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The inconsistency of diagnostic criteria for malnutrition has confused clinicians since the 1980s. After the implementation of disease diagnosis related group payment (DRG) in China's public hospitals, the diagnosis of malnutrition and the correct documentation of nutrition-related diagnosis on the front sheet of medical records are related to the correct classification of the disease group and the medical insurance payment. Therefore, the reliable diagnostic criteria for malnutrition, especially disease-related malnutrition, is urgently needed in clinical practice. In September 2018, The global leadership Iinitiative on malnutrition (GLIM) diagnostic criteria consensus was launched. GLIM aimed to provide the explicit and unified diagnostic criteria for malnutrition in adult hospitalized patients. However, GLIM criteria was based on the voting by nutritional experts and was merely a consensus in nature. The clinical validity of GLIM criteria needs prospective verification, i.e., to demonstrate that patients with malnutrition as per GLIM criteria could have improved clinical outcomes with reasonable nutritional interventions. In November 2020, the article titled Nutritional support therapy after GLIM criteria may neglect the benefit of reducing infection complications compared with NRS 2002 was published on the journal Nutrition. It was the first study comparing nutritional risk screening 2002 (NRS 2002) and GLIM malnutrition diagnostic criteria among Chinese patients for the indication of nutritional support therapy. The clinical effectiveness of the two tools was retrospectively verified as well. Here we discussed the key points of this retrospective study, including the critical research methods, to inform the currently ongoing prospective validation of the GLIM malnutrition diagnostic criteria (the item of reduced muscle mass not included).
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Patients with end-stage liver disease after liver transplantation constantly suffer from malnutrition due to primary diseases and transplantation-related factors. Malnutrition will worsen clinical condition of the patients, increase the incidence of complication, length of hospital stay and medical expense after transplantation, and lower the survival rate. Sufficient nutritional support at all stages of liver transplantation is of significance. Accurate assessment of nutritional status and timely intervention are prerequisites for perioperative nutritional treatment in liver transplantation. In this article, the latest nutritional risk screening indexes and evaluation tools, nutritional support methods and other perioperative nutritional intervention measures for liver transplantation were reviewed, aiming to deepen the understanding and cognition of perioperative nutritional therapy for liver transplantation and provide reference for improving nutritional status and clinical prognosis of liver transplant recipients.
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Objective:To explore the characteristics of the changes in risk score for intensive care unit (ICU) patients during hospitalization by the intelligent calculation method, and to provide evidence for the risk prevention.Methods:In this retrospective study, ICU patients of the Fifth Central Hospital in Tianjin from November 3, 2021 to March 28, 2022 were enrolled and divided into ≥ 14 days group, 10-13 days group, 7-9 days group, and 3-6 days group according to the ICU length of stay. Risk scores assessed by the intelligent calculation method of the ICU patients were collected, including nutritional risk screening 2002 (NRS 2002), Caprini score and Padua score. NRS 2002 score for all patients, Caprini score for surgical patients and Padua score for internal medicine patients were selected. Trends in change of each score were compared between patients admitted to ICU 1, 3, 7 (if necessary), 10 (if necessary), and 14 days (if necessary).Results:A total of 138 patients were involved, including 79 males and 59 females, with an average age of (61.71±18.86) years and an average hospital stay of [6.00 (4.00, 9.25)] days. ① in the group with ICU length of stay ≥ 14 days (21 cases): there was no significant change in the NRS 2002 scores of the patients within 10 days, but the NRS 2002 score was significantly decreased in 14 days as compared with 1 day [3.00 (2.50, 3.50) vs. 4.00 (3.00, 5.00), P < 0.05]; both Caprini and Padua score were increased with prolonged hospital stay and compared with 1 day, the scores at the other time points were significantly increased, especially at 14 days [Caprini score: 5.00 (3.25, 7.00) vs. 2.50 (1.25, 5.50), Padua score: 6.00 (6.00, 7.00) vs. 3.00 (1.00, 3.00), both P < 0.05].