Nutritional Risk Screening In Patients Research Articles

The value of abPG-SGA in the nutritional risk screening of patients with malignant tumors.

Nutritional risk screening 2002 (NRS2002) is a commonly used tool for screening the risk of malnutrition in hospitalized patients, while patient-generated subjective global assessment (PG-SGA) is a nutritional assessment tool for malignant tumor patients. However, there are still gaps in the rapid nutritional risk screening methods for cancer patients. We aimed to evaluate the value of abridged scored patient-generated subjective global assessment (abPG-SGA) for nutritional risk screening and prognosis in cancer patients. The NRS 2002 and abPG-SGA scores of 100 malignant tumor patients hospitalized in our department in December 2020 were collected. Take NRS2002 ≥ 3 as the positive standard (risk of malnutrition). Data were analyzed using Kappa test, ROC curves, cut-off values and Kaplan-Meier. In the screening of 100 patients, 25.0% of patients were at risk of malnutrition (NRS2002), abPG-SGA yielded a sensitivity and specificity of 92.0% and 72.0%, respectively (area under curve [AUC] = 0.884, cut-off value ≥ 4.5); In the screening of patients with digestive system malignancies, 22.6% of patients were at risk of malnutrition (NRS2002), and the sensitivity and specificity of abPG-SGA were 91.67% and 87.80%, respectively (AUC = 0.945, cut-off value ≥ 5.5). The results of survival analysis showed that the overall survival (OS) of patients with abPG-SGA ≥ 5 and < 5, NRS2002 ≥ 3 and abPG-SGA < 5, NRS2002 < 3 and abPG-SGA ≥ 5 were significantly different (P < .0001), the OS of patients with NRS2002 ≥ 3 and abPG-SGA ≥ 5, NRS2002 < 3 and abPG-SGA < 5 were not significantly different (P > .05). Like NRS2002, abPG-SGA can also be used for malnutrition screening and prognosis judgment in cancer patients. It can quickly screen out cancer patients who may be at risk of malnutrition and facilitate the development of nutritional assessments.

Research on Associations of MiR-149 with Nutritional Risk Assessment and Postoperative Complications of Patients with Colorectal Cancer

Background: MiRNAs play an important role in the development of colorectal cancer, however, there’s few evidence of miRNAs in the screening of nutritional risks of patients with colorectal cancer. Objectives: To explore the role of preoperative miR-149 in nutritional screening of patients with CRC, and its associations with clinicopathological characteristics and postoperative complications of patients with CRC. Methods: The associations of serum miR-149 with clinicopathological characteristics and postoperative complications of patients were analyzed. The ROC curves were plotted with miR-149 as the test variable, and the grouping results of patients with nutritional risks [total NRS2002 score ≥3 points] and no nutritional risks (total NRS2002 score &lt;3 points) based on the preoperative NRS2002 score as the state variables. The consistency of miR-149 and NRS2002 in nutritional screening of CRC was analyzed using Kappa test. Results: MiR-149 was low in patients with CRC. There was a statistically significant difference in the miR-149 expression among patients with different tumor diameters and TNM stages in the two groups. The preoperative total NRS2002 score of CRC patients was &lt;3 points (without nutritional risks) in 271 cases, and ≥3 points (with nutritional risks) in 129 cases. The sensitivity and specificity of miR-149 in the diagnosis of nutritional risks were 76.74% and 84.50%. The Kappa value was 0.622 with miR-149 =3.095 as the critical value. Conclusions: MiR-149 can reflect the perioperative nutritional status of patients with CRC, and miR-149 =3.095 can be used as the cut-off point for nutritional risk screening of patients with CRC, which is an important index for assessing the nutritional risk in the perioperative period. The expression of miR-149 has a certain association with postoperative complications.

Preliminary Exploration of Setting the Disease Severity Score in the Nutritional Risk Screening of Patients with Severe Novel Coronavirus Pneumonia by Applying NRS2002.

