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KMID : 1034120110040010007
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Journal of Clinical Nutrition
2011 Volume.4 No. 1 p.7 ~ p.15
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Comparison of the Impact of Malnutrition by Nutritional Assessment and Screening Tools on Operative Morbidity after Gastric Cancer Surgery
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Kim Yoon
Kim Won-Gyoung
Lee Hyuk-Joon
Park Mi-Sun
Lee Young-Hee
Kong Seong-Ho
Yang Han-Kwang
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Abstract
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Purpose: This study aimed to evaluate the agreement of Seoul National University Hospital-Nutrition Screening Index (SNUH-NSI) and Nutrition Risk Screening-2002 (NRS- 2002) with patient generated-Subjective Global Assessment (PG-SGA) and the association between nutrition risk determined by these screening tools and operative morbidity after a gastrectomy for gastric cancer.
Methods: This study enrolled 174 patients who had undergone a gastrectomy for gastric cancer at Seoul National University Hospital from March to July 2009. We assessed a nutrition risk by two nutrition screening tools (SNUH-NSI, NRS-2002) and a nutrition assessment tool (PG-SGA) at hospital admission. We collected general patient information, serum albumin level, cholesterol amount, total lymphocyte count, hemoglobin, and body mass index, operative method, hospital stay, and operative morbidity.
Results: The mean age was 59.1±11.6 years, and 8.6% (n=15) of patients were assessed as having severe malnutrition by the PG-SGA. Agreement between the PG-SGA, SNUH-NSI (?=0.498, P＜0.001), and NRS-2002 (?= 0.439, P＜0.001) was moderate. Patients with a high risk of malnutrition by PG-SGA, SNUH-NSI, or those with advanced gastric cancer showed more operative morbidity (P＜0.05). There were no relationships between a high risk of malnutrition by NRS-2002 and operative morbidity. On multivariate analysis, malnutrition by PG-SGA (OR 2.159, 95% CI 0.693∼6.721) or SNUH-NSI (OR 2.630, 95% CI 0.906∼7.638) had a tendency to show higher operative morbidity, but it was not a significant independent risk factor.
Conclusion: Both SNUH-NSI and NRS-2002 had moderate agreement with PG-SGA. Severe malnutrition risk as assessed by SNUH-NSI had an association with operative morbidity as PG-SGA did. SNUH-NSI was expected to be a valuable and efficient screening tool to detect malnutrition risk as much as PG-SGA
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KEYWORD
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Malnutrition, Nutrition screening, Nutrition assessment, Agreement, Operative morbidity
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