② in the group with ICU length of stay from 10-13 days (15 cases): with the prolonged hospital stay, there was no significant change in NRS 2002 score, but both Caprini and Padua score were increased at 3, 7, 10 days, especially at 10 days [Caprini score: 3.00 (2.00, 4.75) vs. 2.00 (0.25, 2.75), Padua score: 5.00 (3.50, 6.00) vs. 2.00 (0.50, 4.00), both P < 0.05].③ in the group with ICU length of stay from 7-9 days (23 cases): compared with 1 day, the NRS 2002 score at 3 days and7 days were decreased, but the Caprini and Padua score were increased, especially at 7 days [NRS 2002 score: 2.00 (1.00, 4.00) vs. 2.00 (2.00, 4.00), Caprini score: 3.00 (2.00, 5.50) vs. 2.00 (0.25, 3.00), Padua score: 5.00 (4.00, 6.00) vs. 2.00 (0, 2.00), all P < 0.05]. ④ in the group with ICU length of stay from 3-6 days (79 cases): compared with 1 day, the NRS 2002 score at 3 days was decreased [NRS 2002 score: 2.00 (1.00, 3.00) vs. 2.00 (1.00, 3.00), P < 0.05], Caprini and Padua score were significantly increased [Caprini score: 3.00 (2.00, 4.00) vs. 2.00 (1.00, 3.00), Padua score: 5.00 (4.00, 5.00) vs. 2.00 (1.00, 3.00), both P < 0.05]. Conclusion:Based on dynamic assessment of intelligent calculation methods, the risk of thrombosis in ICU patients increased with hospital length of stay, and the nutritional risk was generally flat or reducing in different hospitalization periods.
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In the 42 nd and 44 th workshops of CSPEN-nutritional risk-undernutrition-support-outcome-cost effectiveness ratio (NUSOC) multi-center database collaboration group, Jens Kondrup and Henrik Rasmussen described again the application of NRS 2002, the evidence-based basis of NRS 2002 development and the methodology for prospective validation of clinical effectiveness. There is no gold standard for validation. They both considered that malnutrition could be identified as a score of 3 or more for impaired nutritional status in NRS 2002. Although NRS 2002 is simple and easy to be applied, it is not comprehensive enough for malnutrition diagnosis. ASPEN and ESPEN on-line published the Global Leadership (nutritional) Initiative on Malnutrition(GLIM)diagnosis criteria in September 2018. With the gradual implementation of medicare payment based on diagnosis related groups(DRG)in China, the nutritional risk and the malnutrition diagnosis with Chinese version of ICD-10 (2016) code should be recorded in the first page of the medical records. In this terminology interpretations, the terms of nutritional risk screening(NRS 2002.01.016)and malnutrition diagnosis (GLIM-phenotypic criteria 01.028, etiologic criteria 01.029) published in Parenteral and Enteral Nutrition Terminology 2019 are discussed based on the reports given by Kondrup and Rasmussen in Beijing and Zhengzhou.
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Objective To investigate the use of parenteral nutrition preparations in Jiangsu Province,and to provide reference for the standardized management of parenteral nutrition preparations.Methods 720 cases using parenteral nutrition preparations from January 2017 to June 2017 in the department of general surgery of 12 hospitals in Jiangsu province were selected.The rate of nutritional risk screening,the indications of parenteral nutrition,the way of infusion,the rationality and economy of the prescriptions were retrospectively evaluated.The calorie,amino acid content,non-protein calorie/nitrogen ratio,glycolipid ratio and cation concentration of the patients received total parenteral nutrition were calculated.Results The total costs of parenteral nutrition preparations of 720 cases were 1.614 1 millions,and 346 cases did not have the indications for parenteral nutrition.The results of prescription comment showed that only 16 patients were screened for nutritional risk by Nutritional Risk Screening 2002 tool at admission.544 cases were intravenous dripped with amino acid and fat emulsion from peripheral vein.In the 176 total parenteral nutrition prescriptions,there were 39 non-protein calorie/nitrogen ratio cases,15 glycolipid ratio cases,69 cation concentration cases,61 calorie cases and 32 amino acid content cases failing to comply with the recommendation of the guidelines.Only 31 total parenteral nutrition prescriptions were completely reasonable.Conclusion The costs of parenteral nutrition preparations used in hospitals of Jiangsu are high but the rate of rationality is low.Nutrition support team should be established to regulate the use of parenteral nutrition preparations and save medical resources.