ObjectiveThis study was designed to explore the impact of different scoring settings of disease severity on the accuracy of screening by NRS2002.MethodsPatients with severe COVID-19 who were admitted to our hospital from January 26, 2020, to March 16, 2020, were enrolled in this study. The basic data, the scores of the NRS2002 score sheet, and the serum prealbumin (PAB) level when these patients were admitted were collected, and the reflection of NRS2002 scores under different disease severity score settings to abnormal patients was analyzed.Results1. When the severity of the disease was set to 0 points, four of the six hospitalized patients with PAB levels below the lower normal limit were not screened out; 2. When the severity was set to 1 point, two patients with COVID-19 who developed to a severe stage during the treatment process were screened out, but three of the six hospitalized patients with PAB levels below the lower normal limit at admission were not screened out; 3. When the severity of the disease of a patient with severe COVID-19 and fever scored 2 points, and that of a patient without fever scored 1 point, two patients with COVID-19 who developed to the severe stage during the treatment process were screened out, and six patients who were hospitalized with PAB levels below the lower normal limit at admission were also screened out.ConclusionWhen the severe degree of patients with COVID-19 and fever is rated as 2 points, and that of the patients without fever is rated as 1 point, it can more accurately reflect the severity degree of patients with undernourishment.

Effect of Preoperative Nutritional Risk Screening and Enteral Nutrition Support in Accelerated Recovery after Resection for Esophageal Cancer

Patients with esophageal cancer are often accompanied by malnutrition, especially in patients with obvious swallowing tract. Many studies have shown that preoperative nutritional support can reduce postoperative complications, but there are few studies comparing preoperative enteral nutrition with intravenous nutrition. The aim of the study was to compare the effects of the two nutritional support path in esophageal cancer patients undergoing surgery. We used the nutritional risk screening 2002 (NRS2002) for preoperative nutritional risk screening in patients with esophageal cancer treated at our department between April 2016 and March 2019. A total of 56 patients with an NRS2002 score ≥ 3 and with apparent difficulty swallowing received preoperative parenteral nutrition (PN; n = 29) or enteral nutrition (EN; n = 27). Both groups received 7 day of nutritional support before surgery. Nutritional indicators were measured on preoperative day 7, preoperative day 1, and postoperative day 7. The baseline characteristics, perioperative condition, nutritional status, and postoperative complications of the two groups were compared and analysed. There was no significant difference in baseline characteristics and perioperative nutrition indicators between two groups. Postoperative hospital stay and the costs of nutrition support were significantly reduced in the EN group compared with PN group (P = 0.000). The times of first passing gas and bowel movement were shorter in the EN group compared with PN group (P = 0.001). The incidence of gastrointestinal complications was lower in the EN group compared with PN group (P = 0.039). For esophageal cancer patients with an NRS2002 score ≥ 3 and apparent difficulty swallowing, preoperative EN with a gastric tube is safe and easy to perform. Preoperative EN can shorten the recovery time of gastrointestinal function, reduce the incidence of gastrointestinal complications, finally accelerate postoperative recovery.

What diet should I recommend my patient with Hepatic Encephalopathy?

The burden of malnutrition is high in patients with cirrhosis, especially in those with hepatic encephalopathy (HE). This has a bearing on increased morbidity and mortality. Heightened attention needs to be paid to screen the patients at high nutritional risk both in the outpatient and hospitalized settings. This review summarizes the current evidence for nutritional support in HE patients and compares the recommendations about nutritional requirement as laid out by various organizations. On survey of the literature, there is a consensus on avoiding protein restriction of the diets in HE patients along with uniform recommendations on caloric requirements. An exciting field of manipulating the gut microbiome in nutritional sciences may hold promise as well as there may be a future role for branched chain amino acids in nutritional management of HE patients. Even though the data suggest that nutritional improvement lead to better outcomes including lower readmission rates in cirrhosis, operationalizing these into practice remains a challenge. To achieve this, a multi-disciplinary approach with nutritional education of the frontline care providers, earlier nutritional risk screening of patients, involvement of the nutrition professionals as part of the team and repeated dietary counseling for the patient and caregiver/s is required. Ultimately, this may need more focus, resource allocation and uniform guidelines across all countries to make this a success.

