Instant Nutritional Assessment Research Articles

Prognostic Nutritional Index and Instant Nutritional Assessement Are Associated with Clinical Outcomes in a Geriatric Cohort of Acutely Inpatients.

Among elderly inpatients, malnutrition is one of the most important predictive factors affecting length of stay (LOS), mortality, and risk of re-hospitalization. We conducted an observational, retrospective study on a cohort of 2206 acutely inpatients. Serum albumin and lymphocytes were evaluated. Instant Nutritional Assessment (INA) and the Prognostic Nutritional Index (PNI) were calculated to predict in-hospital mortality, LOS, and risk of rehospitalization. An inverse relationship between LOS, serum albumin, and PNI were found. Deceased patients had lower albumin levels, lower PNI values, and third- and fourth-degree INA scores. An accurate predictor of mortality was PNI (AUC = 0.785) after ROC curve analysis; both lower PNI values (HR = 3.56) and third- and fourth-degree INA scores (HR = 3.12) could be independent risk factors for mortality during hospitalization after Cox regression analysis. Moreover, among 309 subjects with a lower PNI value or third- and fourth-class INA, hospitalization was re-hospitalization. PNI and INA are two simple and quick-to-calculate tools that can help in classifying the condition of hospitalized elderly patients also based on their nutritional status, or in assessing their mortality risk. A poor nutritional status at the time of discharge may represent an important risk factor for rehospitalization in the following thirty days. This study confirms the importance of evaluating nutritional status at the time of hospitalization, especially in older patients. This study also confirms the importance for adequate training of doctors and nurses regarding the importance of maintaining a good nutritional status as an integral part of the therapeutic process of hospitalization in acute departments.

Definition of malnutrition from routinely-collected data for orthopedic surgery research: the global leadership initiative on malnutrition (GLIM) tool and others.

The correct identification of malnourished patients in the context of hip, knee, or spine surgery research would enhance the quality of analytical studies investigating the prediction potential of preoperative nutritional disorders on postoperative recovery. However, accurate malnutrition screening and diagnostic assessment rely on parameters that were not routinely collected in routine practice until a few years ago. The authors of this article present substitute literature-based equations that can be built up using historical routinely collected data to classify patients that had been at risk of malnutrition or malnourished. For what concerns the risk screening, several methods are available to identify patients at risk of over- or undernutrition, encompassing the BWd (body weight difference from the ideal weight), GNRI (geriatric nutritional risk index), INA (instant nutritional assessment), LxA (combination of lymphocyte count and albumin), PMA (protein malnutrition with acute inflammation), PMAC (protein malnutrition with acute and chronic inflammation), IDM (iron deficit malnutrition), and VBD (vitamin B deficit malnutrition). Conversely, the GLIM (global leadership initiative on malnutrition) criteria can be used to assess malnutrition and diagnose subclasses of undernutrition. Rational use of these tools can facilitate the conduction of efficient prospective studies in the future, as well as bespoke retrospective cohort studies and database research.

Nutritional assessment of patients with aplastic anemia: comparison of four nutritional screening tools.

Introduction: nutritional status can affect the treatment of hospitalized patients, and malnutrition can even lead to death. However, the nutritional status of patients with aplastic anemia (AA) is unclear. Objective: to assess the nutritional status of aplastic anemia patients with body mass index (BMI) ≥ 24 kg/m2 (high BMI group) and BMI < 24 kg/m2 (low BMI group), and to compare the consistency between different nutritional screening tools. Methods: patients with aplastic anemia hospitalized from January 2016 to December 2020 were collected. We used the combined index generated by Nutritional Risk Index (NRI), Prognostic Nutritional Index (PNI), Control Nutritional Status (CONUT) and Instant Nutritional Assessment (INA) to assess nutritional status of patients with aplastic anemia. Kappa index was used to measure the consistency between different nutritional screening tools. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of different nutritional screening tools. Results: one hundred and ninety-five patients with aplastic anemia were enrolled. The overall prevalence of malnutrition calculated by the combined index in patients with aplastic anemia was 51.3 %. The malnutrition rates of patients in the low BMI group and high BMI group were 60.9 % and 38.8 %, respectively. The malnutrition rates of very severe aplastic anemia (VSAA) patients, severe aplastic anemia (SAA) patients and ordinary patients were 76 %, 63.8 % and 45.1 %, respectively. Compared with the combined index, NRI had the highest consistency and area under the curve. Conclusions: the nutritional status of patients with aplastic anemia was very poor; the more serious the disease, the worse the nutritional status. Although the malnutrition rate in the low-BMI group was higher than in the high BMI group, the nutritional status of overweight or obese patients can not be ignored. NRI is the best tool for assessing the nutritional status of patients with aplastic anemia.

