Incidence Rate Of Malnutrition Research Articles

Comparison of GLIM, SGA, PG-SGA, and PNI in diagnosing malnutrition among hepatobiliary-pancreatic surgery patients.

To compare the diagnostic value of four tools-the Global Leadership Initiative on Malnutrition (GLIM) criteria, the subjective global assessment (SGA), patient-generated subjective global assessment (PG-SGA), and prognostic nutritional index (PNI) in malnutrition among hospitalized patients undergoing hepatobiliary-pancreatic surgery. Meanwhile, to observe the nutritional intervention of these patients. Present study was a cross-sectional study, including 506 hospitalized patients who underwent hepatobiliary-pancreatic surgery between December 2020 and February 2022 at Ningbo Medical Center Lihuili Hospital, China. The incidence rate of malnutrition was diagnosed using the four tools. The consistency of the four tools was analyzed by Cohen's kappa statistic. Data, including nutritional characteristics and nutritional interventions, were collected. The nutritional intervention was observed according to the principles of Five Steps Nutritional Treatment. The prevalence was 36.75, 44.58, and 60.24%, as diagnosed by the GLIM, PG-SGA, and PNI, respectively, among 332 tumor patients. Among the 174 non-tumor patients, the prevalence was 9.77, 10.92, and 32.18% as diagnosed by the GLIM, SGA, and PNI. The diagnostic concordance of PG-SGA and GLIM was higher (Kappa = 0.814, <0.001) than SGA vs. GLIM (Kappa = 0.752, P < 0.001) and PNI vs. GLIM (Kappa = 0.265, P < 0.001). The univariate analysis revealed that older age, lower BMI and tumorous were significantly associated with nutritional risks and malnutrition. Among 170 patients with nutritional risk, most of patients (118/170, 69.41%) did not meet the nutritional support standard. The incidence of nutritional risk and malnutrition is high among patients with hepatobiliary and pancreatic diseases, specifically those with tumors. The GLIM showed the lowest prevalence of malnutrition among the four tools. The PG-SGA and GLIM had a relative high level of agreement. There was a low proportion of nutritional support in patients. More prospective and well-designed cohort studies are needed to confirm the relevance of these criteria in clinical practice in the future.

Clinical effectiveness of Subjective Global Nutritional Assessment in hospitalized children with cerebral palsy

OBJECTIVE To investigate the nutritional status of children with cerebral palsy (CP) and the clinical effectiveness of Subjective Global Nutritional Assessment (SGNA) in nutritional assessment of hospitalized children with CP. METHODS A total of 208 children with CP, aged 1-5 years, who were hospitalized from April to October 2019 were enrolled as subjects. SGNA was used to investigate nutritional status, and the Z-score method recommended by the World Health Organization was used as a reference standard to validate the clinical effectiveness of SGNA. RESULTS The detection rate of malnutrition in children with CP was 42.3% by SGNA and 39.4% by the Z-score method (P>0.05). The application of SGNA showed high consistency between different evaluators (κ=0.621, P<0.001). With the Z-score method as the reference standard, SGNA had a sensitivity of 80.5%, a specificity of 82.5%, a positive predictive value of 75.0%, and a negative predictive value of 86.7%, and high consistency was observed between the two evaluation methods (κ=0.622, P<0.001). SGNA was moderately consistent with weight-for-age Z-score and height-for-age Z-score (κ=0.495 and 0.478 respectively, P<0.001) and was poorly consistent with weight-for-height Z-score (κ=0.197, P<0.05). CONCLUSIONS There is a relatively high incidence rate of malnutrition in children with CP. SGNA can be used as a tool to assess the nutritional status of children with CP.

The clinical study of Nutric score system and nutritional assessment in neurological critical ill patients

Objective To investigate the clinical utility of critical nutrients nutrition risk assessment(Nutric score) in neurological critical ill patients, laying the foundation for clinical nutrition support. Methods From July 2016 to March 2017, 59 ICU patients with neurological critical ill in the First Affiliated Hospital of Anhui Medical University were divided into low score group(Nutric score 0-4) and high score group(Nutric score 5-9) according to Nutric score system.On the first and seventh day after ICU admission, the body mass index(BMI), triceps skinfold thickness (TSF), mid-upper arm circumference (MAC) and mid-upper arm muscle circumference (MAMC) were measured.The serum albumin(ALB), prealbumin(PA), hemoglobin(Hb) and lymphocyte(LY) were detected as nutritional indicators.And at the same time, recorded the 28-day outcomes, and made the SGA evaluation. Results At the first day admission in ICU, there were no statistically significant differences between the two groups in TSF, MAC and MAMC (all P>0.05). But at the seventh day, the TSF, MAC, MAMC of the high score group were (0.943±0.484)cm, (24.143±3.203)cm, (21.187±2.625)cm, respectively, which were significantly lower than those of the low score group[(1.185±0.403)cm, (26.981±2.731)cm, (23.265±2.327)cm], there were statistically significant differences between the two groups(t=2.090, 3.672, 3.223, all P<0.05). At the first day after admission, the serum levels of ALB and Hb in the high score group were (34.5±7.3)g/L, (103.68±13.5)g/L, which of the low score group were (39.0±6.9)g/L, (122.29±20.4)g/L, respectively, and there were statistically significant differences between the two groups(t=2.466, 4.168, all P<0.05). And at the seventh day after admission, the serum levels of ALB, PA, Hb and Ly in the high score group were (30.6±5.1)g/L, (146.0±77.0)mg/L, (83.9±11.9)g/L, (1.123±0.535)×109/L, respectively, which were significantly lower than those in the low score group[(35.8±5.5)g/L, (209.9±105.1)mg/L, (105.8±19.2)g/L, (1.709±1.377)×109/L]. Compared with the first day after admission, the ALB, Hb levels in the two groups at the seventh day after admission were significantly decreased (t=2.29, 2.042, 5.817, 3.286, all P<0.05); the PA level in the low score group had no statistically significant difference at the seventh day after admission, but the PA level in the high score group was decreased significantly (t=2.024, P<0.05). The incidence rate of malnutrition, mortality of the high score group were 32.1%, 32.1%, respectively, which were significantly higher than those in the low score group (9.7%, 6.5%) (χ2=4.583, 6.402, all P<0.05). Conclusion The Nutric score system can be used in the purpose of early nutrition assessment in neurological critical ill patients, and it is benefit for clinical early nutritional support. Key words: Nutric score system; Neurological; Critical illness

