ObjectiveTo investigate the status of undernutrition, nutritional risk as well as nutritional support in patients with gastrointestinal tumor. MethodsIn this prospective cohort study, patients with gastrointestinal tumor were recruited from Septemper 2009 to June 2011. Patients were screened by using Nutritional Risk Screening 2002 (NRS2002) at admission. Data of the nutritional risk, application of nutritional support, complications, and tumor staging were collected. ResultsNine hundred and sixty-one patients with gastrointestinal tumor were recruited, the overall prevalence of nutritional risk was 38.9% (374/961) at admission, 49.2% （176/358） in gastric tumor and 32.8% （198/603） in colorectal tumor, respectively. The highest prevalence was found in stage Ⅳ gastric tumor 〔87.3% (48/55)〕 and colorectal tumor 〔58.8% (50/85)〕 while the lowest prevalence was found in stage ⅡA gastric tumor 〔16.1% (5/31)〕 and stageⅠcolorectal tumor 〔9.8% (6/61)〕. 62.3% (152/244) of gastric tumor patients with nutritional risk while 48.6% (144/296) without nutritional risk received nutritional support. 37.7% (92/244) of colorectal tumor patients with nutritional risk while 51.4% (152/296) without nutritional risk received nutritional support. The ratio of parental nutrition and enteral nutrition was 1.251. The rate of complications in the gastrointestinal tumor patients with nutritional risk was higher than that in the patients without nutritional risk 〔32.4% (121/374) versus 20.4% (120/587), P=0.000 0〕. For the gastrointestinal tumor patients with nutritional risk, the complication rate of the patients with nutritional support was significantly lower than that of the patients without nutritional support 〔27.5% (67/244) versus 40.8% (53/130), P=0.008 6〕. For the gas trointestinal tumor patients without nutritional risk, the complication rate of gastric tumor patients with nutritional support was significantly lower than that of the patients without nutritional support (P=0.039 6), while the complication rate was not significantly different in the colorectal tumor patients with nutritional support or not (P=0.464 7). ConclusionsPatient with gastrointestinal tumor has a high nutritional risk which is related to tumor staging. Patients with nutritional risk have more complications, and nutritional support is beneficial to the patients with nutritional risk by a lower complication rate.
ObjectiveTo introduce the progresses and applications of nutritional status assessment in hospitalized patients. MethodsThe related literatures of nutritional status assessment were reviewed. ResultsThe rates of malnutrition and nutritional risk were high in hospitalized patients worldwide. Traditional nutrition assessment tools were not in common use in all hospitalized patients. All clinical health care workers should use the most suitable tool when faced with different patients. ConclusionAll hospitalized patients should be screened for nutritional risk on admission in order to improve clinical outcomes and reduce overall treatment costs.
ObjectiveTo investigate the nutritional risk, incidence of malnutrition, and clinical application of nutrition support in hospitalized patients with gastric cancer by the nutritional risk screening (NRS) 2002 score summary table. MethodsFrom June 2009 to February 2010, nutritional risk screen and application of clinical nutritional support were carried out in the hospitalized patients with gastric cancer in this hospital. Nutritional risk was assessed case-by-case according to the severity of illness, nutritional status 〔including body mass index (BMI), recent changes in body weight and eating〕 and patients age. NRS ≥3 was accepted as nutritionally at-risk, while NRS lt;3 no nutritional risk; BMI lt;18.5 kg/m2 (or albumin lt;30 g/L) combined with clinical conditions was judged to be malnourished. Results Three hundreds and eighty-six patients were included, 329 of which completed the NRS2002 screening. One hundred and sixty-five patients (50.15%) were at nutritional risk, while another 164 (49.85%) were no nutritional risk. Malnutrition was found in 57 patients (17.33%). By gender, male malnourished patients and nutritionally at-risk patients were accounting for 16.45% (38/231) and 48.05% (111/231) respectively, while female nutritionally at-risk patients and malnourished patients were accounting for 55.1% (54/98) and 19.39% (19/98) respectively, 72.04% (237/329) of the screened patients accepted clinical nutrition support, among which, 115 patients were at nutritional risk, accounting for 69.70% in that group, and 122 patients were no nutritional risk, accounting for 74.39% in that group. ConclusionsThe incidences of malnutrition and nutritionally at-risk in hospitalized gastric cancer patients are high. And irrationality of clinical nutrition support exists. Evidence-based guidelines are required to improve the nutritional status of support.