Near-term prognostic impact of integrated muscle mass and function in upper gastrointestinal cancer

Despite the known association between muscle mass/function and malnutrition-related mortality in upper gastrointestinal (UGI) cancer, no comprehensive study to determine the impact of muscle mass-dominant nutritional status on cancer prognosis has been conducted. The present study aimed to investigate the prognostic significance of integrated muscle mass and function in UGI cancer. Between July 2013 and March 2018, we enrolled 2546 cancer patients with risks of malnutrition (Nutrition Risk Screening 2002, ≥3 points) from a multicenter cohort study and split 527 patients with primary UGI cancer into an internal validation group. We prospectively performed instant nutritional assessment and recorded all general clinical characteristics of the participants, such as weight loss, body mass index, anthropometric measurements of muscle mass and function, dietary intake conditions, and disease burden and/or inflammation status based on the validated tools. Prognostic analyses were performed with post-assessment overall survival (OS). According to the entire set, UGI cancer was identified as the dominant risk factor for disease burden and inflammation criteria (hazard ratio (HR), 2.08, 95% confidence interval (Cl), 1.81-2.39, P<0.001). Integrated muscle mass/function analysis with validated cutoff values showed that hand grip strength/weight followed by triceps skinfold thickness and maximum calf circumference are the most potent predictors. Univariate and multivariate analyses revealed that reduced muscle mass/function (74.8%) and dietary intake (66.2%) independently affect OS of patients with UGI cancer. Significant associations were found between the reduced muscle mass/reduced dietary intake and the shortest OS (HR, 4.48; 95% Cl, 3.07-6.53; P<0.001). Appending subgroups of muscle mass/function and dietary intake to the pre-existing risk model increased the efficiency of the time-dependent receiver operating characteristic curve analysis for OS in UGI cancer, particularly within 2 years of instant nutritional assessment. Impaired muscle mass/function adversely affects the near-term prognosis in patients with UGI cancer. Along with a comprehensive evaluation of dietary intake conditions, the timely nutritional assessment might be useful for risk stratification of UGI cancers with potential for enteral and parenteral nutrition interventions. ChiCTR1800020329.

Identifying reliable predictors of protein-energy malnutrition in hospitalized frail older adults: A prospective longitudinal study

BackgroundDecreased food intake is a risk factor for relevant complications (e.g. infections, pressure ulcers), longer hospital stays, higher readmission rates, greater health care costs and increased patient mortality, particularly in frail hospitalized older adults who are malnourished or at risk of malnutrition. Nurses are called to improve this criticality, starting from accurately identifying malnourished patients at hospital admission and effectively monitoring their food intake. ObjectivesThe primary aim was to identify reliable predictive indicators of reduced food intake at hospital admission. The secondary aims were to assess the adequacy of daily energy and protein intake and the impact of nutrient intake on patient outcomes. DesignProspective observational longitudinal study. SettingInternal Medicine Ward of an Academic Teaching University Hospital. ParticipantsAcute older adults who were malnourished or at risk of malnutrition (Nutritional Risk Score-2002 ≥ 3, middle-upper arm circumference <23.5 cm or impaired self-feeding ability) at admission. MethodsThe effective energy and protein intake was monitored during the first 5 days of hospital stay by a photographic method and compared to the daily energy and protein requirement calculated by specific equations. Data on anthropometry, inflammation/malnutrition laboratory data and body composition (phase angle calculated using bioelectrical impedance analysis) were collected. ResultsEighty-one subjects (age 81.5 ± 11.5 years) were enrolled. Mean energy intake was 669.0 ± 573.9 kcal/day, and mean protein intake was 30.7 ± 25.8 g/day. Over 60% of patients ingested ≤50% of their calculated energy and protein requirements: these patients were older (p = 0.026), had a lower middle-upper arm circumference (p = 0.022) and total arm area (p = 0.038), a higher C-reactive protein/albumin ratio and Instant Nutritional Assessment score (p < 0.01), and experienced longer hospital stays (p ≤ 0.04) and higher in-hospital and 30-day post-discharge mortality (p < 0.001). In the multivariate analysis, lower middle-upper arm circumference, higher C-reactive protein/albumin ratio, and impaired self-feeding at admission were independently associated with critically reduced energy and protein intake. ConclusionsMiddle-upper arm circumference, C-reactive protein/albumin ratio, and impaired self-feeding are easily obtainable indicators of impaired energy and protein intake and poor clinical outcomes. Such parameters should be adopted as screening criteria to assess the risk for critically reduced energy/protein intake in hospitalized older adults. These findings are relevant to improve clinical practice through the implementation of multidisciplinary strategies, given the adverse clinical outcomes related to hospital malnutrition.