Comparison of the effect of different nutritional testing methods on preoperative nutritional risk screening for patients with head and neck cancer

Objective To explore the role of bioelectrical impedance analysis (BIA) and laboratory tests for nutrition related indicators in preoperative nutritional risk screening of patients with head and neck cancer. Methods Totally 131 patients with head and neck cancer were selected by convenient sampling method. The nutritional risk was screened by NRS 2002 nutritional risk screening scale. The bioelectrical impedance indexes were collected by human body component analysis instrument and the nutritional related laboratory indicators were collected by electronic medical records. Results The incidence of nutritional risk in patients with head and neck cancer before operation was 18.6% (22/131). Correlation analysis showed that nutrition-related laboratory indicators were not related to nutritional risk, while bioelectrical impedance indicators such as fat-free mass, skeletal muscle mass, bodi mass index (BMI), inorganic salt content, water content and protein content were significantly correlated with NRS 2002 screening results(r=-0.228- -0.183, P<0.05 or 0.01). Univariate analysis showed that BMI, fat-free mass, protein content, skeletal muscle mass, water content, pharyngeal cancer, lymphatic metastasis, and diabetes mellitus were risk factors for nutritional risk (t=-4.121-2.918, χ2=4.167, 6.353, 4.032, P<0.01 or 0.05). Multivariate analysis showed that lymphatic metastasis was the independent risk factors of nutritional risk. Conclusions Preoperative nutritional risk screening is required for patients with head and neck cancer, especially those with tumor located in the pharynx, lymphatic metastasis and diabetes mellitus. Bioelectrical impedance analysis can be used as a reference for preoperative nutritional risk screening of patients with head and neck cancer, and can provide specific questions about human body composition for patients with nutritional risk, so as to provide a clear direction for nutritional risk intervention and can be used as an evaluation method of intervention. It is recommended that bioelectrical impedance analysis can be used as an auxiliary tool for nutritional risk screening. Key words: Head and neck neoplasms; Electric impedance; Laboratory techniques and procedures; Nutrition assessment

Nutritional blood parameters and nutritional risk screening in patients with spinal cord injury and deep pressure ulcer-a retrospective chart analysis.

Retrospective chart review. To describe (i) the nutritional blood parameters (NBP) and the nutritional risk screening (NRS) in patients with spinal cord injury (SCI) and pressure ulcers (PU) III and IV according to the EPUAP classification, and (ii) the relationship between both NBP and NRS. SCI acute care and rehabilitation clinic in Switzerland. The NBPs were measured upon the admission of patients treated for PU III and IV between 11/2011 and 12/2014. Descriptive analyses and group comparisons were done. A total of 170 patients, including 42 (25%) women, 19 (12%) people with paraplegia and 104 (61%) people with traumatic SCI, were admitted and analyzed. Pathologic blood values and NBP were found for c-reactive protein (83%), vitamin D (73%), protein (41%), erythrocyte sedimentation rate (ESR) (41%), albumin (34%), hemoglobin (34%), zinc (29%), folic acid (22%), transferrin (15.3%), and copper (1.2%). Overall, the NRS was >3 in 39% of the patients, wherefrom 28% in patients with PU III and 44% with PU IV (p=0.07). No statistical significant differences were found between patients with PU III and IV in terms of NBP and NRS. We found abnormal values in NBP and in NRS in a significant number of patients with SCI and PU of both III and IV. Both laboratory examinations and nutritional assessments at admission can help to detect and correct the nutritional deficits in patients at risk. Neither the grade of the PUs, nor the NBP or the NRS can replace one another.

Research progress of nutritional risk screening in patients with nasopharyngeal carcinoma

To review the common tools of nutritional risk screening, the importance of nutritional risk screening, the selection of nutritional risk screening and nutritional intervention time in patients with nasopharyngeal carcinoma, and discuss the existing deficiency of nutritional risk screening in patients with nasopharyngeal carcinoma, so as to provide basis for clinical nutritional research in patients with nasopharyngeal carcinoma. Key words: Review; Nasopharyngeal neoplasms; Nutrition assessment

Preoperative nutritional risk screening in patients undergoing duodenum-preserving pancreatic head resection for chronic pancreatitis

Preoperative nutritional risk screening in patients undergoing duodenum-preserving pancreatic head resection for chronic pancreatitis

An investigation of paths for nutritional risk screening in patients with liver cirrhosis

An investigation of paths for nutritional risk screening in patients with liver cirrhosis

Nutritional risk screening and clinical outcome assessment among patients with community-acquired infection: A multicenter study in Beijing teaching hospitals

