Department of Thyroid Surgery, Zhejiang Cancer Hospital, Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Science, Hangzhou, Zhejiang, China.
Department of Intensive Care Unit, Zhejiang Cancer Hospital, Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Science, Hangzhou, Zhejiang, China.
Medicine (Baltimore). 2024 Oct 25;103(43):e40025. doi: 10.1097/MD.0000000000040025.
This study aimed to compare the effectiveness of 2 nutritional assessment tools, the Nutritional Risk Screening Scale 2002 (NRS2002) and the Patient-Generated Subjective Global Assessment (PG-SGA), for evaluating the nutritional status of perioperative head and neck squamous cell carcinoma (HNSCC) patients, to facilitate early nutritional interventions and improve clinical outcomes. An observational, comparative study was conducted at the Zhejiang Cancer Hospital, recruiting patients diagnosed with HNSCC scheduled for surgical treatment. The NRS2002 and PG-SGA were applied to assess patients' nutritional risk at multiple time points: upon admission, the day before surgery, 2 days after surgery, a week after surgery, and at discharge. Statistical analyses were performed using McNemar and Kappa tests to assess differences and consistency between NRS2002 and PG-SGA. A total of 209 patients were included in this study, predominantly male, with an average age of 60 years. Nutritional risk assessments identified an inverted "V" trend in nutritional risk, with the peak occurring 2 days post-surgery. PG-SGA consistently showed a higher screening positivity rate compared to NRS2002. The receiver operating characteristic curve analysis highlighted the discriminative power of both tools, with PG-SGA and NRS2002 showing high area under the curve values. Both NRS2002 and PG-SGA are effective for nutritional screening in HNSCC patients, with PG-SGA demonstrating a slightly higher sensitivity before surgery. PG-SGA may be more suitable for preoperative application, whereas NRS2002 is more appropriate for postoperative use.
本研究旨在比较两种营养评估工具，即营养风险筛查 2002 量表（NRS2002）和患者主观整体评估（PG-SGA），用于评估围手术期头颈部鳞状细胞癌（HNSCC）患者的营养状况，以便进行早期营养干预并改善临床结局。本研究为一项在浙江省肿瘤医院进行的观察性、比较性研究，共招募了 209 名计划接受手术治疗的 HNSCC 患者。在多个时间点，即入院时、手术前一天、手术后 2 天、手术后一周和出院时，使用 NRS2002 和 PG-SGA 评估患者的营养风险。采用 McNemar 和 Kappa 检验进行统计分析，以评估 NRS2002 和 PG-SGA 之间的差异和一致性。这些患者主要为男性，平均年龄为 60 岁。营养风险评估显示，营养风险呈倒“V”型趋势，术后 2 天达到峰值。PG-SGA 的筛查阳性率始终高于 NRS2002。受试者工作特征曲线分析突出了两种工具的判别能力，PG-SGA 和 NRS2002 的曲线下面积均较高。NRS2002 和 PG-SGA 均能有效筛查 HNSCC 患者的营养状况，PG-SGA 在术前的敏感性略高。PG-SGA 可能更适合术前应用，而 NRS2002 更适合术后使用。
