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营养评分:一种用于肿瘤门诊患者的新型营养筛查工具。

NUTRISCORE: A new nutritional screening tool for oncological outpatients.

作者信息

Arribas Lorena, Hurtós Laura, Sendrós Maria José, Peiró Inmaculada, Salleras Neus, Fort Eduard, Sánchez-Migallón Jose Manuel

机构信息

Clinical Nutrition Unit, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Barcelona, Spain.

Clinical Nutrition Unit, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Barcelona, Spain.

出版信息

Nutrition. 2017 Jan;33:297-303. doi: 10.1016/j.nut.2016.07.015. Epub 2016 Aug 13.

Abstract

OBJECTIVES

The aim of this study was to design a new nutritional screening tool (NUTRISCORE) to detect nutritional risk in outpatients with cancer.

METHODS

A multicenter, cross-sectional study was conducted. We randomly selected outpatients receiving onco-specific, palliative, or symptomatic treatment for malignant neoplasms (including solid tumors and hematologic malignancies). These patients were assessed using the NUTRISCORE tool, the Malnutrition Screening Tool (MST), and the Patient-Generated Subjective Global Assessment (PG-SGA) to detect risk for malnutrition. The new tool included questions regarding the cancer site and active treatment. Sensitivity, specificity, and positive and negative predictive values were calculated for NUTRISCORE and MST using the PG-SGA as a reference method.

RESULTS

We evaluated 394 patients. According to NUTRISCORE, 22.6% were at risk for malnutrition. The MST detected a risk in 28.2%, and the PG-SGA found that 19% were malnourished or at nutritional risk. Using the PG-SGA as a reference method, the MST had a sensitivity of 84% and a specificity of 85.6%, whereas NUTRISCORE exceeded these values, at 97.3% sensitivity and 95.9% specificity. The better performance of NUTRISCORE as compared with MST was confirmed by the receiver operating characteristic curve analysis, with area under the curve values of 0.95 (95% confidence interval, 0.92-0.98) for NUTRISCORE and 0.84 (95% confidence interval, 0.79-0.89) for the MST.

CONCLUSIONS

NUTRISCORE has been found to be a novel, fast, and valid nutritional screening tool for outpatients with cancer. Its simplicity and high level of accuracy in detecting nutritional risk facilitates its applicability.

摘要

目的

本研究旨在设计一种新的营养筛查工具(营养评分),以检测癌症门诊患者的营养风险。

方法

开展了一项多中心横断面研究。我们随机选取接受针对恶性肿瘤(包括实体瘤和血液系统恶性肿瘤)的肿瘤特异性、姑息性或对症治疗的门诊患者。使用营养评分工具、营养不良筛查工具(MST)和患者主观整体评定法(PG-SGA)对这些患者进行评估,以检测营养不良风险。新工具包括有关癌症部位和积极治疗的问题。以PG-SGA作为参考方法,计算营养评分和MST的灵敏度、特异度以及阳性和阴性预测值。

结果

我们评估了394例患者。根据营养评分,22.6%的患者存在营养不良风险。MST检测出风险的比例为28.2%,而PG-SGA发现19%的患者存在营养不良或有营养风险。以PG-SGA作为参考方法,MST的灵敏度为84%,特异度为85.6%,而营养评分超过了这些值,灵敏度为97.3%,特异度为95.9%。接受者操作特征曲线分析证实了营养评分与MST相比表现更优,营养评分的曲线下面积值为0.95(95%置信区间,0.92 - 0.98),MST的曲线下面积值为0.84(95%置信区间,0.79 - 0.89)。

结论

营养评分已被证明是一种用于癌症门诊患者的新型、快速且有效的营养筛查工具。其在检测营养风险方面的简单性和高准确性便于其应用。

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