ObjectiveThe aim of this study was to implement nutritional risk screening in patients with community-acquired infection (CAI) and analyze its relationship with clinical outcomes. MethodsWe consecutively assessed 595 patients with CAI from two teaching hospitals for eligibility during this study. Their nutritional risk was evaluated using Nutritional Risk Screening-2002. The hospital length of stay (LOS), rate of readmission, and nutritional support were recorded. ResultsIn all, 336 patients with CAI were recruited. Of these, 40.61% were at nutritional risk at admission. The prevalence of nutritional risk in those patients age ≥70 y was significantly higher than in younger patients (51.38% versus 37.29%; P = 0.017). There was significant increase in the prevalence of nutritional risk from admission to 2-wk post-admission in all patients (40.61% versus 48.93%; P = 0.036) and in elderly patients (51.38% versus 69.90%; P = 0.010). Of the at-risk patients, the LOS (19.6 ± 12.2 d versus 11.2 ± 5.3 d; P < 0.001) and the rate of readmission (8.8% versus 3.0%; P = 0.026) were significantly higher than those of the patients not at risk. Multivariate analysis showed nutritional support was a protective factor for longer LOS when adjusted for confounders (odds ratio, 0.51; 95% confidence interval, 0.36–0.68; P < 0.001). Only 55.9% of patients at risk received nutritional support and the average ratio of parenteral to enteral nutrition was 4.2:1. ConclusionsMany patients with CAI were at nutritional risk and tended to worsen during hospitalization, which has been associated with increased LOS and rate of readmission. Nutritional support might be beneficial to the patients by shortening LOS. Inappropriate use of nutritional support was observed in patients with CAI.

Nutritional risk screening in patients with Crohn's disease

To screen the nutritional risk in patients with Crohn's disease (CD), to explore the prevalence and characteristics of nutritional risk in CD patients, and to identify the possible risk factors. A cross-sectional study was performed in 712 patients who was diagnosed as CD in the Center for Inflammatory Bowel Disease of First Affiliated Hospital of Sun Yat-sen University between January 2003 and January 2014. Montreal classification was used to classify CD, Crohn's Disease Activity Index (CDAI) was used to evaluate disease activity, and Nutritional Risk Screening 2002 (NRS2002) was used to assess the nutritional risk in each patient. Reappraisal with NRS 2002 was conducted in patients followed up for 1 year to identify the possible effect of treatment on nutritional risk of the CD patients. The prevalence of nutritional risk was 65.2% (464/712) in the enrolled CD patients. The prevalence of nutritional risk was significantly different among patients with different disease activity (χ(2)=117.169, P<0.001), also significantly different among patients of different age at diagnosis (χ(2)=11.256, P=0.004), with different lesion location (χ(2)=18.841, P=0.001) and different disease behavior (χ(2)=15.793, P<0.001), but not significantly different in patients of different sex (χ(2)=0.601, P=0.245). Multivariate Logistic regression showed that the independent predictive risk factors for nutritional risk included abdominal tenderness (OR=1.895, 95%CI: 1.080-3.324); mild (OR=1.846, 95%CI: 1.179-2.890), moderate (OR=4.410, 95%CI: 2.701-7.200) and severe (OR=14.069, 95%CI: 1.718-115.192) disease activity; B2 (stricturing) (OR=1.620, 95%CI: 1.034-2.538) and B3 (penetrating) (OR=1.920, 95%CI: 1.025-3.596) types of disease behavior; and high level with erythrocyte sedimentation rate (ESR) (OR=1.024, 95%CI: 1.015-1.034). On the other hand, >40 years at diagnosis (A3 type) (OR=0.332, 95%CI: 0.135-0.814) and high albumin level (OR=0.962, 95%CI: 0.934-0.990) were independent protective factors for nutritional risk. After 1-year follow-up, nutritional risk was eliminated in 32.0%(111/347)of the patients, and the rate was higher in patients received surgery than in those treated with medicine alone (42.9%(54/126)vs 25.8%(57/221), χ(2)=10.742, P=0.001). Two thirds of CD patients may have nutritional risk at diagnosis, which may differ with disease activity and Montreal classification. Abdominal tenderness, disease activity, B2 and B3 types of disease behavior, and high ESR may be independent risk factors for nutritional risk, whereas A3 type of age at diagnosis and high albumin level may be independent protective factors.

Nutritional Risk Screening in patients with chronic kidney disease.

