Screening Of Nutritional Status Research Articles

MON-PO380: Screening for Nutritional Status in Radiation Oncology Outpatients

MON-PO380: Screening for Nutritional Status in Radiation Oncology Outpatients

Nutritional care: The 'poor child' of clinical care in children with cerebral palsy.

There is a considerable risk of malnutrition for children with Cerebral Palsy (CP) due to insufficient nutritional intake. The most important causes of insufficient intake are feeding problems which are highly prevalent in children with CP (depending on definition, age and heterogeneity of the researched population). Considering these facts, nutritional status should have the full attention of healthcare professionals but this is not yet the case. Evidence from research in clinical practice suggests that: 1) there is no consensus regarding who should perform the measurement and how often, 2) no standardised nutritional assessment is implemented, and 3) there is suboptimal communication and management about feeding and nutritional status in most healthcare networks. To overcome these problems, validated and practical tools for the screening and assessment of nutritional status should be a topic of research and subsequently made available and implemented in clinical practice. Because body composition is an objective indicator of available energy stores, research should focus on optimising measurement methods to determine body composition using anthropometric measures or bioelectrical impedance analysis (BIA). Furthermore, there is a definite need among health care providers for explicit and clear agreements on organisation and communication about nutritional care for children with CP.

Accuracy of new CIMDER tapes and the standard MUAC tape for screening nutritional status in children

Background: The mid-upper arm circumference (MUAC) to assess children nutritional status under 5 years of age, has been used since late fifties. Methods: The study was conducted to assess the accuracy in classifying the nutritional status of children under 5 years of age using the new CIMDER tapes compared to the new standard MUAC tape S0145620, distributed by UNICEF, taking weight-for-age as gold-standard from WHO multicenter study. Results.

Effective nutritional status screening in orthopaedic oncology patients and post-operative complications.

This study aims to determine the prevalence of malnutrition among orthopaedic oncology patients with malignant tumour during preoperative period. This is a prospective observational study involving patients from the orthopaedic oncology unit who were undergoing surgery. They were assessed with Patient Generated Subjective Global Assessment (PG-SGA), Malnutrition Screening Tool (MST) and 3-minute Nutritional Screening (3MinNS) questionnaires. Anthropometric data such as body mass index, mid upper arm circumference (MUAC) and blood parameters such as serum albumin, total lymphocyte count and haemoglobin were also investigated. Patients were then followed up for 3 months. Post-operative complications were divided into infectious and non-infectious groups. Length of stay and unplanned readmission were also documented. Prevalence of malnutrition ranged from 13.3% to 45.8% under different nutritional assessment methods. Patients who were determined as malnourished were significantly associated with both infectious and non-infectious post-operative complications ( p < 0.001). PG-SGA and 3MinNS values were also significant in univariate and multivariate analysis, respectively. Low serum albumin (<35 g/L) was associated with post-operative infectious complications, especially surgical site infection ( p < 0.001), prolonged hospital stay ( p = 0.009) and unplanned readmission ( p = 0.017). 3MinNS and Charlson Comorbidity Index were predictive of non-infectious complications, whereas serum albumin and the presence of metastasis were predictive of infectious complications. This pilot study of patients with soft tissue and bone sarcoma of upper and lower limbs showed that malnutrition is a significant independent factor related to infectious and non-infectious complications which leads to unplanned readmission and prolonged length of stay. Periodic screening using the PG-SGA or 3MinNS questionnaires, MUAC and evaluation of serum albumin levels is recommended during clinic session and pre-surgery assessment rounds to identify those predisposed to malnutrition and help in reducing incidence of post-operative complications.