Nutrition support services in post operative patients in Kerala, India - An exploratory study

Pre-operative nutritional status and nutritional support in post operative services are critical determinants for outcome of surgery. In the present study thirty patients undergoing gastrointestinal surgery from a private hospital in Kochi, Kerala were selected as subjects for the study. Nutritional status assessment was carried out using Subjective Global Assessment (SGA) and Instant Nutritional Assessment (INA) respectively. The results indicated that fifty and fifty seven percent of subjects fell under the severely malnourished category by SGA and INA respectively. Twenty three percent of the subjects had a BMI less than 80 % of reference standards. Enteral feeding by jejunostomy and nasojejunal route was initiated 48 to 72 hours post operatively. Forty three and seventy five percent of the subjects met RDA of energy on day five and day eight respectively. Incidence of post operative complications was higher among subjects who were malnourished pre-operatively. By INA there is a reduction in percent subjects malnourished during the hospital stay .High post operative morbidity and mortality rate have been associated with malnutrition and post operative nutritional support has a significant corrective role in improving the outcome of surgery. Key Words: Nutrition Support Services, Subjective Global Assessment, Instant Nutritional Assessment, Malnutrition

Pancreatic enzyme supplementation after gastrectomy for gastric cancer: a randomized controlled trial

BackgroundGastrectomy for gastric cancer is a significant cause of secondary exocrine pancreatic insufficiency. Pancreatic enzyme replacement therapy may influence nutritional status and quality of life after gastrectomy, but the pertinent clinical research to date remains controversial. A randomized controlled trial to test this hypothesis was carried out.MethodsAfter gastrectomy, 43 patients with gastric cancer were randomly assigned to a normal diet (Normal-d; n = 21) or to a pancreatic enzyme supplementation diet (PES-d; n = 22) and were followed up during a 12-month period, assessing nutritional status and quality of life through body mass index (BMI), instant nutritional assessment (INA) class status, serum pre-albumin (SPA) values, and GastroiIntestinal Quality of Life Index (GIQLI).ResultsBMI was not significantly influenced by the type of diet; INA class status was significantly improved in the PES-d arm, particularly during the first 3 months after gastrectomy; SPA levels increased in both arms at 6 months after gastrectomy, reaching significantly higher values in the PES-d arm at 12 months. GIQLI was not significantly influenced by the type of diet throughout the follow-up period; however, this index significantly improved in the PES-d arm between the first and third month after gastrectomy.ConclusionsPES-d improves nutritional status and quality of life after gastrectomy for gastric cancer, particularly within 3 months from the operation. A larger, multicenter trial is necessary to address the potential influence of several confounding variables such as disease stage and adjuvant treatments.