Knowledge concerning nutritional status of patients with chronic kidney disease (CKD) is limited. Nutritional Risk Screening-2002 (NRS-2002) has been used to evaluate the nutritional aspects of patients according to the recommendation of European Society for Clinical Nutrition and Metabolism. Here we aim to assess the prevalence and characteristics of nutritional risk in CKD patients by using NRS-2002. NRS-2002 scores of 292 CDK patients were recorded in first 24 hours subsequent to their admission to hospital. All patients have never been on dialysis. BMI, weight and various biochemical parameters were also characterized for these patients. Possible correlations between these parameters and NRS-2002 score were investigated. The overall prevalence of nutritional risk was 44.9% (53.6% in CKD stage 4-5 patients and 38.3% in stage 1-3 patients). Statistically significant differences were found in serum Albumin, Haemoglobin B, and lymphocyte counts between patients with or without increased nutritional risk. Under the situation that attending physicians were completely unaware of NRS-2002 scores, only 35.1% of the patients at risk received nutritional support. The nutritional risk status was associated with CKD stages but independent from primary diagnosis type. More attention should be paid to the nutritional status in CKD patients (including early stage patients). We recommended using NRS-2002 for nutritional risk assessment among non-dialysis CKD patients in routine clinical practice.

Clinical application of the fast track surgery model based on preoperative nutritional risk screening in patients with esophageal cancer.

To investigate the clinical application of the fast track surgery (FTS) model based on preoperative nutritional risk screening (NRS) in patients with esophageal cancer. 180 patients with esophageal cancer who underwent surgery between January 2008 and April 2014 were randomly divided into study and control groups based on matched-pairs. The study group underwent assessment using the NRS 2002 and received treatment before surgery and the control group was treated by the conventional method. Postoperative indicators including time to first exsufflation, time to defecation, time to chest tube removal, hospitalization duration, and postoperative complications were examined after surgery. Compared with the control group, the postoperative indicators including time to first exsufflation (88.4±2.76 vs 57.83±2.68 hours), time to first defecation (4.68±1.71 vs 3.28±1.34 days), time to chest tube removal (4.30±0.25 vs 2.70±0.33 days), postoperative hospitalization durations (11.71±1.39 vs 9.00±0.78 days), and total complication rate (18.9% [17/90] vs 6.67% [6/90]) were all significantly reduced in the study group (p<0.05). The FTS model based on NRS can effectively promote postoperative rehabilitation of patients, reduce the incidence of postoperative complications, and shorten hospital stay.

Characteristics of NRS-2002 Nutritional Risk Screening in Patients Hospitalized for Secondary Cardiovascular Prevention and Rehabilitation

Objective: The aim of our study was to assess the prevalence and characteristics of nutritional risk in patients scheduled for cardiovascular rehabilitation.Background: Knowledge concerning nutritional aspects of cardiovascular diseases is contemporary limited.Methods: Nutritional risk screening using a standardized Nutritional Risk Screening–2002 (NRS-2002) questionnaire was performed on a cohort of consecutive patients scheduled for rehabilitation 1–6 months after treatment for ischemic, valvular, or combined causes of heart diseases. Baseline weight was available for more than 80% of patients.Results: The study population consisted of 317 patients, aged 23–85 years, with a mean age of 62.5 ± 11.3 years. Male to female share was 253 (79.8%) and 64 (20.2%), respectively. Twenty-eight (8.8%) were treated for myocardial infarction conservatively, 151 (47.6%) by percutaneous coronary interventions, and 145 (45.7%) by surgery. NRS-2002 was 3.56 ± 1.54 in range 0–6. A high correlation was found between the NRS-2002 and percentage weight loss history (rho = 0.813; p <0.001). Significant differences according to increased nutritional risk (NRS-2002 ≥ 3) were found within age groups (p < 0.001), disease etiology (p = 0.002), cardiovascular treatments (p < 0.001), and grades of renal function (p < 0.001). Odds for developing increased nutritional risk (NRS-2002 ≥ 3) were significant for cardiovascular treatments (odds ratio [OR] = 4.35, 95% confidence interval [CI], 2.28–8.30, p < 0.001), age (OR = 3.19, 95% CI, 2.00–5.09, p < 0.001), grade of renal function (OR = 1.91, 95% CI, 1.17–3.09, p = 0.009), diabetes mellitus (OR = 2.37, 95% CI, 1.09–5.16, p = 0.029), and any psychological disturbance (OR = 2.04, 95% CI, 1.06–3.90, p = 0.032).Conclusions: Pronounced nutritional risk frequently existed among patients at stationary cardiovascular rehabilitation. Nutritional risk was connected with preceding cardiovascular treatments, patient age, and renal function. Further studies concerning nutritional risk and its connections with clinical outcomes might serve as a resourceful perspective to improve outcomes or quality of care for the entities from the cardiovascular diseases continuum.