Pengaruh Edukasi dengan Media Linzi terhadap Sikap dan Kinerja Kader dalam Memantau Status Gizi Balita

Child nutrition problems can be handled from the start through the activation of the posyandu. The first screening was conducted at the posyandu by comparing body weight with age. Each cadre has a different attitude and performance in implementing posyandu. The use of assistive devices can influence the attitude and performance of cadres . The aim is to determine the effect of LINZI media on cadres' attitudes and performance. The sample used 25 treatment groups and 25 control groups. The attitude with paired t test showed that in the control group there was a difference between the pre test and post test p = 0.042 (p &lt;0.05) and the treatment group p = 0.04 (P &lt;0.05). The performance of paired t test showed that in the control group there was a difference between before and after p = 0.001 (p &lt;0.05) and p = 0.000 (P &lt;0.05) in the treatment group. There is the influence of LINZI media education on cadre attitudes with an average score of 33.08 treatment attitudes greater than controls 32.96. There is the influence of LINZI media education on the performance of cadres with an average performance score of 26.16 greater than the control 24.84. Cadres can use LINZI media for early screening of toddlers' nutritional status that is more interesting and easy to use.

Innovative Nutritional Approach to Attenuate the Progression of HIV to AIDS Among People Living with HIV (PLWH): A Study Based in Abuja, Nigeria

The success of recent nutrition interventions in HIV demonstrate the progress made in HIV care and support. The idea to adapt principles and technologies from the TFR concept to the development of a functional recipe to slow the progression of HIV to AIDS proves to be meaningful and realisable in Amtewa meal nutrition intervention approach. Although the achieved results take the form of specific technology, it suggests that a prolong consumption of the intervention meal (Amtewa) will be suitable to sustain the gained improvements in the anthropometric and biochemical indices. The research highlighted crucial issues and identified key design parameters that require further attention and research in developing countries like Nigeria. Overall, it addresses the synergistic relationship between nutrition and HIV infection, the nutritional requirement and nutritional care and support for PLWHIV in Nigeria. While the nutrition intervention demonstrated a positive effect, the study also suggests that the initial visit of a newly diagnosed HIV-positive patient should include screening for nutritional status, identify risks and offer appropriate nutrition counseling which was not in existence but currently has been imbedded as “Nutritional Framework” within the HIV care and support programme in one of the accredited HIV treatment centres in Nigeria. This Nutritional Framework has provided information to PLWHIV on their HIV medication and food interactions and about nutritional screening tools available in the health setting. Finally, the research provides evidence which may be used as a basis for policy makers to incorporate Amtewa meal nutrition intervention in HIV care and support programme in other HIV treatment centres in Nigeria with a view of attenuating the progression of HIV to AIDS amongst PLWHIV in Nigeria.

Screening of Nutritional Status Based on Mini Nutritional Assessment Short-Form (MNA-SF) among Elderly

Screening of Nutritional Status Based on Mini Nutritional Assessment Short-Form (MNA-SF) among Elderly

Psychometric properties of the Persian version of the nutritional form for the elderly (NUFFE) in nursing home residents.

Background: The Nutritional Form for the Elderly (NUFFE) is a newly developed tool. This study aimed to carry out a psychometric evaluation of the Persian version of NUFFE (NUFFE-P) among nursing home residents. Methods: Nursing home participant’s aged ≥ 60 years (n=97) were enrolled. The inclusion criteria were residency for at least 6 months in the nursing home, and ability to communicate. Exclusion criteria included cognitive impairment, having depressed mood, severe hearing loss, problems in upper and lower extremities also, history of hospital admission during 6 months before enrollment. Anthropometric measures, laboratory tests, three-day food intake, NUFFE-P version, Mini Nutritional Assessment (MNA), Barthel Index (BI) and Geriatric Depression Scale (GDS-15) were assessed. The relationship between the NUFFE-P and MNA scores was considered as concurrent validity. Results: The Cronbach’s alpha coefficient of NUFFE-P tool was 0.76. The intraclass correlation coefficient for the total score between two raters obtained 0.98 (CI 0.97-0.99). The correlation coefficient between the NUFFE-P and the MNA scores was -0.75 (p<0.01). Four factors were extracted for the NUFFE-P in an exploratory factor analyses. Sensitivity 69.8% and 100% and specificity 75.7% and 85.6% were achieved to detect elderly at medium risk (cutoff=6), and at high risk of under-nutrition (cutoff=11) respectively. Conclusion: The NUFFE-P has sufficient psychometric properties in nutritional status screening among the Iranian elderly nursing homes residents.