Scores of nutritional risk and parameters of nutritional status assessment as predictors of in-hospital mortality and readmissions in the general hospital population

We have no "gold standard" for the diagnosis of malnutrition. The aim of this study was to determine the importance of many of the parameters used in nutritional status screening and assessment among inpatients for the prediction of in-hospital mortality, readmission and length of hospitalization. On the base of the medical documentation a retrospective analysis was performed of nutritional status screening and assessment parameters for all 20,237 non-selected, consecutive hospitalizations in 15,013 patients over 18 years of age treated in one hospital during the course of one year. The risk of malnutrition expressed as a Nutritional Risk Screening (NRS)-2002 score≥3 concerned 6.4% hospitalizations. The greater risk of in-hospital death, as well as readmission within 14 days and 30 days, was related to an NRS-2002 score ≥3, age >65 years, male gender, urgent admission, body mass deficit calculated as the difference between actual body mass and ideal weight determined according to the Lorentz formula, higher degree of Instant Nutritional Assessment (INA), greater value of a C-reactive protein (CRP)/albumin ratio, and plasma glucose concentration. Whereas, greater blood concentration of albumin, hemoglobin, cholesterol and triglycerides, as well as a greater blood lymphocyte count, were associated with reduced risk of the measured outcomes. NRS-2002 score, blood albumin, CRP/albumin ratio, and INA seem to be good predictors of in-hospital mortality, readmission rate and length of hospital stay.

Assessment of Nutritional Status in Patients with Metabolic Syndrome and Chronic Hepatitis C

Abstract Background and Aims: The aim of the study was to assess nutritional status in patients with chronic hepatitis C and metabolic syndrome by different methods and to evaluate predictors of malnutrition. Material and Methods: This cross-sectional study was held in three centers from Bucharest and included 171 patients with chronic hepatitis C, divided into two groups according to the presence of metabolic syndrome (MetS). Anthropometric and biochemical parameters (including fasting plasma glucose, glycosylated hemoglobin, lipid profile, liver profile, complete blood count, and cytokines) were recorded. Nutritional status was assessed using Body Mass Index (BMI), Mini-nutritional assessment (MNA), Instant Nutritional Assessment (INA) and Nutritional Risk Index (NRI). We also recorded a malnutrition combined score. We considered patients to be malnourished according to the combined score if any score indicate malnutrition. Hepatic fibrosis was assessed using Forns index. Results: The average age was 53.14±8.3 years and 52% (n=89) were women. Using the combined score, malnutrition was present in 18 patients (10.5%). Multivariate logistic regression analysis showed that diabetes, hepatic fibrosis and IL-6 were independent risk factors for malnutrition (all p &lt;0.05). Conclusions: Prevalence of malnutrition was high in patients with chronic hepatitis C (10.5%). In these patients diabetes, hepatic fibrosis and IL-6 were independent predictors for malnutrition.

Assessment of nutritional status of patients with hepatitis C virus‐related liver cirrhosis

Nutrition support for patients with liver cirrhosis, such as late evening snacks and branched-chain amino acids, has been demonstrated to be effective. However, the assessment of the malnutrition of liver cirrhosis is still a problem. The aim of this study was to assess the nutritional status of patients with liver cirrhosis due to hepatitis C virus by six methods and to test the sensitivity and specificity of these methods. In total, 86 patients with liver cirrhosis due to hepatitis C virus were assessed for nutritional status by triceps skinfold thickness (TSF), arm muscle circumference (AMC), subjective global assessment (SGA), nutritional risk index (NRI), Maastricht index (MI), and instant nutritional assessment (INA). Malnutrition was found in 11 (12.8%) patients by TSF, 15 (17.4%) by AMC, 22 (25.6%) by SGA, 52 (60.5%) by the NRI, 66 (76.7%) by the MI, and in 54 (62.8%) by INA. The MI detected malnutrition at a significantly higher rate compared with the other five methods. Sixty-two patients were diagnosed as malnourished by the combined index, which defines the patients as malnourished when any two of the NRI, MI, and INA also define them as malnourished. The misclassification rate compared with the combined indexes was significantly lower in the MI (4.7%) than in any of the TSF (59.3%), AMC (59.3%), SGA (46.5%), NRI (16.3%), and INA (14.0%). The MI was the best single score to identify the patients who had malnutrition, including early stage, and may benefit from nutrition support.