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Objective To observe the incidence of malnutrition, the therapeutic effect of nutritional support and the prognosis of patients with chronic obstructive pulmonary disease (COPD) under mechanical ventilation (MV) in patients with different traditional Chinese medicine (TCM) syndrome types and discuss the relationships between these indicators and the differentiation of cold-heat/deficiency-excess syndrome. Methods One hundred and three patients with COPD and MV admitted to Zhuji Hospital of TCM from September 2015 and July 2017 were enrolled, according to the different TCM syndromes, they were divided into an excess-heat syndrome group 42 cases and an asthenia-cold syndrome group 61 cases, and the differences in nutrition indexes and prognosis between the two groups were compared. Results The acute physiology and chronic health evaluationⅡ (APACHE Ⅱ) score, nutritional risk screening 2002 (NRS2002) score and the incidence of malnutrition in excess-heat syndrome group were significantly lower than those in the asthenia-cold syndrome group, while the body mass index (BMI) in excess-heat syndrome group was obviously higher than that in the asthenia cold syndrome group [APACHE Ⅱ score: 20.1±5.4 vs. 22.0±3.4,NRS2002 score: 5.2±0.6 vs. 6.2±0.8, incidence of malnutrition: 61.9% (26/42) vs. 80.3% (49/61), BMI (kg/m2): 22.6±3.8 vs. 19.9±4.8, all P < 0.05]. The levels of albumin (Alb), prealbumin (PA) and transferrin (TF) of the excess-heat syndrome group were higher than those in the asthenia-cold syndrome group, and the differences between the two groups were statistically significant on the 7th day under MV [Alb (g/L): 36.14±2.97 vs. 34.40±3.37, PA (mg/L): 237.67±28.01 vs. 185.34±30.86, TF (g/L): 2.13±0.38 vs. 1.95±0.12, all P < 0.05]. In the excess-heat syndrome group, the percentage of weaning from MV was higher than that of the asthenia-cold syndrome group [85.7% (36/42) vs. 65.6% (40/61)], the 28-day mortality [14.3% (6/42) vs. 31.1% (19/61)] and ICU stay time (days: 9.21±2.96 vs. 11.13±3.96) were lower than those of the asthenia cold syndrome group (all P < 0.05). Conclusion The analysis of TCM differentiation of cold-heat/deficiency-excess syndrome has a certain reference value to realize the changing rules in nutritional status and prognosis of patients with COPD under mechanical ventilation.
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Objective:NRS 2002 nutritoanl risk assessment and PG-SGA scale were used to evaluate the effect of different nutritional treatments on fibula myocutaneous flap reconstruction of mandibular defect postoperative patients,and to find the appropriate timing and method of nutritional support for this kind of patients.Methods:50 cases of fibula myocutaneous flap reconstruction of mandibular defect postoperative patients were divided into two groups according to the nutritional risk assessment and the opinions of the research team including the mixed nutrition support treatment group (SPNS + EN) and the conventional nutrition support treatment group (TEN).The indexes of the patients on the day before surgery and 1,7,13 postoperative days were monitored,including lymphocyte count (LYM),serum albumin (ALB),hemoglobin (HB),potassium (K),sodium (NA),chloride (CL) and nutritional risk screening score (NRS) and other indicators to evaluate therapeutic effect of two groups.Results:The indicators showed no significant differences in the two groups before operation.For K and Na,the levels of the SPN + EN group was higher than that of the TEN group.Hemoglobin (HB) and NRS score on the 13rd day after surgery were statistically different between the two groups (P ＜ 0.05).Besides,Lymphocyte count (LYM) and chloride (CL) on the 1st and 7th after operation showed significant different,too(P ＜ 0.05).Conclusion:By nutritional risk assessment in patients with NRS 2002 before operation,PG-SGA after operation,we corrected the electrolyte and acid-base imbalance,improved stress state of postoperative patients with adjustment of nutritional therapy and intervention to timely and effectively provide plenty of energy and protein.