MNA® nutritional screening identifies COPD patients with higher rate of complications

Rationale: This review aimed to describe the evidence on clinical screening and prognostic relevance of nutritional status evaluated by Mini Nutritional Assessment (MNA®) in Chronic Obstructive Pulmonary Disease (COPD) patients.

Correlation analysis between the Nutritional Risk Screening Tool (NRS-2002), and clinical efficacy and adverse events of concurrent chemoradiotherapy for the esophageal squamous cell carcinoma patients

Objective To investigate the effect of nutritional risk screening tool (NRS-2002) upon the clinical efficacy and survival outcomes in patients with unresectable locally advanced esophageal squamous cell carcinoma (LAESCC) receiving concurrent chemoradiotherapy. Methods Clinical data of 105 LAESCC patients treated with concurrent chemoradiotherapy in Zhejiang Provincial People′s Hospital from January 2013 to December 2015 were retrospectively analyzed. Nutritional status screening was performed using the NRS-2002 scale. The rate comparison was analyzed by using chi-square test. Kaplan-Meier survival analysis was adopted to calculate the survival rate. Log-rank test was utilized to statistically analyze the differences in survival outcomes. Cox regression model was used for uni-and multi-variate analyses. Results Prior to concurrent chemoradiotherapy, 37.1% of patients had the nutritional risk. Patients with NRS-2002 score ≥3 had a significantly higher incidence of ≥ grade 3 toxic reactions compared with their counterparts obtaining NRS-2002 score of 1-2(P=0.007). The median overall survival (OS) and progression-free survival (PFS) of all patients were 17.0 and 11.8 months. The OS and PFS of patients with NRS-2002 score ≥ 3 were significantly lower than those of their counterparts obtaining NRS-2002 score of 1-2(both P=0.000). Multivariate analysis demonstrated that NRS-2002 score of ≥3 was an independent prognostic factor for OS (P=0.000) and PFS (P=0.001). Conclusions NRS-2002 tool reveals that patients with esophageal cancer possess a relatively high nutritional risk. Prior to treatment, NRS-2002 score of ≥3 is significantly correlated with an increasing risk of toxic reactions and decreasing survival rate, which is worthy of subsequent investigation. Key words: Esophageal neoplasms/concurrent chemoradiotherapy; Nutritional risk screening tool; Prognosis

411Mini nutritional assessment short form tool for nurse quick screening of nutritional status in an outpatient heart failure unit

411Mini nutritional assessment short form tool for nurse quick screening of nutritional status in an outpatient heart failure unit

A survey of Changes in nutritional risk and incidence of malnutrition among patients with chronic cardiovascular disease during 7-30 days hospitalization in 3 tertiary hospitals in Beijing

Objective To investigate the changes of nutritional status of chronic cardiovascular patients during hospitalization by using nutritional risk screening 2002 (NRS 2002) and subjective global assessment (SGA). Methods A prospective, parallel multicenter study was carried out in 3 tertiary A hospitals in Beijing from June 2014 to September 2014. Subjects in the study had been hospitalized for 7-30 days for various types of chronic cardiovascular diseases. Physical indexes and laboratory examination results were recorded within 24 hours after admission and 24 hours before discharge. The nutritional status was evaluated using NRS 2002 and SGA. Results 454 inpatients were enrolled in this study. Prevalence of undernutrition, defined as body mass index<18.5 kg/m2 with poor general condition, was 7.0% on admission. Prevalence of nutritional risk (NRS 2002 score≥3) was 27.9%. Patients with heart valve disease (34.6%) and arrhythmia (47.5%) had higher prevalence of nutritional risk, which decreased on discharge. At admission, the prevalence of SGA-based moderate and severe undernutrition (grade B+ C) was 16.7%. In particular, this prevalence was higher in patients with heart valve disease (30.7%) and arrhythmia (22.5%). At discharge, the proportion of patients (except patients with coronary heart disease) with moderate and severe dystrophy, especially severe dystrophy, decreased significantly. Conclusions Patients with chronic cardiovascular disease were likely to have comorbid nutritional risk at the time of admission, including undernutrition, as defined by body mass index<18.5 kg/m2 plus poor general condition, and SGA-based moderate or severe malnutrition, which was partially improved on discharge. Attention should be paid to nutritional status screening and evaluation on admission. Reasonable nutrition intervention should be done to correct malnutrition and improve clinical outcomes. Key words: Chronic cardiovascular disease; Dynamic nutrition survey; Nutritional status of discharged patients; Nutritional risk screening 2002; Subjective global nutritional assessment

