营养不良筛查工具在肝硬化中的验证。
Validation of Malnutrition Screening Tools in Liver Cirrhosis.
机构信息
Department of Clinical Medical Nutrition, University Hospital Graz, 8036 Graz, Austria.
Department of Nutritional Sciences, RF Molecular Nutritional Science, University Vienna, 1090 Vienna, Austria.
出版信息
Nutrients. 2020 May 3;12(5):1306. doi: 10.3390/nu12051306.
Abstract
Malnutrition in liver cirrhosis is frequently underestimated. To determine if a patient is at risk of malnutrition, several screening tools have been established. However, most of them are not validated for patients with liver cirrhosis. Therefore, we compared the RFH-NPT (Royal Free Hospital Nutritional Prioritizing Tool) as the validated gold standard for malnutrition screening in cirrhosis patients with GMS (Graz Malnutrition Screening), NRS-2002 (Nutritional Risk Screening) and MNA-SF (Mini Nutritional Assessment-Short Form). Based on common validity criteria for screening tools, only the MNA-SF showed fair correlation (12/15 points) with the RFH-NPT, whereas NRS-2002 and GMS performed worse (6/15 points). Taken together, our results suggest that NRS-2002 and GMS are not suitable for screening of malnutrition in cirrhosis patients. A cirrhosis-specific screening tool like RFH-NPT should be used to assess malnutrition and to identify those at risk of malnutrition.
摘要
肝硬化患者常存在营养不良被低估的情况。为了确定患者是否存在营养不良风险，已经建立了几种筛选工具。然而，它们大多数都没有针对肝硬化患者进行验证。因此，我们比较了 RFH-NPT（皇家自由医院营养优先工具）作为肝硬化患者营养不良筛选的验证金标准，与 GMS（格拉茨营养不良筛选）、NRS-2002（营养风险筛选）和 MNA-SF（迷你营养评估-短表）的应用。根据筛选工具的共同有效性标准，只有 MNA-SF 与 RFH-NPT 显示出良好的相关性（12/15 分），而 NRS-2002 和 GMS 的相关性较差（6/15 分）。综上所述，我们的结果表明，NRS-2002 和 GMS 不适合用于肝硬化患者的营养不良筛选。应使用像 RFH-NPT 这样的肝硬化特异性筛选工具来评估营养不良，并识别那些有营养不良风险的患者。
相似文献
1
Validation of Malnutrition Screening Tools in Liver Cirrhosis.营养不良筛查工具在肝硬化中的验证。
Nutrients. 2020 May 3;12(5):1306. doi: 10.3390/nu12051306.
2
Royal Free Hospital-Nutritional Prioritizing Tool improves the prediction of malnutrition risk outcomes in liver cirrhosis patients compared with Nutritional Risk Screening 2002.皇家自由医院-营养优先工具与营养风险筛查 2002 相比，能更好地预测肝硬化患者的营养不良风险结局。
Br J Nutr. 2020 Dec 28;124(12):1293-1302. doi: 10.1017/S0007114520002366. Epub 2020 Jun 30.
3
Mini Nutritional Assessment - Short Form Is a Useful Malnutrition Screening Tool in Patients with Liver Cirrhosis, Using the Global Leadership Initiative for Malnutrition Criteria as the Gold Standard.微型营养评定 - 简表是一种有用的营养不良筛查工具，适用于肝硬化患者，以全球营养不足倡议标准作为金标准。
Nutr Clin Pract. 2021 Oct;36(5):1003-1010. doi: 10.1002/ncp.10640. Epub 2021 Apr 5.
4
The Graz Malnutrition Screening (GMS): a new hospital screening tool for malnutrition.格拉茨营养不良筛查（GMS）：一种用于营养不良的新型医院筛查工具。
Br J Nutr. 2016 Feb 28;115(4):650-7. doi: 10.1017/S0007114515004924. Epub 2015 Dec 14.
5
Evaluation of the effectiveness of eight screening tools in detecting risk of malnutrition in cirrhotic patients: the KIRRHOS study.评估八项筛查工具在检测肝硬化患者营养不良风险中的有效性：KIRRHOS 研究。
Br J Nutr. 2019 Dec 28;122(12):1368-1376. doi: 10.1017/S0007114519002277. Epub 2019 Nov 18.