Nutritional risk screening in patients at the gastroenterology department

Objective To study the incidence of risk of malnutrition , nutritional support rate , and the relationship between nutrition risk scores and nutrition indicators .Methods A total of 139 patients were investigated by nutrition risk screening 2002 （ NRS2002 ） .The relationships between NRS 2002 scores and nutrition indicators were analyzed .Results The incidence of risk of malnutrition （ NRS≥3 ） and nutritional support rate were 48%.37.5%patients had nutritional support .The pre-albumin was （142.56 ±68.23） mg/L in nutritional risk group, that was less than the risk-free group with （208.45 ±59.65）mg/L, the difference was statistically significant （t=23.95,P〈0.05）.The results of nutritional risk assessment and the pre-albumin, albumin, hemoglobin was negatively correlated （r=-0.882, -0.713,-0.689, respectively;P〈0.05）. Conclusions Screening for new patients is helpful to learn the nutritional status of the patients .The method is easy to operate.NRS2002 has many advantages and should be widely used to predict the nutrition risks of digestive patients . Key words: Nutritional support; Nutritional risk screening; Gastroenterology department

Clinical and Seasonal Variations of Nutritional Risk Screening in Patients Scheduled for Rehabilitation after Heart Surgery

Current knowledge on the pervasiveness of increased nutritional risk in cardiovascular diseases is limited. Our aim was to analyze the characteristics of nutritional risk screening in patients scheduled for rehabilitation after heart surgery. Prevalence and extent of nutritional risk were studied in connection with patients' characteristics and seasonal climate effects on weight loss dynamics. The cohort included 65 consecutive patients with an age range of 25-84 years, 2-6 months after surgical treatment for ischemic or valvular heart disease. Nutritional risk screening was appraised using a standardized NRS-2002 questionnaire. Groups were analyzed according to a timeline of rehabilitation according to the "cold" and "warm" seasons of the moderate Mediterranean climate in Opatija, Croatia. Increased nutritional risk scores (NRS-2002) of >3 were found in 96% of studied patients. Mean NRS-2002 of patients was 5.0 ± 1.0, with a percentage weight loss history of 11.7% ± 2.2% (4.6-19.0). Risk was found to be more pronounced during the warmer season, with NRS-2002 scores of 5.3 ± 0.7 versus 4.8 ± 1.1 (P = 0.136) and greater loss of weight of 13.0% ± 3.2% versus 10.6% ± 3% (P = 0.005), respectively. Increased nutritional risk correlated significantly with creatinine concentrations (rho = 0.359; P = 0.034 versus 0.584; P = 0.001, respectively). Significant discordance in correlations was found between NRS-2002 and the decrease in left ventricle systolic function (rho correlation coefficient [rho-cc] = -0.428; P = 0.009), the increase in glucose concentrations (cc = 0.600; P < 0.001), and the decrease in erythrocyte counts (cc = -0.520; P = 0.001) during the colder season. Increased nutritional risk was found to be frequently expressed in the course of rehabilitation after heart surgery. Although seasonal climate effects influenced the weight loss dynamics, the impact on reproducibility of NRS-2002 was clinically less important. Further studies on the connection of nutritional risk with composited end points might offer improvements in overall quality of treatment.

Nutritional risk screening in patients hospitalized for stationary cardiac rehabilitation