Near-infrared spectroscopy and X-ray fluorescence data fusion for olive leaf analysis and crop nutritional status determination

Leaf analysis is a useful way of diagnosing the nutritional status of the plants and therefore fast methods of analysis are demanded to aid in fertilization management decisions. In this work, a strategy based on the combined use of near-infrared spectroscopy (NIR) and portable energy dispersive X-Ray Fluorescence (EDXRF) is proposed as a suitable cheap and rapid alternative to traditional wet analytical methodologies. The approach has the major benefit of minimal sample preparation since leaves need to be only dried and ground. The ability of both techniques individually and applying two strategies of data fusion for the prediction of the most important plant nutrients, namely N, P, K, Ca, Mg, Mn, Zn, and B was tested. Predictive models were constructed using Partial Least Squares (PLS) to correlate the spectra with the nutrient contents. Models of unequal prediction performance in terms of the ratio of predictive deviation (RPD) were obtained for the different parameters when considering both techniques separately. Low-level data fusion, which consists of a concatenation of the raw data from both techniques, showed little improvement and even decreased the predictive ability for some elements. Better results were obtained with mid-level data fusion, that is, merging data after a feature extraction step performed by means of Principal components analysis (PCA). The results show that a fair quantitative prediction is possible for Ca, K and Mn with RPDs ≥ 2 for external validation, whereas models for N and P allowed a semiquantitative estimation. Mg and B models were less satisfactory and can be used only for distinguish between low and high levels, while Zn content cannot be predicted. Finally, the potential of the fusion of FT-NIR and EDXRF spectroscopic data for the fast screening of olive crop nutritional status has been tested. Deficiencies in important elements like N and K has been successfully detected.

American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Nutrition Screening and Therapy Within a Surgical Enhanced Recovery Pathway.

Perioperative malnutrition has proven to be challenging to define, diagnose, and treat. Despite these challenges, it is well known that suboptimal nutritional status is a strong independent predictor of poor postoperative outcomes. Although perioperative caregivers consistently express recognition of the importance of nutrition screening and optimization in the perioperative period, implementation of evidence-based perioperative nutrition guidelines and pathways in the United States has been quite limited and needs to be addressed in surgery-focused recommendations. The second Perioperative Quality Initiative brought together a group of international experts with the objective of providing consensus recommendations on this important topic with the goal of (1) developing guidelines for screening of nutritional status to identify patients at risk for adverse outcomes due to malnutrition; (2) address optimal methods of providing nutritional support and optimizing nutrition status preoperatively; and (3) identifying when and how to optimize nutrition delivery in the postoperative period. Discussion led to strong recommendations for implementation of routine preoperative nutrition screening to identify patients in need of preoperative nutrition optimization. Postoperatively, nutrition delivery should be restarted immediately after surgery. The key role of oral nutrition supplements, enteral nutrition, and parenteral nutrition (implemented in that order) in most perioperative patients was advocated for with protein delivery being more important than total calorie delivery. Finally, the role of often-inadequate nutrition intake in the posthospital setting was discussed, and the role of postdischarge oral nutrition supplements was emphasized.