Nutritional Status Affects the Rate of Pancreatic Fistula after Distal Pancreatectomy: A Multivariate Analysis of 132 Patients

Although malnutrition was found to increase the risk of intraabdominal and systemic complications in surgical patients, data for distal pancreatic resections are scarce. Data on 132 consecutive patients undergoing distal pancreatectomy as the primary procedure for pancreatic pathology, between 1996 and 2005, were reviewed to identify risk factors for postoperative complications and determine the impact of nutritional status. Nutritional assessment was performed with clinical and laboratory variables, including unintentional weight loss, body mass index, blood albumin level, lymphocyte count, and Nutritional Risk Index (NRI) and Instant Nutritional Assessment (INA) scores. Seventy-five (56.8%) patients developed 1 or more complications, including 18 (13.6%) cases of pancreatic fistula. The median values of NRI were significantly lower in patients with pancreatic fistula (96.9; 95% CI, 89.8 to 101.0) compared with those in the remaining subjects (102.5; 95% CI, 101.5 to 105.5; p=0.014). In the univariate analysis, the incidence of malnutrition defined by NRI (61% versus 30%, p=0.019) and the Instant Nutritional Assessment (67% versus 34%, p=0.017) was significantly higher in patients who developed pancreatic fistula. In the multivariate analysis, malnutrition characterized as NRI of 100 or less was the only factor that significantly increased the risk of pancreatic fistula, with an odds ratio of 8.12 (95% CI, 1.06 to 22.30). Malnutrition, as defined by composite nutritional assessment scales consisting of clinical and laboratory parameters, is a major risk factor for pancreatic fistula after distal pancreatectomy.

The Effect of Malnutrition on Morbidity after Surgery for Chronic Pancreatitis

Protein-energy malnutrition is a notable problem in the management of patients with chronic pancreatitis. The effect of malnutrition on pancreatic surgery is not well known. The records of 313 consecutive patients who underwent lateral pancreaticojejunostomy (LPJ, n = 152), pancreaticoduodenectomy (PD, n = 78), or distal pancreatectomy (DP, n = 83) for chronic pancreatitis were retrospectively reviewed and analyzed. Subjective Global Assessment, Nutritional Risk Index, and Instant Nutritional Assessment were used to assess the nutritional state. An average of all three nutritional indexes was established, and patients were categorized into well nourished (n = 101) as well as mild (n = 91), moderate (n = 94), and severe malnourished (n = 27). Poor nutritional state was associated with an increase in postoperative complication rate (LPJ: well nourished 14%, mild 25%, moderate 31%*, severe 50%*; PD: well nourished 44%, mild 44%, moderate 60%, severe 88%*; DP: well nourished 17%, mild 13%, moderate 30%, severe 55%*; *P < 0.045 vs well nourished). Low serum albumin levels also increased operative morbidity. The increase in morbidity was reflected by a higher rate of infectious complications as well as increased ICU stay. Body mass index and weight loss did not contribute to change in outcome. Malnutrition was associated with a higher incidence of postoperative complications after surgery for chronic pancreatitis. An increase in operative morbidity might be related to decreased protein synthesis and impaired immunocompetence.

Assessment of nutritional status on hospital admission: nutritional scores.

Malnutrition is still a largely unrecognized problem in hospitals. Malnutrition in hospitalized patients is generally related to increasing morbidity and mortality, and costs and length of stay. The aim of this study was to assess the nutritional status of patients on admission to a general hospital using different nutritional scores and to test the sensitivity and specificity of these scores. Sample population included 60 patients (55% male; 45% female) selected (aged 65.6+/-15.9 y) at random by using a computer software program. The nutritional state assessment was performed within 48 h of admission, using different nutritional indices (Subjective Global Assessment (SGA), Nutritional Risk Index (NRI), Gassull classification, Instant Nutritional Assessment (INA) and a combined index). About 78.3% of patients were found to be malnourished on admission. The frequency of malnutrition degree varied from 63.3% as assessed by the SGA to 90% with the NRI. Malnutrition severity was not related to the diagnosis. However, an elderly population was associated with a higher prevalence of malnutrition. INA was the best single score to identify patients who are malnourished or at risk of malnutrition and who may benefit from nutrition support.

