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[肿瘤患者三种营养筛查方法的分析]

[Analysis of three methods of nutritional screening in oncologic patients].

作者信息

Sánchez Sánchez Eduardo, López-Aliaga Inmaculada, Muñoz Alférez María José

机构信息

Hospital Punta Europa (Algeciras).

出版信息

Nutr Hosp. 2018 Dec 3;35(6):1324-1330. doi: 10.20960/nh.1878.

Abstract

BACKGROUND

malnutrition is one of the complications that appears most frequently in oncological patients and causes serious consequences such as loss of lean mass.

OBJECTIVE

to know which nutritional screening method is most useful in predicting the loss of lean mass in cancer patients.

METHODS

a descriptive study was carried out evaluating three methods of nutritional screening, Malnutrition Screening Tool (MST), Malnutrition Universal Screening (MUST) and Nutritional Risk Screening (NRS-2002), in oncological patients undergoing radiotherapy treatment. Each method was analyzed by ROC curves with AUC calculation.

RESULTS

loss of lean mass is present in 48.73% of the patients. Of them, 29.44% present a loss of lean mass between 0-2%; 10.66% of patients, between 2-5%; and 8.13% of patients present a loss of lean mass > 5%. The results show that when taking a loss of lean mass > 5% as a cut-off point, the MST method has a higher AUC than the one presented by the MUST and the NRS-2002 (0.596, CI: 0.444-0.747), with significant statistics (p = 0.041). In addition, it presents high sensitivity and positive and negative predictive value.

CONCLUSIONS

MST is a more valid nutritional screening method than MUST and NRS-2002 to predict the loss of lean mass > 5% in oncological patients undergoing radiotherapy treatment. Its routine use is recommended in patients under radiotherapy treatment.

摘要

背景

营养不良是肿瘤患者中最常见的并发症之一,会导致诸如瘦体重丢失等严重后果。

目的

了解哪种营养筛查方法最有助于预测癌症患者的瘦体重丢失。

方法

开展一项描述性研究,评估三种营养筛查方法,即营养不良筛查工具(MST)、营养不良通用筛查工具(MUST)和营养风险筛查工具(NRS - 2002),对接受放射治疗的肿瘤患者进行评估。通过计算AUC的ROC曲线对每种方法进行分析。

结果

48.73%的患者存在瘦体重丢失。其中,29.44%的患者瘦体重丢失在0 - 2%之间;10.66%的患者瘦体重丢失在2 - 5%之间;8.13%的患者瘦体重丢失>5%。结果显示,以瘦体重丢失>5%作为截断点时,MST方法的AUC高于MUST和NRS - 2002(0.596,CI:0.444 - 0.747),具有统计学意义(p = 0.041)。此外,它具有较高的敏感性以及阳性和阴性预测值。

结论

对于接受放射治疗的肿瘤患者,预测瘦体重丢失>5%时,MST是比MUST和NRS - 2002更有效的营养筛查方法。建议在接受放射治疗的患者中常规使用该方法。

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