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外科肿瘤患者的营养评估:方法之间的比较分析

Nutritional assessment in surgical oncology patients: a comparative analysis between methods.

作者信息

Cunha Carla de Magalhães, Sampaio Ethiane de Jesus, Varjão Maria Lúcia, Factum Clarissa Simon, Ramos Lilian Barbosa, Barreto-Medeiros Jairza Maria

机构信息

Master's Degree of Food Nutrition and Health, School of Nutrition, Federal University of Bahia..

Department of Nutrition and Dietetics, Professor Edgard Santos University Hospital, Bahia..

出版信息

Nutr Hosp. 2014 Nov 1;31(2):916-21. doi: 10.3305/nh.2015.31.2.7715.

Abstract

BACKGROUND AND AIMS

The malnutrition found in oncology patients is the main responsible for the increase in morbimortality and worsening of their quality of life. Currently, the assessment of malnutrition is performed by subjective and objective methods, or the combination of them. Although these methods are routinely applied and their association is very common in clinical practice, there are few studies on the agreement between them. Thereby, this study aims to compare different methods for nutritional status assessment in surgical oncology patients.

METHODS

173 oncology patients, admitted for surgery, were submitted to an anthropometric evaluation and answered a SGA, PG-SGA and NRS-2002. Kappa test was used to evaluated the level of concordance between the methods.

RESULTS

Poor concordance were observed between BMI and NRS-2002 (K=0,286), SGA (K=0,372) and PGSGA (K=0,173). Among the subjective methods, the best results were found for SGA and PG-SGA (K=0,690), and the lowest between NRS-2002 and both others (SGA: K=0,345; PG-SGA: K=0,322).

CONCLUSIONS

The poor concordance found between objective and subjective methods reinforces the importance of associating indicators in the nutritional assessment of this population Despite of the poor concordance found between the nutritional status assessment methods investigated in this study, patients who had greater depletion of body stores were also diagnosed with a higher degree of malnutrition by subjective methods.

摘要

背景与目的

肿瘤患者中发现的营养不良是导致其发病率和死亡率增加以及生活质量恶化的主要原因。目前,营养不良的评估通过主观和客观方法或两者结合来进行。尽管这些方法在临床实践中经常应用且它们的联合使用非常普遍,但关于它们之间一致性的研究却很少。因此,本研究旨在比较外科肿瘤患者营养状况评估的不同方法。

方法

173名因手术入院的肿瘤患者接受了人体测量评估,并回答了SGA、PG-SGA和NRS-2002问卷。采用Kappa检验评估各方法之间的一致性水平。

结果

观察到BMI与NRS-2002(K = 0.286)、SGA(K = 0.372)和PG-SGA(K = 0.173)之间的一致性较差。在主观方法中,SGA和PG-SGA的结果最佳(K = 0.690),而NRS-2002与其他两种方法之间的一致性最低(SGA:K = 0.345;PG-SGA:K = 0.322)。

结论

客观和主观方法之间发现的低一致性强化了在该人群营养评估中关联指标的重要性。尽管本研究中调查的营养状况评估方法之间一致性较差,但通过主观方法,身体储备消耗更大的患者也被诊断为营养不良程度更高。

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