Clinical Significance of Preoperative Nutritional Status in Pediatric Surgical Patients

This prospective study was undertaken to correlate the preoperative nutritional status in pediatric surgical patients with postoperative morbidity. The prevalence of protein-calorie malnutrition in our patients is also evaluated. Sixty-two consecutive pediatric surgical patients were admitted elective to King Khalid University Hospital for different reasons. Seventy-four major and intermediate surgical procedures were carried out. The patients were assessed nutritionally on the day of admission by using anthropometric and biochemical methods. Patients were monitored for complications during their hospital course. Eighty percent of patients have one or more abnormal values suggestive of protein-calorie malnutrition. Six patients had 8.1% complication rate. Five of them showed moderate to severe malnutrition. The correlation between malnutrition and postoperative morbidity was evident but was not of clinical or statistical significance. And the predictive value of nutritional variables in predicting postoperative complications were difficult to assess in this study but they generally were of little help.

The value of nutritional assessment methods in surgical patients living in Saudi Arabia

Several methods have been propsed to assess nutritional status of patients in relation to post-operative complications including instant nutritional assessment (INA) and prognostic nutritional index (PNI). Weight loss (WL) has also been related to post-operative morbidity. A prospective study was conducted to evaluate the prognostic ability of INA, PNI and WL in 300 patients affected by major and semi-major surgeries. Post-operative sepsis occurred in 28 (9.3%) patients. Of the 300 patients studied, 91 (30.2%) had WL ⩾ 10%; 12 patients were septic. Of the 28 septic patients indentified, 24 (85.7%) were within the high-risk group as identified by PNI characterisation. When both serum albumin and total lymphocyte count were abnormal, sepsis rate was 100%. All methods had a Youden index greater than one. Therefore, WL should be the first parameter assessed, and if WL is > 10%, then INA can be used to assess the patient further.

Instant nutritional assessment (INA) has limited value in predicting septic complications after surgery for gastric cancer

Instant nutritional assessment (INA) has limited value in predicting septic complications after surgery for gastric cancer

Prognostic ability of nutritional assessment methods in surgical cancer patients

To identify patients at high-risk for post-operative infections, several methods have been proposed, including prognostic nutritional index (PNI), instant nutritional assessment (INA) and nutritional assessment (NA). Weight loss (WL) has also been related to post-operative morbidity. We have evaluated the prognostic ability of PNI, INA, NA and WL in a prospective study carried out in 94 patients affected by gastro-intestinal malignancy, who underwent major surgery. Post-operative infections occurred in 26 (27.7%) patients. PNI, INA and NA identified classes of patients with a progressive risk of septic complications. To determine the prognostic ability of PNI, INA, NA and WL, sensitivity, specificity, Youden index and predictive values were evaluated. All methods had a Youden index greater than one, with a positive predictive value ranging from 0.33 to 0.36. Since all the methods studied showed a similar predictive ability, it seems reasonable to identify the high-risk surgical patient by using weight loss in association with those nutritional parameters derived from routine hospital laboratory tests.

Preoperative Parenteral Nutrition in the High Risk Surgical Patient

In order to assess the significance of malnutrition in determining surgical complications and the possibility of their reduction by preoperative nutritional support (PNS), a randomized controlled trial is being performed at our institution. The results relative to 100 patients who underwent major surgery for gastrointestinal disease, are presented here. In the treatment group 49 patients received 30 kcal/kg/day and 200 mg/kg/day of nitrogen for at least 7 days in the immediate preoperative period (nine patients were excluded from this group due to early surgery--seven cases; or refusal to accept PNS--two cases. Data analysis with their inclusion or exclusion showed similar results.) Fifty-one patients constituted the control group. The observed septic complication rate was, respectively, 30 and 35.3% (p:NS). When the analysis was restricted to the patients with abnormal instant nutritional assessment (INA), as defined by Seltzer et al (serum albumin less than 3.5 g/dl and/or total lymphocyte count less than 1500 cells/mm3), a statistically significant difference was observed in the incidence of sepsis between the two subgroups (21% vs 53.3%, p less than 0.05). Analogous results were obtained from the patients who underwent gastrectomy for gastric cancer: 16.7% of septic complications in the malnourished treated patients and 100% in the malnourished control ones (p less than 0.05). The occurrence of serious sepsis (sepsis score greater than or equal to 10, according to the scoring system developed by Elebute and Stoner) in the malnourished subgroups was 5.2% and 26.7%, respectively, (p = 0.09). The postoperative mortality rate was not significantly changed by the PNS (reduction from 3.9% to 2.5%, p:NS).(ABSTRACT TRUNCATED AT 250 WORDS)

The value of nutritional assessment in the surgical patient.