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OBJECTIVE:To provide reference for strengthening the rational nutritional intervention of patients with malignant tumor. METHODS:From Sept. 2016 to Oct. 2017,191 inpatients diagnosed as malignant tumor in our hospital were targeted. Nutritional support pharmacist used Nutritional Risk Screening 2002 (NRS 2002) and Patient-generated Subjective Global Assessment(PG-SGA)to conduct nutritional status assessment within 48 h of admission;at the same time,nutritional intervention for patients during hospitalization was investigated. RESULTS:Among 191 patients,NRS 2002 score ≥3 (with nutritional risk) was classified in 123 cases,and total incidence of nutritional risk was 64.40％. Totally 129 cases were classified into grade B and C(malnutrition)by PG-SGA,and total incidence of malnutrition was 67.54％. There was statistical significance in the incidence of malnutrition among patients aged below 60 years old and patients aged more than 60 years old(P<0.05). NRS 2002 and PG-SGA showed a consistency of Kappa=0.557 (P<0.001), with moderate consistency degree. Of 191 patients, only 46 received nutritional intervention(only 2 cases received total enteral nutrition),and the overall intervention rate was 24.08％. Among them, the intervention rate of patients with nutritional risk was only 34.15％(42/123), and the intervention rate of patients with malnutrition was 31.78％(41/129). CONCLUSIONS:The incidence of nutritional risk and malnutrition among patients with malignant tumors is high, especially in elderly patients. But clinical nutrition interventions are obviously inadequate and the application rate of enteral nutrition support is low. Therefore,nutritional support pharmacists are required to assist and cooperate with physicians,combined two tools as NRS 2002 and PG-SGA that can promptly and effectively screen patients who already have nutritional risk or malnutrition on admission and comprehensively evaluate their nutritional status, so as to give appropriate nutritional intervention.
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Objective To investigate the prevalence of nutritional risk and malnutrition in hospitalized lung cancer patients in a tertiary A hospital in Chongqing.Methods From December 2013 to July 2017,2 735 consecutive lung cancer patients were admitted to the Department of Pneumology at Daping Hospital for planned anti-cancer treatment.Patients who did not complete a nutritional status assessment and who had repeated admission wcrc excluded from the study.The demographic and tumor characteristics were investigated in the 548 lung cancer inpatients who completed the study.The nutritional risk screening 2002 (NRS 2002) was used to evaluate the nutritional risk.The individual nutritional status was also evaluated using the patient-generated subjective global assessment (PG-SGA) questionnaire,anthropometry measurements and hematological measurements.The physical status was assessed by the Karnofsky performance status (KPS).Results According to the NRS 2002 score,29.56％ (162/548) of the cancer patients had nutritional risk (score ≥3).The prevalence of nutritional risk was 17.39％,15.00％,22.00％ and 36.86％,respectively,for patients with stage Ⅰ,Ⅱ,Ⅲ and Ⅳ lung cancer.Forty-four patients (9.67％) had a body mass index＜ 18.5 kg/m2 and poor general condition,and the prevalence was 6.52％,5.00％,8.67％ and 11.22％,respectively,for stages I,Ⅱ,Ⅲ and Ⅳ.A total of 107 cases (19.53％) had impaired nutritional status (indicated by a severity score of 3 in the NRS 2002).The prevalence by different stages was 10.87％ (stage Ⅰ),5.00％ (stage Ⅱ),14.67％ (stage Ⅲ) and 25.00％ (stage Ⅳ).One hundred and twenty-five patients (22.81％) had PG-SGA scores ≥ 9,with 2.19％,2.50％,12.67％,and 33.33％ of patients in stages Ⅰ,Ⅱ,Ⅲ and Ⅳ having these high scores.The KPS scores were lower in the patients with nutritional risk and malnutrition than in the patients with a normal nutritional status.Conclusions The prevalence of nutritional risk and malnutrition in patients with lung cancer were mediom.Nutritional risk screening and nutritional status assessment should be considered at the time of admission for lung cancer patients in order to ensure better outcomes of treatment.