Sa1815 - Comparison Between Different Malnutrition Screening Tools for Screening and Assessment of Nutritional Status of Patients with Crohn's Disease in an Ambulatory Setting

Sa1815 - Comparison Between Different Malnutrition Screening Tools for Screening and Assessment of Nutritional Status of Patients with Crohn's Disease in an Ambulatory Setting

Negative role of malnutrition in cell-mediated immune response: Pneumocystis jirovecii pneumonia (PCP) in a severely malnourished, HIV-negative patient with anorexia nervosa

It is generally acknowledged that malnutrition is a propensity factor for secondary infections in different clinical situations (malnutrition-associated infections in hospitalized patients and malnourished children in developing countries). However, it is not clear how malnutrition might facilitate the development of opportunistic infections in human immunodeficiency virus (HIV)-negative patients without a definite etiology (disease or treatment) of impaired cell-mediated immune response. We report here on a case of Pneumocystis jirovecii pneumonia in an HIV-negative patient suffering from anorexia nervosa with extreme malnutrition, which had a favorable outcome despite the severity of her respiratory failure. This report indicates the need for the early screening of nutritional status and rapid treatment initiation in patients with malnutrition, as well as the determination of opportunistic infections in the event of a low lymphocyte count.

Dynamic investigation of nutritional risk in patients with malignant tumor during hospitalization

Objective: To prospectively investigate the changes in nutritional status of patients with malignant tumors during hospitalization by using nutritional risk screening (NRS2002), and to analyze the correlation between the nutritional status and clinical outcomes . Methods: This was a prospective and parallel research done by multi-center collaboration from 34 hospitals in China from June to September 2014.Hospitalized patients with malignant tumors inthese departments (Department of Gastroenterology, respiratory medicine, oncology, general surgery, thoracic surgery and geriatrics)were investigated. Only the patients with age≥ 18 years and hospitalization time between 7-30 days were included. During hospitalization, the physical indexes of human bodywere measured, and the NRS 2002 scores, and monitored the nutritional support at the time points of admission and 24 hours before discharge were recorded.And whether there was a nutritional risk in hospitalized patients and its association with clinical outcomes were investigated. Results: A total of 2 402 patients with malignancies were enrolled in this study. Seventy fourpatients who did not complete NRS2002 were eliminated, and 2 328 patients were included. The number of the main diseases was the top five, including 587 cases of colorectal cancer, 567 cases of lung cancer, 564 cases of gastric cancer, 146 cases of esophageal cancer, and 119 cases of liver tumor. At the time of discharge, compared with admission, the BMI, body weight, grip and calf circumferences of patients with malignant tumor were significantly decreased (P<0.05). The total protein, albumin, prealbumin and hemoglobin were significantly lower than those at admission (P<0.05). In 2 328 patients who were completed nutritional risk screening, the rate of malnutrition at admission was 11.1% (BMI =18.5, 258/2 328) and the rate of malnutrition at discharge was 10.9% (BMI =18.5, 254/2 328), there were no significant differences (χ(2)=0.019 7, P=0.888). There were 1 204 patients with nutritional risk at admission (51.7%, NRS2002 score≥3)and 1 352 patients with nutritional risk at discharge (58.1%, NRS2002 score≥3), with significant differences (χ(2)=49.9, P<0.001). The incidence of nutritional risk in patients with colorectal, stomach, and lung tumors at discharge was significantly higher than that at admission (P<0.05). The infective complications and other complications of patients with nutritional risk were significantly greater than those without nutritional risk at admission and at discharge.ICU hospitalization stay of patients with nutritional risk was increased significantly than those without nutritional risk at admission(P=0.042). Hospitalization expenses of patients with nutritional risk was increased significantly than those of patients without nutritional risk at discharge(P<0.01). Conclusion: The patients with malignant tumor have a higher incidence rate of malnutrition at both admission and discharge and malnutritionhas correlation with adverse clinical outcomes.The aboveindicators did not improve significantly at discharge.Doctors should pay more attention to the nutritional status (screening and evaluation)of patients before discharge and use appropriate and adequate nutrition support in order to prevent the weight loss and improve the life quality of patients.