The prevalence of malnutrition in Veterans Administration Hospitals has been well documented. Several methods have been proposed to assess nutritional status including prognostic nutritional index (PNI) and instant nutritional assessment (INA). A prospective study was done to evaluate the currently used nutritional assessments and determine their efficacy based on sensitivity and specificity in predicting surgical morbidity and mortality. Data on 46 patients were evaluated for the multiparameter index of PNI, total lymphocyte count and serum albumin for INA, and weight loss alone. In this analysis, intermediate and high risk PNI were combined as positive predictor of complications. Any abnormal value in INA was considered positive as was weight loss of greater than 6% of usual body weight. Sensitivity and specificity of each assessment method were determined by 2 X 2 contingency table, and significance of observed differences between methods was determined by chi 2 analysis. There were no complications or deaths in patients with less than 6% weight loss. All three patients with abnormal albumin and total lymphocyte count had complications as compared to only three of 32 patients when both of these parameters were normal. The PNI was also able to predict complications with an increasing incidence as the PNI increased. Only the difference between specificity of weight loss alone vs INA was statistically significant, p less than 0.05. Thus, weight loss alone can be used as a rapid, inexpensive assessment of nutritional status for predicting postoperative complications.

Instant nutritional assessment: absolute weight loss and surgical mortality.

Journal of Parenteral and Enteral NutritionVolume 6, Issue 3 p. 218-221 Journal Article Instant Nutritional Assessment: Absolute Weight Loss and Surgical Mortality Murray H. Seltzer M.D., Murray H. Seltzer M.D. Nutrition Support Service, Department of Surgery, Saint Barnabas Medical Center, Livingston, New JerseySearch for more papers by this authorBernadette A. Slocum R.N., Bernadette A. Slocum R.N. Nutrition Support Service, Department of Surgery, Saint Barnabas Medical Center, Livingston, New JerseySearch for more papers by this authorEmma L. Cataldi-Betcher R.D., M.S., Emma L. Cataldi-Betcher R.D., M.S. Nutrition Support Service, Department of Surgery, Saint Barnabas Medical Center, Livingston, New JerseySearch for more papers by this authorCecilia Fileti R.D., Cecilia Fileti R.D. Nutrition Support Service, Department of Surgery, Saint Barnabas Medical Center, Livingston, New JerseySearch for more papers by this authorNoel Gerson, Noel Gerson Nutrition Support Service, Department of Surgery, Saint Barnabas Medical Center, Livingston, New JerseySearch for more papers by this author Murray H. Seltzer M.D., Murray H. Seltzer M.D. Nutrition Support Service, Department of Surgery, Saint Barnabas Medical Center, Livingston, New JerseySearch for more papers by this authorBernadette A. Slocum R.N., Bernadette A. Slocum R.N. Nutrition Support Service, Department of Surgery, Saint Barnabas Medical Center, Livingston, New JerseySearch for more papers by this authorEmma L. Cataldi-Betcher R.D., M.S., Emma L. Cataldi-Betcher R.D., M.S. Nutrition Support Service, Department of Surgery, Saint Barnabas Medical Center, Livingston, New JerseySearch for more papers by this authorCecilia Fileti R.D., Cecilia Fileti R.D. Nutrition Support Service, Department of Surgery, Saint Barnabas Medical Center, Livingston, New JerseySearch for more papers by this authorNoel Gerson, Noel Gerson Nutrition Support Service, Department of Surgery, Saint Barnabas Medical Center, Livingston, New JerseySearch for more papers by this author First published: 01 May 1982 https://doi.org/10.1177/0148607182006003218Citations: 82AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume6, Issue3May 1982Pages 218-221 RelatedInformation