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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 can-ied 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.
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Objective To investigate the prevalence of nutritional risk,undernutrition and nutritional support among elderly inpatients with coronary heart disease in 11 tertiary A hospitals in China.Methods Records of elderly patients under the age of 90 with coronary heart disease were collected between March 2012 and May 2012 from 11 tertiary A hospitals in China following the direction of diagnosis related group of Beijing government.Results A total of 1 279 consecutive cases were recruited with the average age 74 years old (65-89).The total nutritional risk prevalence was 28.14％ (360/1 279).The prevalence of nutritional risk and nutritional risk score ≥ 5 increased with age.The prevalence of nutritional risk (12.88％ vs.30.08％ vs.42.28％) and nutritional risk scored ≥5 (10.86％ vs.18.61％ vs.27.78％)increased with age.Judging from BMI,most patients were overweight or obese (BMI ≥ 24 kg/m2),accounting for 53.0％ of the total,and prevalence of nutritional risk in this subgroup was 15.12％ (96/635).The prevalence of nutritional risk in patients with normal BMI was 34.24％.The prevalence of undernutrition defined as BMI＜ 18.5 kg/m2 was 4.25％ (51/1 279),among which patients with score ≥ 5 account for 64.7％ (33/51).The prevalence of undernutrition defined as nutritional impairment score =3 was 7.58％ (97/1 279).In patients with nutritional risk,57 were administrated nutrition support (16.6％);in patients without nutritional risk,21 received nutrition support,mostly parenteral nutrition (16 cases,76.2％).In patients with nutritional risk [(79.46± 7.19) years vs.(76.40± 6.16) years],there were statistically significant difference between those who received nutrition support and those who did not in terms of age and the ratio of patients with nutritional risk scored≥5 (35.1％ vs.17.1％) (P =0.001,P=0.002).Conclusions The prevalence of nutritional risk in patients with coronary heart disease was high.The prevalence of undernutrition was low.Prevalence of overweight and obese was high,but there was still nutritional risk in this group of patients.The patients who received nutrition support were older and had high nutritional impairment score,but the indication is not rationale.
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Objective The objectives of this study were to use Nutrition Risk Screening 2002( NRS2002) to conduct nutri-tional assessment research on patients with advanced cancer in our hospital,and to assess the patients′nutritional deficiencies,nutri-tional risk and nutritional support,and to discuss the nutritional status and clinical indicators of patients with different tumor types in order to provide a scientific evidence for individualized nutritional support. Methods Patients with advanced tumors met the require-ments were enrolled from January 2016 to February 2017. Nutritional questionnaires and anthropometry were conducted and recorded the information of measurements and relevant laboratory tests. NRS2002 was used to screen nutritional risk of patients. Results The nutritional insufficiency rate was 19. 54% in 517 patients with advanced cancer and 49. 52% in nutrition risk. The proportion of nutri-tion-free patients receiving nutritional support was 14. 56% ,and the nutritional support patients with nutritional support were 63. 67%.Theaveragelengthofhospitalstaywas(14.43±11.82)daysforpatientswithnutritionalrisk,and(8.29±6.93)daysforpa-tients without nutritional risk. The incidence of nutritional risk in patients with digestive tract cancer was higher than other tumor types. Conclusion As an effective nutritional screening tool,NRS2002 can help clinicians to screen the potential nutritional risk of patients in oncology and provide the basis for patients to develop rational nutrition support.
