HGS） cut-point values for malnutrition or nutritional risk in elderly inpatients. Methods A cross-sectional study of 1,343 elderly inpatients was conducted in the Chinese PLA General Hospital. nutrition Risk Screening（NRS 2002） and Subjective Global assessment（SGA） were administered. Anthropometric measurements and blood biochemical indicators were obtained using standard techniques. The gender-and age-specific receiver operating characteristic（ROC） curves were constructed to evaluate the HGS for nutritional status by SGA and NRS 2002. Sensitivity, specificity, and areas under the curves（AUCs） were calculated. Results According to NRS 2002 and SGA, 63.81% of elderly inpatients were at nutritional risk and 28.22% were malnourished. Patients with higher HGS had an independently decreased risk of malnutrition and nutritional risk. The AUCs varied between 0.670 and 0.761. According to NRS 2002, the optimal HGS cut-points were 27.5 kg（65-74 years） and 21.0 kg（75-90 years） for men and 17.0 kg（65-74 years） and 14.6 kg（75-90 years） for women. According to SGA, the optimal HGS cut-points were 24.9 kg（65-74 years） and 20.8 kg（75-90 years） for men and 15.2 kg（65-74 years） and 13.5 kg（75-90 years） for women. Conclusion Elderly inpatients had increased incidence of malnutrition or nutritional risk. HGS cut-points can be used for assessing nutritional status in elderly inpatients at hospital admission in China.

关键词： Handgrip strength Elderly inpatients nutrition assessment nutrition status Malnutrition

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nutrition support in surgical patients with colorectal cancer

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World Journal of Gastroenterology 2011年第13期17卷 1779-1786页

作者： Yang Chen Bao-Lin Liu Bin Shang Ai-Shan Chen Shi-Qing Liu Wei Sun Hong-Zhuan Yin Jian-Qiao Yin Qi su Department of Surgery Shengjing Hospital China Medical UniversityShenyang 110004 Liaoning Province China

AIM: To review the application of nutrition support in patients after surgery for colorectal cancer, and to propose appropriate nutrition strategies. METHODS: A total of 202 consecutive surgical patients admitted to our hospital with a diagnosis of colon cancer or rectal cancer from January 2010 to July 2010, meeting the requirements of nutrition Risk Screening 2002, were enrolled in our study. Laboratory tests were performed to analyze the nutrition status of each patient, and the clinical outcome variables, including postoperative complications, hospital stay, cost of hospitalization and postoperative outcome, were analyzed. RESULTS: The "non-risk" patients who did not receive postoperative nutrition support had a higher rate of postoperative complications than patients who received postoperative nutrition support (2.40 ± 1.51 vs 1.23 ± 0.60, P = 0.000), and had a longer postoperative hospital stay (23.00 ± 15.84 d vs 15.27 ± 5.89 d, P = 0.009). There was higher cost of hospitalization for patients who received preoperative total parenteral nutrition (TPN)than for patients who did not receive preoperative TPN (62 713.50 ± 5070.66 RMB Yuan vs 43178.00 ± 3596.68 RMB Yuan, P = 0.014). Applying postoperative enteral nutrition significantly shortened postoperative fasting time (5.16 ± 1.21 d vs 6.40 ± 1.84 d, P = 0.001) and postoperative hospital stay (11.92 ± 4.34 d vs 15.77 ± 6.03 d, P = 0.002). The patients who received postoperative TPN for no less than 7 d had increased serum glucose levels (7.59 ± 3.57 mmol/L vs 6.48 ± 1.32 mmol/L, P = 0.006) and cost of hospitalization (47 724.14 ± 16 945.17 Yuan vs 38 598.73 ± 8349.79 Yuan, P = 0.000). The patients who received postoperative omega-3 fatty acids had a higher rate of postoperative complications than the patients who did not (1.33 ± 0.64 vs 1.13 ± 0.49, P = 0.041). High level of serum glucose was associated with a high risk of postoperative complications of infection. CONCLUSION: Appropriate and moderate nutrition

关键词： nutritional support nutrition assessment Colorectal cancer Surgery Prognosis

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Prognostic significance of hemoglobin,albumin,lymphocyte,platelet in gastrointestinal stromal tumors:A propensity matched retrospective cohort study

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World Journal of Gastroenterology 2022年第27期28卷 3476-3487页

作者： Zhou Zhao Xiao-Nan Yin Jian Wang Xin Chen Zhao-Lun Cai Bo Zhang Department of Gastrointestinal Surgery Sichuan University West China HospitalChengdu 610041Sichuan ProvinceChina