6
Comparison between criteria for diagnosing malnutrition in patients with advanced chronic liver disease: GLIM group proposal versus different nutritional screening tools.比较诊断晚期慢性肝病患者营养不良的标准：GLIM 组建议与不同的营养筛查工具。
J Hum Nutr Diet. 2020 Dec;33(6):862-868. doi: 10.1111/jhn.12759. Epub 2020 May 7.
7
Outpatient screening with the Royal Free Hospital-Nutrition Prioritizing Tool for patients with cirrhosis at risk of malnutrition.皇家自由医院营养不良优先工具对肝硬化营养不良风险患者的门诊筛查。
Nutrition. 2023 Oct;114:112139. doi: 10.1016/j.nut.2023.112139. Epub 2023 Jun 20.
8
Prognosis of systemic inflammation at an early stage of cirrhosis using the monocyte-to-lymphocyte ratio during malnutrition risk screening: a prospective cohort study.利用营养不良风险筛查期间单核细胞与淋巴细胞比值预测肝硬化早期的全身炎症反应：一项前瞻性队列研究。
Postgrad Med. 2022 Nov;134(8):801-809. doi: 10.1080/00325481.2022.2110600. Epub 2022 Sep 11.
9
Differences in nutritional risk assessment between NRS2002, RFH-NPT and LDUST in cirrhotic patients.肝硬化患者 NRS2002、RFH-NPT 和 LDUST 营养风险评估的差异。
Sci Rep. 2023 Feb 27;13(1):3306. doi: 10.1038/s41598-023-30031-1.
10
Mini-Nutritional Assessment, Malnutrition Universal Screening Tool, and Nutrition Risk Screening Tool for the Nutritional Evaluation of Older Nursing Home Residents.用于老年疗养院居民营养评估的微型营养评定法、营养不良通用筛查工具和营养风险筛查工具。
J Am Med Dir Assoc. 2016 Oct 1;17(10):959.e11-8. doi: 10.1016/j.jamda.2016.06.028. Epub 2016 Aug 12.
引用本文的文献
1
Predictive Feasibility of the Graz Malnutrition Screening, Controlling Nutritional Status Score, Geriatric Nutritional Risk Index, and Prognostic Nutritional Index for Postoperative Long-Term Mortality After Surgically Treated Proximal Femur Fracture.格拉茨营养不良筛查、控制营养状况评分、老年营养风险指数和预后营养指数对手术治疗股骨近端骨折术后长期死亡率的预测可行性
Nutrients. 2024 Dec 11;16(24):4280. doi: 10.3390/nu16244280.
2
Falls and malnutrition are associated with in-hospital mortality in patients with cirrhosis.在肝硬化患者中，跌倒和营养不良与院内死亡率相关。
Hepatol Commun. 2024 Sep 27;8(10). doi: 10.1097/HC9.0000000000000535. eCollection 2024 Oct 1.
3
Comparison of different nutritional screening tools in nutritional screening of patients with cirrhosis: A cross-sectional observational study.不同营养筛查工具在肝硬化患者营养筛查中的比较：一项横断面观察性研究。
Heliyon. 2024 Apr 29;10(10):e30339. doi: 10.1016/j.heliyon.2024.e30339. eCollection 2024 May 30.
4
Nutritional aspects of prehabilitation in adults with cirrhosis awaiting liver transplant.等待肝移植的肝硬化成人患者术前康复的营养问题
Hepatology. 2024 Mar 28. doi: 10.1097/HEP.0000000000000818.
5
Value of the controlling nutritional status score and psoas muscle thickness per height in predicting prognosis in liver transplantation.控制营养状况评分及身高标准化腰大肌厚度在预测肝移植预后中的价值。
World J Clin Cases. 2021 Dec 16;9(35):10871-10883. doi: 10.12998/wjcc.v9.i35.10871.