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Objective:To explore the potential relationship between nutritional risk evaluated by NRS 2002 and the indexes of physical and biochemical parameters.Methods:From January 2015 to December 2015,218 hospitalized patients with chronic obstructive pulmonary disease (COPD) were randomly selected to assess the nutrition risk by using NRS 2002,and the physical examination indexes and biochemical indicators were also collected.The potential correlations between NRS 2002 score and the physical and biochemical parameters were analyzed.Results:The incidence of nutritional risk (the score of NRS 2002 ≥ 3) was 31.7％ in 218 COPD inpatients.Both age and pulmonary function was significantly related to the incidence of nutritional risk (P ＜ 0.05).The relevance also was found between NRS 2002 score and 2 physical indexes (BMI and FFMI) and 2 biochemical indicators (ALB and PA).Conclusion:The frequency of nutritional risk is very high among hospitalized patients with COPD,especially in old patients.NRS 2002 is a suitable nutritional risk screening tool in COPD patients,but a comprehensive nutrition assessment should combine proper nutritional risk screening tool with physical examination indexes and biochemical indicators in clinical applications.
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Objective To investigate the prevalence of nutritional risk and undernutrition of geriatric patients with hip fracture in the department of orthopaedics and analyze the relationship between nutritional risk scores and clinical outcomes.Methods In this prospective cohort study,the baseline demographic data of 235 elderly patients with hip fracture in the department of orthopaedics of Ningbo First Hospital were consecutively recorded from November 2013 to December 2015.The prevalence of nutritional risk and undernutrition,infectious complications,and length of hospital stay were also recorded.The infectious complications and length of hospital stay in patients in different age groups(60-69 years,70-79 years,and ≥80 years)and those with different nutritional risks(<3 points,3-4 points,and ≥5 points)were analyzed.Results All patients without PN EN support during hospitalized durations.The incidence of nutritional risk was 62.98％in 235 elderly patients with hip fracture,twenty patients were undernutritioned by multi-item standard based on Nutritional Risk Screening 2002 nutrition disorder score,and 15 patients were undernutritioned by one-item standard with body mass index.Hip arthroplasty patients had significantly higher nutritional risk than those who had undergone internal fixation(74.04％vs.54.20％,P=0.002).Patients with comorbidities had significantly higher nutritional risk than patients without comorbidities(71.56％vs.55.56％,P=0.011).There were significant differences in infectious complications(2.30％vs.3.91％vs.50.00％)and length of hospital stay[(6.35±0.87)d vs.(8.12±1.13)d vs.(10.85±1.52)d,(8.66±2.06)d vs.(10.45±2.43)d vs.(13.25 ±3.65)d] among patients with different nutritional risks(<3 points,3-4 points,and ≥5 points)(P=0.000).Conclusions Elderly patients with hip fracture has relatatively high nutritional risk.These patients tend to have more complications and longer hospital stay.
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Objective:To investigate the effects of enteral nutrition support in inoperable advanced gastric cancer patients during chemotherapy.Methods:This was a prospective randomized study.A total of 62 patients with advanced gastric cancer were firsted evaluated according to the Nutritional Risk Screening 2002 (NRS 2002) scale,and were randomly divided into two groups.All patients received oxaliplatin combined with tegefur gimeracil oteraci.Patients in the control group (n =30) received chemotherapy along with nutrition consultation,and patients in the treatment group (n =32) were provided enteral nutrition-additionally.NRS 2002 assessment was conducted before and after chemotherapy,The body weight,BMI,serum albumin,and the efficacy and toxicity were collected during the study.Results:Patients in the treatment group had significantly higher serum albumin levels,body weight and BMI than those of the control group (P ＜ 0.05).No differences were found as for the efficacy and toxicity of chemotherapy between two groups.Conclusion:Enteral nutrition support therapy can improve the nutrition status of gastric cancer patients who received chemotherapy and reduce the risk of malnutrition.