BACKGROUND The combined index of hemoglobin,albumin,lymphocyte,and platelet(HALP)can reflect systemic inflammation and nutritional status simultaneously,with some evidence revealing its prognostic value for some ***,the effect of HALP on recurrence-free survival(RFS)in patients with gastrointestinal stromal tumors(GISTs)has not been *** To investigate the prognostic value of HALP in GIST *** Data from 591 untreated patients who underwent R0 resection for primary and localized GISTs at West China Hospital between December 2008 and December 2016 were *** data,preoperative albumin,blood routine information,postoperative treatment,and recurrence status were *** eliminate baseline inequivalence,the propensity scores matching(PSM)method was ***,the relationship between RFS and preoperative HALP was *** The optimal cutoff value for HALP was determined to be 31.5 by X-tile *** was significantly associated with tumor site,tumor size,mitosis,Ki67,National Institutes of Health(NIH)risk category,and adjuvant therapy(all P<0.001).Before PSM,GIST patients with an increased HALP had a significantly poor RFS(P<0.001),and low HALP was an independent risk factor for poor RFS[hazard ratio(HR):0.506,95%confidence interval(95%CI):0.291-0.879,P=0.016].In NIH high-risk GIST patients,GIST patients with low HALP had a worse RFS than patients with high HALP(P<0.05).After PSM,458 GIST patients were identified;those with an increased HALP still had significantly poor RFS after PSM(P<0.001)and low HALP was still an independent risk factor for poor RFS(HR:0.558,95%CI:0.319-0.976,P=0.041).CONCLUSION HALP was significantly correlated with postoperative pathology and postoperative ***,HALP showed a strong ability to predict RFS in GIST patients who underwent radical resection.

关键词： Gastrointestinal stromal tumors nutrition assessment Immuno-inflammatory-based prognostic scores Prognosis Propensity score

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Value of the controlling nutritional status score and psoas muscle thickness per height in predicting prognosis in liver transplantation

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World Journal of Clinical Cases 2021年第35期9卷 10871-10883页

作者： Xing Dai Ben Gao Xin-Xin Zhang Jiang Li Wen-Tao Jiang Department of Liver Transplant The First Central College of Tianjin Medical UniversityTianjin 300110China Department of Endocrinology Tianjin Medical University Chu Hsien-I Memorial HospitalTianjin 300134China Department of Liver Transplant Tianjin First Central HospitalTianjin 300110China

BACKGROUND Patients with end-stage liver disease usually have varying degrees of malnutrition,and severe malnutrition may affect the prognosis of patients after liver transplantation(LT).However,there is no recommended standard for the nutrition assessment of patients waiting for LT,and it is unknown whether malnutrition has an impact on the occurrence of postoperative *** The study aim was to investigate the value of the controlling nutritional status(CONUT)score and psoas muscle thickness per height(PMTH)in predicting prognosis in *** We retrospectively analyzed the clinical data of 313 patients who underwent classic orthotopic LT from January 2016 to December 2018 in Tianjin First Central Hospital affiliated with Tianjin Medical *** CONUT score is derived from the preoperative serum albumin and total cholesterol levels,and total lymphocyte *** were divided into low(≤4),medium(5–8),and high(9–12)CONUT score groups perioperative characteristics,Clavien-Dindo grade III/IV/V postoperative complications,graft loss and infection,and cumulative postoperative survival in the three groups were compared 3 mo after *** was calculated as the ratio of the transverse thickness of the psoas muscle in the umbilical plane to the height of the *** cutoff values of receiver operating characteristic curves were determined separately for men and *** values were 14.1 cm/m2 for women and 17.9 cm/m2 for *** patients were then divided into low and high PMTH groups by the cutoff *** comparison of data between the two groups was the same as *** Patients with medium and high CONUT scores had lower preoperative serum hemoglobin,more intraoperative red blood cell(RBC)transfusions,longer postoperative intensive care unit stay and hospital stays,higher 7 and 14 preoperative-day serum bilirubin levels,and a higher incidence of postoperative grade III/IV complications and infections than patients with low CONUT scor

关键词： Liver transplantation Controlling nutritional status score Psoas muscle thickness per height nutrition assessment Complications Prognosis

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Malnutrition and liver disease in a developing country

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World Journal of Gastroenterology 2021年第30期27卷 4985-4998页

作者： Asra tus Saleha Siddiqui Om Parkash Syeda Amrah Hashmi Department of Medicine The Aga Khan UniversityKarachi 74800Pakistan Department of Medicine Division of GastroenterologyThe Aga Khan UniversityKarachi 74800Pakistan Medical College The Aga Khan UniversityKarachi 74800Pakistan

Malnutrition is a highly prevalent and under recognized condition in developing countries of South *** presence of malnutrition causes a severe impact on patients with liver *** etiology of cirrhosis differs in the South Asian region compared to the West,with hepatitis B and C still being the leading causes and the prevalence of nonalcoholic fatty liver disease increasing over *** malnutrition worsens outcomes for cirrhosis *** attention to address malnutrition is needed to improve patient *** etiology and pathophysiology of malnutrition in liver diseases is multifactorial,as reduction in liver function affects both macronutrients and micronutrients.A need for nutritional status assessment for liver disease patients exists in all parts of the *** are many widely studied tools in use to perform a thorough nutritional assessment,of which some tools are low cost and do not require extensive *** tools can be studied and evaluated for use in the resource limited setting of a country like *** guidelines for proper nutrition maintenance in chronic liver disease exist for all parts of the world,but the knowledge and practice of nutritional counseling in Pakistan is poor,both amongst patients and *** on assessment for nutritional status at the initial visit with recording of vital signs is ***,treating physicians need to be made aware of the misconceptions surrounding nutritional restrictions in cirrhosis so that patient education is done correctly based on proper scientific evidence.

