营养筛查工具与 GLIM 在需要手术的复杂 IBD 中的关系。
Relationship between Nutritional Screening Tools and GLIM in Complicated IBD Requiring Surgery.
机构信息
Department of Health Science, Careggi University Hospital, 50134 Florence, Italy.
Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, 50134 Florence, Italy.
出版信息
Nutrients. 2021 Oct 30;13(11):3899. doi: 10.3390/nu13113899.
BACKGROUND
Accurate identification of malnutrition and preoperative nutritional care in Inflammatory Bowel Disease (IBD) surgery is mandatory. There is no validated nutritional screening tool for IBD patients. We developed a novel nutritional screening tool for IBD patients requiring surgery and compared it with other tools.
METHODS
we included 62 consecutive patients scheduled for elective surgery. The IBD Nutritional Screening tool (NS-IBD) was developed to screen patients for further comprehensive assessment. NRS-2002, MUST, MST, MIRT, SaskIBD-NR are compared with the new test. All screening tests were subsequently related to new GLIM criteria.
RESULTS
according to GLIM criteria, 25 (40%) IBD patients were malnourished (15 CD and 10 UC, 33% vs. 63%, = 0.036). Stage 1 malnutrition was reported in ten patients, while stage 2 was detected in 15 patients. The comparison of each nutritional risk tool with GLIM criteria showed sensitivity of 0.52, 0.6, 0.6, 0.84, 0.84 and 0.92 for SASKIBD-NR, MUST, MST, NRS-2002, MIRT, and the new NS-IBD, respectively.
CONCLUSIONS
in IBD, currently adopted nutritional screening tools are characterized by a low sensitivity when malnutrition diagnosis is performed with recent GLIM criteria. Our proposed tool to detect malnutrition performed the best in detecting patients that may require nutritional assessment and preoperative intervention.
背景
在炎症性肠病（IBD）手术中，准确识别营养不良和进行术前营养护理是强制性的。目前还没有针对 IBD 患者的经过验证的营养筛查工具。我们开发了一种针对需要手术的 IBD 患者的新型营养筛查工具，并将其与其他工具进行了比较。
方法
我们纳入了 62 例连续接受择期手术的患者。IBD 营养筛查工具（NS-IBD）用于筛查患者以进行进一步的全面评估。NRS-2002、MUST、MST、MIRT、SaskIBD-NR 与新测试进行了比较。所有筛查测试随后与新的 GLIM 标准相关联。
结果
根据 GLIM 标准，25 例（40%）IBD 患者存在营养不良（15 例 CD 和 10 例 UC，33%比 63%， = 0.036）。10 例患者报告存在 1 期营养不良，15 例患者存在 2 期营养不良。每种营养风险工具与 GLIM 标准的比较显示，SaskIBD-NR、MUST、MST、NRS-2002、MIRT 和新的 NS-IBD 的灵敏度分别为 0.52、0.6、0.6、0.84、0.84 和 0.92。
结论
在 IBD 中，目前采用的营养筛查工具在使用最近的 GLIM 标准进行营养不良诊断时，灵敏度较低。我们提出的用于检测营养不良的工具在检测可能需要营养评估和术前干预的患者方面表现最佳。
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