Selection and optimization of nutritional risk screening tools for esophageal cancer patients in China

Wen Dong; Xiguang Liu; Shunfang Zhu; Di Lu; Kaican Cai; Ruijun Cai; Qing Li; Jingjing Zeng; Mei Li

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저자정보: Wen Dong (Southern Medical University) Xiguang Liu (Southern Medical University) Shunfang Zhu (Southern Medical University) Di Lu (Southern Medical University) Kaican Cai (Southern Medical University) Ruijun Cai (Southern Medical University) Qing Li (Southern Medical University) Jingjing Zeng (Southern Medical University) Mei Li (Southern Medical University)

저널정보: 대한지역사회영양학회 Nutrition Research and Practice Nutrition Research and Practice Vol.14 No.1

발행연도: 2020.2

수록면: 20 - 24 (5page)

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BACKGROUND/OBJECTIVES: Malnutrition has multiple impacts on surgical success, postoperative complications, duration of hospital stay, and costs, particularly for cancer patients. There are various nutrition risk screening tools available for clinical use. Herein, we aim to determine the most appropriate nutritional risk screening system for esophageal cancer (EC) patients in China.
SUBJECTS/METHODS: In total, 138 EC patients were enrolled in this study and evaluated by experienced nurses using three different nutritional screening tools, the Nutrition Risk Screening 2002 tool (NRS2002), the Patient-generated Subjective Globe Assessment (PG-SGA), and the Nutrition Risk Index (NRI).We compared sensitivity, specificity, positive and negative likelihood ratios, and Youden index generated by each of the three screening tools. Finally, cut-off points for all three tools were re-defined to optimize and validate the best nutritional risk screening tool for assessing EC patients.
RESULTS: Our data suggested that all three screening tools were 100% sensitive for EC patients, while the specificities were 44.4%, 2.96%, and 59.26% for NRS 2002, PG-SGA, and NRI, respectively. NRI had a higher positive likelihood ratio as well as a higher area under the receiver operating characteristic curve compared to those of NRS 2002 and PG-SGA; although, all three tools had null negative likelihood ratios. After adjusting the cut-off points, the specificity and accuracy for all tools were significantly improved, however, the NRI remained the most appropriate nutritional risk screening system for EC patients.
CONCLUSIONS: The NRI is the most suitable (highest sensitivity and accuracy) nutritional risk screening tool for EC patients. The performance of the NRI can be significantly improved if the cut-off point is modified according to the results obtained using MedCalc software.

#Nutritional risk screening #esophageal cancer #NRI #Youden index

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