ObjectiveTo investigate the association between the preoperative nutritional risk and anastomotic leakage following anterior resection for the rectal cancer. MethodsA total of 321 patients with rectal cancer underwent anterior resection in our hospital between January 2008 and December 2013 were retrospectively analyzed. Preoperative nutritional status was evaluated using NRS 2002. Correlation of clinicopathologic characteristics with postoperative anastomotic leakage was evaluated using single factor analysis and Logistic regression model. ResultsAmong the 321 patients, the incidence of postoperative anastomotic leakage was 5.6% (18/321). Single factor analysis showed that the NRS2002 score≥3, clinicalpathologic stage (Ⅲ-Ⅳstage) and distance of tumor from the anal verge were the risk factors of anastomotic leakage after anterior leakage following anterior resection for rectal cancer. Logistic regression analysis revealed that the NRS2002 score (OR=4.125, 95% CI=2.062-7.004), clinicalpathologic stage (OR=3.334, 95% CI=2.062-7.004) and the distance of tumor from the anal verge (OR=2.341, 95% CI=2.559-15.838) were the independent risk factors for anastomotic leakage after anterior leakage following anterior resection for rectal cancer. Conciusions Preoperative NRS2002 score is helpful to predict the risk of anastomotic leakage after anterior resection of rectal cancer. Nutrition education should be strengthened to decrease the morbidity of the anastomotic leakage following anterior resection for the patients who's NRS2002 score≥3.
ObjectiveTo evaluate the impact of using alanyl-glutamine dipeptide on clinical outcome for gastric cancer patients with nutritional risk after total gastrectomy. MethodsThis study was carried out in the period from March to August 2015. The nutritional risk was screened by continuous sampling method in the new hospitalized patients with gastric cancer who would undergo total gastrectomy. The patients were grouped randomly. Alanyl-glutamine was given to the experimental group patients. The clinical data of the two groups were analyzed, such as the laboratory parame-ters of nutritional status and hepatorenal function, complications of surgery, the nutrition-related hospitalization day, etc. ResultsThe preoperative data were consistent in the two groups of the included 40 cases. The results showed, in the third and seventh days after surgery, the level of plasma albumin was higher in the experimental group than in the control group〔(33.9±5.6) g/L vs. (30.8±4.0) g/L and (36.6±3.9) g/L vs. (33.9±4.2) g/L, respectively). Also, the CD4+/CD8+ cells immune index was significantly improved in the experimental group after surgery (1.7±0.7 vs. 1.2±0.3, P < 0.05). The recovery time of intestinal function〔(65.7±5.3) h vs. (71.6±7.2)h, P < 0.01)〕and nutrition-related hospitalization day〔(10.1±1.8) d vs. (11.7±1.9)d, P < 0.01)〕in alanyl-glutamine dipeptide group were shorted than that in the control group. No serious adverse drug reactions were found in the patients during the treatment period. ConclusionApplication alanyl-glutamine to the patients with nutritional risk after total gastrectomy could partly improve clinical outcome indicators.
ObjectiveTo evaluate nutritional risk of patients with esophagus cancer before operation using nutritional risk screening 2002 (NRS2002), and explore the relationship between nutritional risk score and postoperative results. MethodsWe prospectively evaluated the nutritional risk of 225 patients with esophagus carcinoma patients who were admitted in Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine between March 2012 and March 2013 using NRS2002, in accordance with disease severity score, nutritional status score and age score(age≥70 years old score was 1 point, < 70 years old for 0 point). There were 136 males and 89 females with age of 64.0±8.2 years (ranged from 41 to 85 years). Postoperative results include postoperative complications, mortality, and length of hospital stay. ResultsThe number of patients with preoperative score≥3 points was 75 (33.3%), < 3 points was 150 (66.7%). The incidence rate of postoperative complications was 26.7% in the patients with NRS2002 score≥3 points, and was 12.0% in those with NRS2002 score < 3 points(P < 0.05). And the total hospital stay time was longer in the patients with NRS2002 score≥3 points than that with NRS2002 score < 3 points(29.80±7.94 d vs. 15.30±2.05 d, P < 0.05). Logistic regression analysis showed that the preoperative NRS2002, the underlying diseases, and surgical method were risk factors for postoperative complications. ConclusionsPreoperative NRS2002 score≥3 points can predict more postoperative complications and longer hospital stay time in patients with esophagus carcinoma. It indicates that scientific nutrition support is necessary for esophagus carcinoma patients with NRS2002 score≥3 points. NRS2002 can be used as a predictive index of nutritional risk after operation of esophagus carcinoma.
