Ye Xiao-Jun, Ji Yan-Bin, Ma Bing-Wei, Huang Dong-Dong, Chen Wei-Zhe, Pan Zong-You, Shen Xian, Zhuang Cheng-Le, Yu Zhen
Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai, China.
Department of Medicine, Medical College of Soochow University, Suzhou, China.
BMJ Open. 2018 Apr 12;8(4):e019750. doi: 10.1136/bmjopen-2017-019750.
The aim of this study was to evaluate and compare three common nutritional screening tools with the new European Society for Clinical Nutrition and Metabolism (ESPEN) diagnostic criteria for malnutrition among elderly patients with gastrointestinal cancer.
Nutritional screening tools, including the Nutritional Risk Screening 2002 (NRS 2002), the Malnutrition Universal Screening Tool (MUST) and the Short Form of Mini Nutritional Assessment (MNA-SF), were applied to 255 patients with gastrointestinal cancer. We compared the diagnostic values of these tools for malnutrition, using the new ESPEN diagnostic criteria for malnutrition as the 'gold standards'.
According to the new ESPEN diagnostic criteria for malnutrition, 20% of the patients were diagnosed as malnourished. With the use of NRS 2002, 52.2% of the patients were found to be at high risk of malnutrition; with the use of MUST, 37.6% of the patients were found to be at moderate/high risk of malnutrition; and according to MNA-SF, 47.8% of the patients were found to be at nutritional risk. MUST was best correlated with the ESPEN diagnostic criteria (К=0.530, p<0.001) compared with NRS 2002 (К=0.312, p<0.001) and MNA-SF (К=0.380, p<0.001). The receiver operating characteristic curve of MUST had the highest area under the curve (AUC) compared with NRS 2002 and MNA-SF.
Among the tools, MUST was found to perform the best in identifyingmalnourished elderly patients with gastrointestinal cancer distinguished by the new ESPEN diagnostic criteria for malnutrition. Nevertheless, further studies are needed to verify our findings.
ChiCTR-RRC-16009831; Pre-results.
本研究旨在评估和比较三种常见的营养筛查工具与欧洲临床营养与代谢学会（ESPEN）新的老年胃肠癌患者营养不良诊断标准。
将包括营养不良风险筛查2002（NRS 2002）、营养不良通用筛查工具（MUST）和微型营养评定简表（MNA-SF）在内的营养筛查工具应用于255例胃肠癌患者。我们以ESPEN新的营养不良诊断标准为“金标准”，比较了这些工具对营养不良的诊断价值。
根据ESPEN新的营养不良诊断标准，20%的患者被诊断为营养不良。使用NRS 2002时，52.2%的患者被发现存在高营养不良风险；使用MUST时，37.6%的患者被发现存在中/高营养不良风险；根据MNA-SF，47.8%的患者被发现存在营养风险。与NRS 2002（К=0.312，p<0.001）和MNA-SF（К=0.380，p<0.001）相比，MUST与ESPEN诊断标准的相关性最佳（К=0.530，p<0.001）。与NRS 2002和MNA-SF相比，MUST的受试者工作特征曲线下面积（AUC）最高。
在这些工具中，发现MUST在识别以ESPEN新的营养不良诊断标准为特征的老年胃肠癌营养不良患者方面表现最佳。然而，需要进一步研究来验证我们的发现。
ChiCTR-RRC-16009831；预结果。