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Objective:To clarify whether nutritional risk screening 2002 could be used as a basis for nutritional support for liver surgery patients.Methods:Among the 243 hospitalized patients,61 patients had ≥ 3 NRS 2002 scores,and 41 of them were given nutrition support.The remaining 182 patients scored ＜ 3,and 73 of them were administrated with nutrition support.Results:The incidence of nutritional risk of hospitalized patients in liver surgery was 25 ％.Among the patients at nutritional risk group,67％ were given nutrition support.And the rates of infection related complication were nutritional supported patients significantly lower than that in the no nutrition support group (P ＜ 0.05).Conclusion:Accurate application of NRS 2002 and necessary nutrition support in liver surgery patients could improve nutritional status and clinical outcome.
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Objective To investigate the relationship between nutritional risk and cognitive score in pa-tients with acute stroke .Methods From January 2015 to December 2015, 160 inpatients with acute stroke were observed and divided into two groups according to Nutritional Risk Screening 2002 (NRS 2002) scores.All the patients were on natural diets and did not receive enteral or parenteral nutrition support .Cognitive functions were evaluated using the Mini-Mental State Examination ( MMSE) within 24 hours and 6 months after the acute cere-bral artery diseases .Logistic regression analysis was performed to investigate the effects of nutritional risks on the cognition.Results Totally 145 patients entered the final analysis , among whom 72 had nutritional risks and 73 had no nutritional risks .The average ages of patients with nutritional risks were significantly older than those without nutritional risks [ (67.04 ±8.95) years vs.(63.10 ±9.12) years, P=0.027], along with significantly higher incidence of diabetes (75.0%vs.49.3%, P=0.001).The lesion locations showed no statistically signif-icant difference between two groups ( frontal lobe 24.5%vs.17.5%, P=0.670;parietal lobe and occipital lobe 40.8%vs.26.3%, P=0.398;basal ganglia region 51.0%vs.49.1%, P=0.490;brain stem and cerebellum 53.0%vs.42.1%, P=0.777).Compared to the patients without nutritional risks , the MMSE scores of the pa-tients with nutritional risks were lower within 24 hours, but without statistical significance (27.45 ±2.21 vs. 28.09 ±1.27, P=0.209);however, six-month follow-up showed that the MMSE scores were significantly differ-ent between two groups (24.70 ±2.16 vs.27.43 ±2.32, P=0.036).Univariate Logistic regression analysis was used to evaluate factors associated with cognitive impairment (MMSE<27).NRS 2002, ages, diabetes mellitus history, and body mass index entered in the Logistic regression analysis .In all patients, ages and NRS 2002 had a positive correlation with cognitive impairment (P=0.000, OR=1.156;P=0.004, OR=2.341).Conclusion The cognitive function in stroke patients with nutritional risks is worse than in patients without nutritional risks .
