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比较全球营养不良领导倡议和患者生成主观整体评估,用于诊断肝胆胰恶性肿瘤手术患者的营养不良。

Comparison of the Global Leadership Initiative on Malnutrition and the Patient-Generated Subjective Global Assessment for diagnosing malnutrition in patients undergoing surgery for hepatobiliary and pancreatic malignancies.

机构信息

Department of Hepatobiliary and Pancreatic Surgery. The First Hospital of Ningbo University.

Department of Nursing. The First Hospital of Ningbo University.

出版信息

Nutr Hosp. 2024 Aug 29;41(4):835-842. doi: 10.20960/nh.05056.

DOI:10.20960/nh.05056
PMID:38804985
Abstract

Objective: to analyse the differences in malnutrition assessment between the Global Leadership Initiative on Malnutrition (GLIM) criteria and the Patient-Generated Subjective Global Assessment (PG-SGA) among patients with hepatobiliary and pancreatic malignancies. Method: this study was a cross-sectional study and included 126 hospitalised patients who underwent surgery for hepatobiliary and pancreatic malignancies between November 1, 2019 and August 1, 2020. The patients' clinical data were collected, and malnutrition assessments were completed using the different nutritional assessment tools. The consistency of both tools was analysed using Cohen's kappa coefficient. Results: the prevalence of malnutrition showed a difference in diagnosis results between the GLIM criteria (36.51 %) and the PG-SGA (55.56 %). The two methods had moderate consistency (kappa = 0.590, p < 0.01). The sensitivity of a malnutrition diagnosis using a combination of GLIM and PG-SGA was 65.7 % (53.3 % and 76.4 %, respectively), and specificity was 100 % (92 % and 100 %, respectively). When malnutrition was evaluated using only PG-SGA, sensitivity was 88.9 % (95 % confidence interval (CI) 63.9 % to 98.1 %), whereas when only the GLIM score was used for malnutrition evaluation, sensitivity was 98.2 % (95 % CI, 92.8 % to 99.7 %). In addition, the PG-SGA score and the GLIM score had significant correlations. Conclusion: GLIM performed better than PG-SGA in the correlation analysis of nutritional indicators. GLIM is more suitable for patients with hepatobiliary and pancreatic malignancies than PG-SGA.

摘要

目的

分析全球营养不良倡议(GLIM)标准与患者主观整体评估(PG-SGA)在肝胆胰恶性肿瘤患者营养不良评估中的差异。方法:本研究为横断面研究,纳入 2019 年 11 月 1 日至 2020 年 8 月 1 日期间因肝胆胰恶性肿瘤接受手术的 126 例住院患者。收集患者的临床资料,采用不同的营养评估工具进行营养不良评估。采用 Cohen's kappa 系数分析两种工具的一致性。结果:GLIM 标准(36.51%)和 PG-SGA(55.56%)的诊断结果显示营养不良的患病率存在差异。两种方法具有中度一致性(kappa=0.590,p<0.01)。GLIM 和 PG-SGA 联合诊断营养不良的敏感性分别为 65.7%(53.3%和 76.4%),特异性均为 100%(92%和 100%)。仅使用 PG-SGA 评估营养不良时,敏感性为 88.9%(95%可信区间 63.9%至 98.1%),仅使用 GLIM 评分评估营养不良时,敏感性为 98.2%(95%可信区间 92.8%至 99.7%)。此外,PG-SGA 评分与 GLIM 评分具有显著相关性。结论:GLIM 在营养指标的相关性分析中优于 PG-SGA。GLIM 比 PG-SGA 更适合肝胆胰恶性肿瘤患者。

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