关键词： Liver cirrhosis Malnutrition nutrition assessment Liver diseases nutritional and metabolic diseases Micronutrients

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Development of a prediction model for enteral feeding intolerance in intensive care unit patients:A prospective cohort study

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World Journal of Gastrointestinal Surgery 2022年第12期14卷 1363-1374页

作者： Xue-Mei Lu Deng-Shuai Jia Rui Wang Qing Yang Shan-Shan Jin Lan Chen School of Nursing Shanghai Jiao Tong UniversityShanghai 200025China Department of Nursing Shanghai General HospitalShanghai Jiao Tong UniversityShanghai 200080China Department of Critical Care Medicine Shanghai General HospitalShanghai Jiao Tong UniversityShanghai 200080China

BACKGROUND Enteral nutrition(EN)is essential for critically ill ***,some patients will have enteral feeding intolerance(EFI)in the process of *** To develop a clinical prediction model to predict the risk of EFI in patients receiving EN in the intensive care *** A prospective cohort study was *** enrolled patients’basic information,medical status,nutritional support,and gastrointestinal(GI)symptoms were *** baseline data and influencing factors were *** regression analysis was used to establish the model,and the bootstrap resampling method was used to conduct internal *** The sample cohort included 203 patients,and 37.93%of the patients were diagnosed with *** the final regression analysis,age,GI disease,early feeding,mechanical ventilation before EN started,and abnormal serum sodium were *** the internal validation,500 bootstrap resample samples were performed,and the area under the curve was 0.70(95%CI:0.63-0.77).CONCLUSION This clinical prediction model can be applied to predict the risk of EFI.

关键词： Enteral feeding intolerance Critical care medicine Clinical prediction model nutrition assessment nutritional support Critical care nursing

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Comparison of different preoperative objective nutritional indices for evaluating 30-d mortality and complications after liver transplantation

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World Journal of Gastrointestinal Surgery 2024年第1期16卷 143-154页

作者： Chuan Li Hong-Xia Chen Yan-Hua Lai Department of Transplantation People’s Hospital of Guangxi Zhuang Autonomous RegionNanning 530021Guangxi Zhuang Autonomous RegionChina Department of Clinical Pharmacy People’s Hospital of Guangxi Zhuang Autonomous RegionNanning 530021Guangxi Zhuang Autonomous RegionChina

BACKGROUND The nutritional status is closely related to the prognosis of liver transplant re-cipients,but few studies have reported the role of preoperative objective nutri-tional indices in predicting liver transplant *** To compare the predictive value of various preoperative objective nutritional indicators for determining 30-d mortality and complications following liver transplantation(LT).METHODS A retrospective analysis was conducted on 162 recipients who underwent LT at our institution from December 2019 to June *** This study identified several independent risk factors associated with 30-d mor-tality,including blood loss,the prognostic nutritional index(PNI),the nutritional risk index(NRI),and the control nutritional *** 30-d mortality rate was 8.6%.Blood loss,the NRI,and the PNI were found to be independent risk factors for the occurrence of severe postoperative *** NRI achieved the highest prediction values for 30-d mortality[area under the curve(AUC)=0.861,Pnutritional risk and develop relevant nutritional therapy.

关键词： Liver transplantation nutritional indicator Complications Prognosis nutrition assessment

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nutritional assessment in cirrhotic patients with hepatic encephalopathy

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World Journal of Hepatology 2015年第30期7卷 2940-2954页

作者： Fernando Gomes Romeiro Lais Augusti Gastroenterology Division Department of Internal Medicine-Botucatu Medical SchoolUNESP-Univ Estadual PaulistaBotucatu 18608-917Sao PauloBrazil

Hepatic encephalopathy(HE) is one of the worst complications of liver disease and can be greatly influenced by nutritional status. Ammonia metabolism, inflammation and muscle wasting are relevant processes in HE pathophysiology. Malnutrition worsens the prognosis in HE, requiring early assessment of nutritional status of these patients. Body composition changes induced by liver disease and limitations superimposed by HE hamper the proper accomplishment of exams in this population, but evidence is growing that assessment of muscle mass and muscle function is mandatory due to the role of skeletal muscles in ammonia metabolism. In this review, we present the pathophysiological aspects involved in HE to support further discussion about advantages and drawbacks of some methods for evaluating the nutritional status of cirrhotic patients with HE, focusing on body composition.

关键词： Hepatic encephalopathy Liver cirrhosis Malnutrition Anthropometry Muscle strength Electric impedance nutrition assessment Dual-energy X-ray absorptiometry

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