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用营养不良炎症评分和老年营养风险指数筛查血液透析患者的营养不良。

Screening for malnutrition with malnutrition inflammation score and geriatric nutritional risk index in hemodialysis patients.

机构信息

Department of Nutrition and Dietetics, Adnan Menderes University Faculty of Health Sciences, Aydın, Turkey.

Department of Nutrition and Dietetics, Gazi University Faculty of Health Sciences, Ankara, Turkey.

出版信息

Hemodial Int. 2022 Oct;26(4):562-568. doi: 10.1111/hdi.13032. Epub 2022 Jul 13.

Abstract

BACKGROUND AND AIMS

Screening malnutrition, which is the most common complication in hemodialysis patients, is extremely important for these patients. Malnutrition inflammation score (MIS) and geriatric nutritional risk index (GNRI) are malnutrition screening tests used in hemodialysis patients in recent years. The purposes of this study are to evaluate the nutritional status of hemodialysis patients with different screening tests and to determine the cutoff values for this disease-specific MIS and GNRI.

METHODS

The study was conducted with 194 adult patients including 98 males and 96 females whose mean age was 53.1 ± 10.96. Subjective global assessment (SGA) and MIS tests were applied, and the GNRI value was calculated for screening malnutrition. MIS and GNRI cutoff values were obtained by adopting the SGA scores as a standard and drawing a receiver operating characteristic curve. The tatistical Package for the Social Sciences-22.0 package program was used in the analysis.

RESULTS

According to SGA, 70.7% of the patients were nourished, 21.1% were mildly-moderately malnourished, and 8.2% were found to be severely malnourished. The optimal cutoff value predicted for malnutrition was 6.5 points (94.7% sensitivity and 98.5% specificity) for MIS and 86.0 points (64.9% sensitivity and 62.8% specificity) for GNRI. Based on these cutoff values, 28.9% of the patients were determined to be malnourished according to MIS and 45.4% according to GNRI.

CONCLUSION

In conclusion, screening tests are very important in the early identification of malnutrition in hemodialysis patients. This study was conducted to evaluate the malnutrition of hemodialysis patients with different screening tests. At the end of the study, the availability of MIS was found to be high in detecting malnutrition in hemodialysis patients because of its high accuracy and sensitivity of MIS. The cutoff points we identified for both MIS and GNRI are thought to facilitate the determination of malnutrition.

摘要

背景与目的

对血液透析患者进行营养不良筛查至关重要,因为营养不良是此类患者最常见的并发症之一。近年来,营养不良炎症评分(MIS)和老年营养风险指数(GNRI)被用于血液透析患者的营养不良筛查。本研究旨在评估不同筛查试验对血液透析患者营养状况的评估,并确定用于该疾病的特定 MIS 和 GNRI 的截断值。

方法

该研究纳入了 194 名成年患者,包括 98 名男性和 96 名女性,平均年龄为 53.1±10.96 岁。应用主观综合评估(SGA)和 MIS 试验,并计算 GNRI 值以筛查营养不良。采用 SGA 评分作为标准绘制受试者工作特征曲线,得出 MIS 和 GNRI 的截断值。使用社会科学统计软件包-22.0 程序进行分析。

结果

根据 SGA,70.7%的患者营养良好,21.1%为轻度至中度营养不良,8.2%为严重营养不良。MIS 预测营养不良的最佳截断值为 6.5 分(敏感性 94.7%,特异性 98.5%),GNRI 为 86.0 分(敏感性 64.9%,特异性 62.8%)。根据这些截断值,MIS 显示 28.9%的患者存在营养不良,GNRI 显示 45.4%的患者存在营养不良。

结论

总之,筛查试验对于早期发现血液透析患者的营养不良非常重要。本研究评估了不同筛查试验对血液透析患者的营养不良评估。研究结束时,由于 MIS 的准确性和敏感性高,发现 MIS 检测血液透析患者营养不良的可用性较高。我们确定的 MIS 和 GNRI 的截断值有助于确定营养不良。

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