Du Hongzhen, Liu Bingbing, Xie Ying, Liu Jinli, Wei Yujia, Hu Huanyu, Luo Bin, Li Zengning
Department of Nutrition, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei 050031, P.R. China.
Oncol Lett. 2017 Jul;14(1):165-170. doi: 10.3892/ol.2017.6154. Epub 2017 May 11.
Nutrition screening to identify patients at risk of malnutrition is vital for cancer patients because of the high prevalence of malnutrition in this population. The aim of the present study was to compare different methods of nutrition assessment in patients with tumors. From June 2013 to June 2014, we conducted an observational multicenter study to compare the assessment of nutritional status in patients with tumors by anthropometry, biochemical indicators, nutritional risk screening (NRS-2002) and patient-generated subjective global assessment (PG-SGA). Mann-Whitney test and Kruskal-Wallis H non-parametric test were used for intergroup comparisons. Spearmans rank correlation coefficients were calculated to evaluate the association between different methods of nutritional assessment. The κ statistic was used to evaluate the agreement between two assessment methods. A total of 927 oncology inpatients underwent full nutritional assessment and nutrition screening. The PG-SGA tool determined that 13.7% of patients were well-nourished (PG-SGA from 0-1) and the rest (86.3%) were malnourished. Among the malnourished patients, 57.8% were moderately malnourished (PG-SGA from 2-8) and 28.5% were severely malnourished (PG-SGA ≥9). According to NRS-2002, 30.7% of patients were at nutritional risk (NRS-2002 ≥3). There was a significant positive correlation between PG-SGA scores and NRS-2002 scores in both men and women. Compared to albumin, the PG-SGA had a sensitivity of 93.78% and specificity of 21.80%. In comparison, NRS-2002 had a low sensitivity of 43.13% and relatively higher specificity of 82.16%. In conclusion, the relationship between PG-SGA, NRS-2002 and nutritional status is statistically significant. Compared with NRS-2002, PG-SGA is a suitable screening tool for detecting the risk of malnutrition in patients with cancer.
由于营养不良在癌症患者群体中普遍存在，因此进行营养筛查以识别有营养不良风险的患者对癌症患者至关重要。本研究的目的是比较肿瘤患者不同的营养评估方法。2013年6月至2014年6月，我们开展了一项观察性多中心研究，以比较通过人体测量学、生化指标、营养风险筛查（NRS - 2002）和患者主观整体评定法（PG - SGA）对肿瘤患者营养状况的评估。采用曼 - 惠特尼检验和克鲁斯卡尔 - 沃利斯H非参数检验进行组间比较。计算斯皮尔曼等级相关系数以评估不同营养评估方法之间的关联。κ统计量用于评估两种评估方法之间的一致性。共有927名肿瘤住院患者接受了全面的营养评估和营养筛查。PG - SGA工具确定13.7%的患者营养良好（PG - SGA为0 - 1），其余（86.3%）为营养不良。在营养不良的患者中，57.8%为中度营养不良（PG - SGA为2 - 8），28.5%为重度营养不良（PG - SGA≥9）。根据NRS - 2002，30.7%的患者存在营养风险（NRS - 2002≥3）。男性和女性的PG - SGA评分与NRS - 2002评分之间均存在显著正相关。与白蛋白相比，PG - SGA的敏感性为93.78%，特异性为21.80%。相比之下，NRS - 2002的敏感性较低，为43.13%，特异性相对较高，为82.16%。总之，PG - SGA、NRS - 2002与营养状况之间的关系具有统计学意义。与NRS - 2002相比，PG - SGA是检测癌症患者营养不良风险的合适筛查工具。