6
Visceral Adiposity Associates With Malnutrition Risk Determined by Royal Free Hospital-Nutritional Prioritizing Tool in Cirrhosis.内脏脂肪与营养不良风险相关，该风险由皇家自由医院营养优先排序工具在肝硬化中确定。
Front Nutr. 2021 Nov 24;8:766350. doi: 10.3389/fnut.2021.766350. eCollection 2021.
7
Malnutrition, Frailty, and Sarcopenia in Patients With Cirrhosis: 2021 Practice Guidance by the American Association for the Study of Liver Diseases.肝硬化患者的营养不良、衰弱和肌肉减少症：美国肝病研究协会2021年实践指南
Hepatology. 2021 Sep;74(3):1611-1644. doi: 10.1002/hep.32049.
8
Malnutrition in Patients with Liver Cirrhosis.肝硬化患者的营养不良。
Nutrients. 2021 Feb 7;13(2):540. doi: 10.3390/nu13020540.
9
Residual clinical damage after COVID-19: A retrospective and prospective observational cohort study.新冠病毒感染后遗留临床损害：一项回顾性和前瞻性观察队列研究。
PLoS One. 2020 Oct 14;15(10):e0239570. doi: 10.1371/journal.pone.0239570. eCollection 2020.
本文引用的文献
1
Malnutrition in Cirrhosis: Frequent but Overlooked.肝硬化中的营养不良：常见却被忽视。
Liver Transpl. 2019 Dec;25(12):1743-1744. doi: 10.1002/lt.25660.
2
GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community.GLIM 营养不良诊断标准 - 全球临床营养界的共识报告。
J Cachexia Sarcopenia Muscle. 2019 Feb;10(1):207-217. doi: 10.1002/jcsm.12383.
3
Aggressive nutrition intervention reduces ascites and frequency of paracentesis in malnourished patients with cirrhosis and ascites.积极的营养干预可减少肝硬化腹水营养不良患者的腹水及腹腔穿刺频率。
JGH Open. 2017 Oct 31;1(3):92-97. doi: 10.1002/jgh3.12016. eCollection 2017 Nov.
4
EASL Clinical Practice Guidelines on nutrition in chronic liver disease.EASL 临床实践指南：慢性肝病中的营养问题。
J Hepatol. 2019 Jan;70(1):172-193. doi: 10.1016/j.jhep.2018.06.024. Epub 2018 Aug 23.
5
A practical approach to nutritional screening and assessment in cirrhosis.肝硬化营养筛查和评估的实用方法。
Hepatology. 2017 Mar;65(3):1044-1057. doi: 10.1002/hep.29003. Epub 2017 Feb 6.
6
The Royal Free Hospital-Nutritional Prioritizing Tool Is an Independent Predictor of Deterioration of Liver Function and Survival in Cirrhosis.皇家自由医院营养优先排序工具是肝硬化患者肝功能恶化和生存的独立预测指标。
Dig Dis Sci. 2016 Jun;61(6):1735-43. doi: 10.1007/s10620-015-4015-z. Epub 2016 Jan 2.
7
The Graz Malnutrition Screening (GMS): a new hospital screening tool for malnutrition.格拉茨营养不良筛查（GMS）：一种用于营养不良的新型医院筛查工具。
Br J Nutr. 2016 Feb 28;115(4):650-7. doi: 10.1017/S0007114515004924. Epub 2015 Dec 14.
8
A systematic review of malnutrition screening tools for the nursing home setting.养老院环境中营养不良筛查工具的系统评价。
J Am Med Dir Assoc. 2014 Mar;15(3):171-184. doi: 10.1016/j.jamda.2013.10.006. Epub 2013 Nov 28.
9
ESPEN guidelines for nutrition screening 2002.2002年欧洲临床营养与代谢学会营养筛查指南
Clin Nutr. 2003 Aug;22(4):415-21. doi: 10.1016/s0261-5614(03)00098-0.
10
Screening for undernutrition in geriatric practice: developing the short-form mini-nutritional assessment (MNA-SF).老年医学实践中营养不良的筛查：开发简版微型营养评定量表（MNA-SF）
J Gerontol A Biol Sci Med Sci. 2001 Jun;56(6):M366-72. doi: 10.1093/gerona/56.6.m366.
Zotero 插件