An Arabic Version of the Geriatric Depression Scale (30 Items): Psychometric Properties and Some Findings in a Lebanese Elderly Sample

Background/Aim: Although the rates of depression and anxiety disorders have been shown to be higher in older people, especially those living in institutional settings, most of this population remains undiagnosed and untreated. The objective is to translate the full-scale Geriatric Depression Scale (30 items, GDS) into Arabic for use in elderly patients in Lebanon, to check its validity and reproducibility in comparison to the original version of the questionnaire, and assess the risk factors associated with depression in the Lebanese geriatric population. Methods: This case-control study was conducted between June and August 2016 and included 500 patients aged more than 60 years (250 living inside and 250 outside a nursing home). Results: Strongly positive correlations (p < 0.001 for all items of the scale) were found between each item of the scale and the total scale. The mean inter-item correlation for our scale was 0.51, higher than that of the original scale (0.36), with an excellent internal consistency (Cronbach α = 0.901). Living in a nursing home, stress, anxiety, being married, age, and the primary level of education would significantly increase depression (β = 2.211, β = 0.223, β = 0.041, β = 0.902, β = 0.118, and β = 3.533, respectively). A normal nutritional status and a university level of education would significantly decrease depression (β = –0.732; β = –1.961). Conclusion: The Arabic version of the GDS can be used to estimate the severity of depression in the Lebanese elderly population. Periodic screening for anxiety, nutritional status, and stress is also recommended among geriatric people living in Lebanon.

Improving nutrition to support healthy ageing: what are the opportunities for intervention?

Alongside declining activity levels, energy needs fall in older age and eating less is expected. However, as total food consumption declines, intakes of many nutrients are also likely to fall; while energy requirements may be met, other nutrient needs may not. Although this highlights the importance of nutrient-dense foods and overall diet quality in older age to ensure nutrient intakes are sufficient, maintaining or increasing diet quality may be difficult at a time when food access and preparation are becoming more challenging, and diets may be more monotonous. Poor nutrition, even in developed settings, is common. Older malnourished adults are more likely to have poorer health outcomes, longer hospital stays and increased mortality. Thus, apart from the evident personal costs, the economic burden of disease-related malnutrition is significant, and effective preventive strategies to promote good nutrition among older populations are needed. In particular, there is a need for wider recognition of malnutrition risk among older adults, including implementation of routine screening of nutritional status and early diagnosis. Design of future interventions to support older community-dwelling adults requires a clear understanding of the personal and contextual influences that affect patterns of food choice and consumption, including consideration of the importance of social and psychological factors. In addition, there are opportunities to intervene earlier in the lifecourse; the most effective preventive efforts to promote good nutrition in older age may need to start ahead of age-related changes in physiology and function, including younger adulthood and at the retirement transition.

A Practical Standardized Composite Nutrition Score Based on Lean Tissue Index: Application in Nutrition Screening and Prediction of Outcome in Hemodialysis Population

Rapid screening and monitoring of nutritional status is mandatory in hemodialysis population because of the increasingly encountered nutritional problems. Considering the limitations of previous composite nutrition scores applied in this population, we tried to develop a standardized composite nutrition score (SCNS) using low lean tissue index as a marker of protein wasting to facilitate clinical screening and monitoring and to predict outcome. This retrospective cohort used 2 databases of dialysis populations from Taiwan between 2011 and 2014. First database consisting of data from 629 maintenance hemodialysis patients was used to develop the SCNS and the second database containing data from 297 maintenance hemodialysis patients was used to validate this developed score. SCNS containing albumin, creatinine, potassium, and body mass index was developed from the first database using low lean tissue index as a marker of protein wasting. When applying this score in the original database, significantly higher risk of developing protein wasting was found for patients with lower SCNS (odds ratio 1.38 [middle tertile vs highest tertile, P<.0001] and 2.40 [lowest tertile vs middle tertile, P<.0001]). The risk of death was also shown to be higher for patients with lower SCNS (hazard ratio 4.45 [below median level vs above median level, P<.0001]). These results were validated in the second database. We developed an SCNS consisting of 4 easily available biochemical parameters. This kind of scoring system can be easily applied in different dialysis facilities for screening and monitoring of protein wasting. The wide application of body composition monitor in dialysis population will also facilitate the development of specific nutrition scoring model for individual facility.