Nutrition Status and Inflammatory Indexes Could Predict Acute Toxicity After Concurrent Chemoradiation Therapy for Esophageal Carcinoma

To evaluate the influence on acute toxicity with different nutrition status and inflammatory indexes ofthe patients after concurrent chemoradiotherapy in esophageal carcinoma. A total of 338 cases of esophageal carcinoma who underwent intensity modulated radiation therapy (IMRT)with concurrent chemotherapy were eligible for retrospectively analysis. The influence on acute toxicity with different nutrition status such as body mass index level (BMI), albumin level (ALB), total lymphocyte count level (TLC), anemia and inflammatory indexes including neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) were observed after the treatment. The incidence rate of malnutrition according to different nutrition status was ranging from 5.62% to 54.14%. The incidence of acute radiation esophagitis of grade 2 and above in low ALB group were higher than that in normal ALB group (χ2=75.677，P=0.000). The incidence of hematologic toxicity among different TLC levels had statistical difference significantly. With the decline of TLC level, the incidence of hematologic system toxicity was increased (χ2=12.891，P=0.006), but the rate of acute radiation pneumonitis was decreased (χ2=19.775，P=0.001). The incidences of acute radiation esophagitis of grade 2 and above in anemia group were much higher than that in normal group (χ2=37.774, P=0.000). An higher incidence of acute radiation esophagitis was shown in NLR and PLR high level groups than in lower NLR and PLR groups (χ2=64.207, P=0.000; χ2=11.260, P=0.004). Accompanied by NLR and PLR levels elevate,the rate of acute radiation esophagitis is ascendant, where as the rate is decendant with ALB and Hb levels decline. The occurrence of hematologic system toxicity will increases and acute radiation pneumonitis decreases when TLC levels goes down.

Application of European nutritional risk screening on inpatients from department of neurology

Objective To evaluate the feasibility of European nutritional risk screening (NRS2002) on inpatients from our department of neurology,and investigate the incidence rate of nutritional risk,malnutrition,overweight and obesity of inpatients from department of neurology and neurosurgery.Methods 817 cases of patients were investigated,those who reached NRS2002 standard were graded on the next day of admission,and those who could not had exact BMI because they were not able to stand or had hydroncus had ALB test on the next day of admission.Patients' adjustment to NRS2002 was analyzed and nutritional risk,malnutrition,overweight and obesity were compared between department of neurology and neurosurgery.Results In department of neurology,the rate of complete adaption was 42.02％,incomplete adaption was 47.89％,and none adaption was 11.93％.while in the department of neurosurgary,the rate of complete adaption was 43.38％,incomplete adaption was 33.82％,and none adaption was 22.79％.The difference was statistically significant (x2 =20.331,P ＜ 0.01).The incidence rate of nutritional risk was 48.33％ in department of neurology and 30.48％ in the department of neurosurgery,and the difference was statistically significant (x2 =19.017,P ＜ 0.01).And the differences of incidence rate of malnutrition,overweight and obesity had no statistical significance between the department of neurology and neurosurgery (P ＞ 0.05).Conclusions NRS-2002 can be applied on patients from department of neurology,but data collection is affected because many patients cannot stand or have normal communication due to diseases,thus deviation may cause incomplete adaption or none adaption.Patients from department of neurology are more suitable to NRS2002 than those from department of neurosurgery and their incidence rate of nutritional risk is higher. Key words: Inpatients; Department of neurology; European nutritional risk screening; Malnutrition; Nutritional risk

Clinical study of mini-nutritional assessment for older Chinese inpatients.

Malnutrition is a common problem in older patients. Early detection of malnutrition is an important task in clinical practice. The MNA has become an extensively used tool to evaluate nutritional status in European countries and the United States. We evaluated the Mini-Nutritional Assessment (MNA) test and the short-form MNA (MNA-SF) test as screening tools for malnutrition in older Chinese inpatients and focused on finding an optimal cutoff point for MNA total score and MNA-SF score. One hundred eighty-four older Chinese inpatients were enrolled in this study from July to August 2006. Nutritional assessment included MNA, anthropometric measurements, and biochemical markers. According to the original cutoff point of the full MNA, 19.6% of those assessed were malnourished, 53.2% were at risk of malnutrition and 27.2% were well nourished. Correlations were found between MNA, MNA-SF and body mass index, triceps skinfold thickness, serum albumin, lymphocyte count, hemoglobin, lymphocyte ratio. With the most proper cutoff point lower than 19 indicating malnutrition, when using serum albumin (< 35.0 g/L) as the indicator, the sensitivity and specificity of the MNA total score were 0.6286 and 0.7466; when using BMI (< 18.5 kg/m2) as the indicator, the sensitivity and specificity were 0.8636 and 0.7469. The incidence rate of malnutrition was 32.6%. The most proper cutoff point of MNA-SF was lower than 12. The MNA and MNA-SF were useful tools to identify older Chinese inpatients with malnutrition. However, the cutoff point of the MNA should be modulated for this population.