a Department Applied Nutrition Faculty of Livestock Fisheries and Nutrition , Wayamba University of Sri Lanka , Makandura , Gonawila , Sri Lanka.
b Nutrition and Dietetics Department , Flinders University , Adelaide , South Australia , Australia.
Nutr Cancer. 2018 Nov-Dec;70(8):1275-1282. doi: 10.1080/01635581.2018.1539186. Epub 2018 Dec 29.
Malnutrition is a common occurrence in cancer. Early detection of malnutrition is imperative but often overlooked in busy clinical routine. This study aimed to assess the agreement between malnutrition universal screening tool (MUST) and the patient-generated subjective global assessment (PG-SGA) to detect risk of malnutrition in a medical oncology outpatient setting. A cross-sectional study was conducted with 100 adult patients with cancer receiving chemotherapy. Nutrition screening and assessment were performed using MUST and PG-SGA, respectively. Sensitivity, specificity, predictive values, kappa agreement, and receiver operating characteristics (ROC) curve were used to compare MUST with PG-SGA. Prevalence of malnutrition or risk of malnutrition among subjects was 45% according to the MUST. Body mass index (BMI) against PG-SGA indicated a low capacity to detect malnutrition with 28.9% sensitivity and 96.4% specificity. Unintentional weight loss in the last 3-6 mo against PG-SGA resulted in 55.6% sensitivity and 98.2% specificity. MUST against PG-SGA resulted in 86.7% sensitivity and 94.5% specificity. MUST indicated a perfect agreement with PG-SGA (Kappa = 0.81; P < 0.05) and highest area under the ROC curve (AUC ROC = 0.91). MUST has high level of agreement with PG-SGA to detect chemotherapy outpatients at risk of malnutrition.
营养不良在癌症患者中很常见。早期发现营养不良至关重要,但在繁忙的临床常规中往往被忽视。本研究旨在评估营养不良通用筛查工具(MUST)和患者生成的主观整体评估(PG-SGA)在肿瘤内科门诊环境中检测营养不良风险的一致性。对 100 名接受化疗的成年癌症患者进行了横断面研究。使用 MUST 和 PG-SGA 分别进行营养筛查和评估。使用敏感性、特异性、预测值、kappa 一致性和受试者工作特征 (ROC) 曲线来比较 MUST 与 PG-SGA。根据 MUST,研究对象中营养不良或营养不良风险的患病率为 45%。PG-SGA 与 BMI 表明营养不良的检出能力较低,敏感性为 28.9%,特异性为 96.4%。PG-SGA 与过去 3-6 个月内的非故意体重减轻相比,敏感性为 55.6%,特异性为 98.2%。MUST 与 PG-SGA 的敏感性为 86.7%,特异性为 94.5%。MUST 与 PG-SGA 具有完美的一致性(Kappa=0.81;P<0.05),ROC 曲线下面积(AUC ROC)最高(AUC ROC=0.91)。MUST 与 PG-SGA 高度一致,可用于检测接受化疗的门诊患者的营养不良风险。