Objectives: Poor nutritional status is related with additional underperformance of several organ systems including cardiovascular system. In this manner patients are prone to treatment inefficiency/failure, health related hazards and complications, affecting quality of life1,2 . Inpatients in general are among highest risk groups for malnutrition. Our aim was to perform nutritional risk screen in patients hospitalized for stationary cardiac rehabilitation. Patients and Methods: Nutritional screening was performed using NRS-2002 on 190 Caucasian patients, 155 male (81.58%) and 35 female (18.42%) in age range 32-84 years. There were 80 patients (42.11%) with recent open heart surgery (20 valvular surgery and 60 coronary bypass revascularizations), 97 (51.05%) percutaneous coronary interventions (PCI) for acute coronary syndrome (ACS), and 13 (6.84%) had conservative ACS treatment. There were 28 (14.89%) patients with body mass index (BMI) 100 cm) and 24/34 (70.51%) of female (>88 cm). Results: Average NRS-2002 score was 3.69 points and average patient lost 6.87kg (range 0-14) i.e. 8.11% (0-19%) weight loss prior to hospitalization for the study. NRS-2002 risk showed to be significantly related to a type of treatment and age of patients (p<0.001). Only 39 patients (20.53%) had normal or low NRS-2002 risk (3). A great deal of patients, n=151 (79.47%) had high nutritional risk with scores over 3 points. Additionally 70 of them had very high grade of NRS-2002 score with values 5. Interestingly, significant differences were noted in patients with very high nutritional risk in relation to the age (p<0.001), Tiffeneau index (p=0.006), electrocardiography heart rate (p=0.017), red blood cell count (p<0.001) and platelet count (p<0.001), blood glucose concentrations (p<0.001), uric acid (p=0.002), creatinine (p=0.001) and total cholesterol (p=0.044). Conclusions: Nutritional status of patients enrolled in stationary cardiac rehabilitation was estimated to be of high risk, disease-related and treatment related. We failed to find a relationship between nutritional status and traditional cardiovascular risk factors, particularly the BMI or waist circumferences. Based on our preliminary results, the nutritional risk screen should be strongly advised in patients with valvular and ischemic heart disease, particularly in the post-operative course 3

Comparison of nutritional risk screening 2002 and malnutrition universal screening tools for preoperative nutritional risk evaluation of patients with gastric cancer

Objective To investigate the clinical value of nutritional risk screening 2002(NRS2002)and malnutritional universal screening tools(MUST)in the preoperative nutrition risk evaluation of patients with gastric cancer.Methods The preoperative nutritional risk of 3 14 patients who had been admitted to the Third Affiliated Hospital of Sun Yat-sen University from January 2004 to December 2007 was assessed by subjective global assessment(SGA),NRS 2002 and M UST,and the influence of nutritional risk on the incidence of postoperative complications and hospital stay was investigated.All data were analyzed by Wilcoxon test,Kappa test and Logistics regression analysis.Results Compared with SGA,the sensitivity,specificity,positive predicting value and negative predicting value were 86.7%,74.2%,86.9% and 73.8% for NRS2002,and were 73.1%,70.6%,74.8% and 68.7% for MUST.Compared with MUST,NRS2002 had a higher consistency with SGA(K_(NRS2002)=0.601,K_(MUST)=0.436).Logistic regression analysis revealed that patients with higher MUST or NRS2002 score had higher incidence of postoperative complications and longer hospital stay.In the aspect of hospital stay,the relative risk of MUST was 2.517,which was lower than 3.426 of NRS2002.The relative risk of MUST was 0.529,which was lower than 0.642 of NRS2002 in the aspect of incidence of postoperative complications.Conclusions NRS2002 and MUST are suitable for preoperative nutritional risk screening of patients with gastric cancer,and the score of NRS2002 or MUST is associated with the incidence of postoperative complications and length of hospital stay.However,NRS2002 is more accurate than MUST in the reflection of nutritional risk of patients with gastric cancer. Key words: Gastric Neoplasms; Nutritional risk screening 2002; Malnutrition universal screening tools

Results of nutritional risk screening of patients admitted to hospital

To identify malnutrition, nutritional risk screening and assessment should be performed. A number of nutritional screening and assessment tools have been developed. Authors monitored the nutritional state of 1266 patients using the MUST (Malnutrition Universal Screening Tool) method. Measurements and questioning were done at admission. The study was cross-sectional, presenting a snapshot about nutritional risk of patients. In this study 21% of the patients had a BMI smaller than 20.29% patients admitted to hospital lost at least 5% of their body weight in the 3 to 6 months before the admission. Altogether in this survey 41% of the patients are considered to be endangered concerning malnutrition! There is a statistically visible difference at BMI values between the disease groups. If only body weight of patients is measured, the rate of malnutrition is about 20%. Using MUST the number of endangered patients is doubled. In these patients it is more likely that any complication would develop. Since there is no significant relation between the age and the risk group, MUST screening can be carried out on all patients. We intended to emphasize the necessity of nutritional risk assessment and nutritional therapy at all levels of health care.