Objective To summarize the nutritional assessment methods for liver cancer patients and their development, and to provide reference for rationally nutritional assessment and nutritional support. Method Domestic and foreign literatures were searched to summarize the nutritional assessment methods for liver cancer patients and their development, in order to determine a practical and feasible assessment method. Results The evaluation validity of traditionally nutritional assessment methods which contained many individual indicators was low. But subjective global assessment (SGA), mini nutritional assessment (MNA), and nutritional risk screening 2002 (NRS-2002) had similar evaluation validity, this 3 kinds of nutritional assessment methods were more suitable for liver cancer patients compared with the traditionally nutritional assessment methods. Conclusion The clinician should simultaneously apply SGA, MNA, NRS-2002, and other comprehensively nutritional assessment methods, as well as related anthropometric and laboratory indexes, to get a more accurate assessment of the nutritional status for patients with liver cancer.
ObjectiveTo evaluate the feasibility of novel coronavirus infection rapid screening tool for liver transplantation donors.MethodsClinical data of 14 cases of organ donation for cardiac death from February 2020 to May 2020 were collected, and risk screening was conducted by using novel coronavirus infection rapid screening tool of liver transplantation donor.ResultsThe risk screening results of 14 donors showed that 9 were at moderate risk and 5 were at low risk. After two negative nucleic acid tests and case discussion, the organ of 9 medium-risk donors could be used. Ten cases were performed the liver transplantion, and all patients recovered smoothly after operation, and no novel coronavirus infection occurred.ConclusionNovel coronavirus rapid screening tool for liver transplantation has shown certain clinical value, which needs to be further verified and improved.
ObjectiveTo analyze the perdictive value of Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) for malnutrition or postoperative complications in children with critical congenital heart disease (CHD).MethodsA total of 875 children with critical CHD who were hospitalized in West China Hospital, Sichuan University form August 2019 to February 2021, including 442 males and 433 females with a median age of 30 (12, 48) months, were assessed by STAMP in Health Information System. Clinical data of postoperative complications were collected.Results(1) Based on World Health Organization Z-score as gold standard, 24.5% had malnutrition risk, and 34.3% were diagnosed with malnutrition. According to STAMP, the children were with medium malnutrition risk of 37.9% and high malnutrition risk of 62.1%. There was a statistical difference of incidence rate of malnutrition and detection rate of STAMP malnutrition risk in gender, age, ICU stay or length of mechanical ventilation (P<0.05); (2) with the optimal cut-off point of 5.5 in STAMP for malnutrition, the sensitivity, specificity, positive predictive value, negative predictive value and area under the curve (AUC) were 68.3%, 84.3%, 48.1%, 88.3% and 0.82, respectively; (3) 12.0% of the children were with postoperative complications; (4) with the optimal cut-off point of 5.5 in STAMP for postoperative complications, the sensitivity, specificity, positive predictive value, negative predictive value and AUC were 83.8%, 73.1%, 18.8%, 99.1% and 0.85, respectively.ConclusionChildren with critical CHD have a higher incidence of malnutrition risk and postoperative complications. STAMP has a good perdictive value for malnutrition or postoperative complications, however, the sensitivity and specificity of STAMP are affected by the gold standard or the cut-off point.
ObjectiveBy mining data from the Database of Colorectal Cancer (DACCA) at West China Hospital of Sichuan University, this study aims to evaluate the relationship between nutritional risk screening (NRS) 2002 scores at initial diagnosis and long-term survival in patients. MethodsThe DACCA database version from November 24, 2023, was selected to compare the clinicopathological data of patients with NRS2002 scores <3 and ≥3, and to explore the impact of NRS2002 scores on survival. ResultsA total of 723 patients were screened, with 585 (80.9%) had NRS2002 scores <3 and 138 (19.1%) had NRS2002 scores ≥3. All 723 patients were followed up, with a follow-up period ranging from 1 to 78 months and a median follow-up time of 34 months. The median survival time for patients with NRS2002 scores <3 was 35 months, while it was 31 months for those with NRS scores ≥3. During the follow-up period, 589 patients (81.5%) survived, including 515 (71.2%) tumor-free survivors and 74 (10.2%) survivors with tumors. There were 134 deaths (18.5%), including 126 cancer-related deaths (17.4%) and 8 non-cancer-related deaths (1.1%). Multivariate logistic regression results showed that after controlling for 6 factors including age, radical surgery, adjuvant therapy, hypertension, differentation, and TNM staging, NRS2002 score was not a factor affecting the survival of colorectal cancer patients (RR=0.98, P=0.875). ConclusionNRS2002 score is not a predictive factor for the survival of colorectal cancer patients, possibly because although patients may have nutritional risks preoperatively, the long-term impact on survival is minimal following surgery and postoperative recovery.