Department of General and Digestive Surgery, Hospital Universitario Rey Juan Carlos, 28933 Madrid, Spain.
Department of Medical Specialties and Public Health, Faculty of Health Sciences, Rey Juan Carlos University, 28933 Madrid, Spain.
Nutrients. 2023 Jul 24;15(14):3283. doi: 10.3390/nu15143283.
A prospective, observational, multicenter, and exploratory study was conducted in 469 gastrointestinal cancer patients undergoing elective surgery. The Malnutrition Universal Screening Tool (MUST) and the Global Leadership Initiative on Malnutrition (GLIM) criteria were used to assess nutritional risk. On admission, 17.9% and 21.1% of patients were at moderate (MUST score 1) and severe (MUST score ≥ 2) nutritional risk, respectively. The GLIM criteria used in patients with a MUST score ≥ 2 showed moderate malnutrition in 35.3% of patients and severe in 64.6%. Forty-seven percent of patients with a MUST score ≥ 2 on admission had the same score at discharge, and 20.7% with a MUST score 0 had moderate/severe risk at discharge. Small bowel, esophageal, and gastric cancer and diabetes were predictors of malnutrition on admission. Complications were significantly higher among patients with a MUST score 1 or ≥2 either on admission ( = 0.001) or at discharge ( < 0.0001). In patients who received nutritional therapy ( = 231), 43% continued to have moderate/severe nutritional risk on discharge, and 54% of those with MUST ≥ 2 on admission maintained this score at discharge. In gastrointestinal cancer patients undergoing elective surgery, there is an urgent need for improving nutritional risk screening before and after surgery, as well as improving nutritional therapy during hospitalization.
一项前瞻性、观察性、多中心、探索性研究纳入了 469 例接受择期手术的胃肠道癌症患者。采用营养不良通用筛查工具（MUST）和全球营养不良领导倡议（GLIM）标准评估营养风险。入院时，分别有 17.9%和 21.1%的患者存在中度（MUST 评分 1）和重度（MUST 评分≥2）营养风险。在 MUST 评分≥2 的患者中使用 GLIM 标准，有 35.3%的患者存在中度营养不良，64.6%的患者存在重度营养不良。入院时 MUST 评分≥2 的 47%患者出院时评分相同，入院时 MUST 评分为 0 的 20.7%患者出院时存在中/重度风险。入院时存在小肠、食管和胃癌以及糖尿病与营养不良相关。入院时 MUST 评分为 1 或≥2 的患者并发症发生率显著更高（=0.001）或出院时（<0.0001）。在接受营养治疗的患者中（=231），43%的患者出院时仍存在中/重度营养风险，入院时 MUST≥2 的患者中 54%的患者出院时仍维持这一评分。在接受择期手术的胃肠道癌症患者中，迫切需要改善术前和术后的营养风险筛查，并改善住院期间的营养治疗。