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Objective To investigate the rates of undernutrition and nutritional risks of surgical pa-tients with pancreatic tumors .Methods Totally 121 surgical patients with pancreatic tumors from Depart-ment of Surgery Beijing Hospital were enrolled in a prospective study during January 2014 to December 2015 . Patients were divided into two groups:the pancreatic cancer group ( n=90 ) and other pancreatic tumor group ( n=31 ) .Nutritional Risk Screening 2002 was used to assess the nutritional status .Other data including an-thropometric measure, body composition, blood biochemistry and clinical outcome were collected and ana-lyzed.Results Among 121 patients, the mean age was ( 61.9 ±13.6 ) years, the mean body mass index was ( 23.20 ±2.95) kg/m2 , the mean mid-upper circumference was ( 28.8 ±3.5 ) cm, the mean muscle weight was (44.6 ±7.4) kg, and the mean fat mass was (16.8 ±7.6) kg .There was no significantly differ-ence in anthropometric measurement results and body compositions between two groups ( all P>0.05 ) .In the pancreatic cancer group, albumin [ (39.0 ±4.7) g/L vs. (42.3 ±2.9) g/L, P<0.001], total protein [ (62.8 ±6.2) g/L vs.(66.3 ±2.9) g/L, P<0.001], and prealbumin [ (136.1 ±85.4) mg/L vs. (197.8 ±112.6 ) mg/L, P=0.011 ] were significantly lower than those in the other pancreatic tumor group and a higher fasting blood-glucose [ (6.45 ±2.47) mmol/L vs.(4.95 ±0.79) mmol/L, P<0.011] was found.Among all patients , the rates of undernutrition and nutritional risk were 4.1% and 78.5%, and the pancreatic cancer group had a higher rate of nutritional risk (91.1% vs.38.7%,χ2 =36.525, P<0.001). Conclusion In this prospective study , surgical patients with pancreatic cancer have a high incidence of nutri -tional risk, with low protein level and abnormal glucose metabolism .
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Objective:The present study was aimed to evaluate the nutritional risk using nutritional risk screening 2002 (NRS2002) score and to investigate the impact of nutrition support on clinical outcome in hospitalized patients.Methods:Six hundred and ninety four hospitalized patients were recruited.NRS 2002 was applied to evaluate the nutritional risk of patients.Meanwhile,the effect of nutrition support on complication rate was evaluated between different types of patients.Results:14.0％ of patients had malnutrition and the incidence of nutritional risk was 27.5％.Patients with nutritional risk had a higher complication rate (P ＜0.01).Totally,22.0％ (153/694) patients received nutrition support,including 81.7％ patients with nutritional risk and 18.3％ patients without nutritional risk.Patients with nutritional risk benefited from nutrition support,as shown by lower complication rate and shorter length of hospital stay.In patients with nutritional risk,complication rate was lower in enteral fed patients compared to parenteral fed patients.Conclusion:With nutritional risk screening,patients' nutritional status can be evaluated and appropriate nutrition support can be performed.Compared to those without nutritional risk,patients with nutritional risk will benefit more from nutrition support,as indicated by lower complication rate and reduced length of hospital stay.
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Objective@#To evaluate changes in nutritional status of hospitalized patients with different diseases by subjective global assessment (SGA) and nutritional risk screening (NRS-2002).@*Methods@#A prospective and parallel research done by multi-center collaboration from 34 hospitals in China from June to September 2014. Hospitalized patients with the following diseases were investigated: malignant tumor (2 487 cases), benign disease of the digestive system (1 358 cases), benign disease of the nervous system (1 043 cases), benign bone disease (451 cases), benign disease of the respiratory system(395 cases), cardiovascular disease (227 cases), benign thyroid and breast disease (179 cases), and endocrine disease (149 cases). Patients above the age of 18 and hospitalization time between 7-30 days were included. Physical indexes were measured, the NRS-2002 and SGA scores were recorded, the nutritional support were recorded during hospitalization and 24 hours after discharge from hospital. Measurement data between groups were analyzed using t test or Wilcoxon rank sum test, enumeration data and ranked data between groups were analyzed using chi-square test or Fisher exact test.@*Results@#There were 6 638 cases of hospitalized patients, 3 861 cases were males and 2 777 were females, the male/female ratio was 1.4∶1.0; the median age was 60 years; the median height was 1.66 m; the median weight was 62 kg; the median body mass index (BMI)was 22.89 kg/m2. At discharge, compared with that of admission, the body weight, BMI, grip strength, upper arm and calf circumferences of patients with malignant tumor were significantly decreased (t=20.15-259.67, all P<0.01); the body weight and calf circumference were significantly decreased (t=35.27, 60.40, P<0.01)of patients with digestive benign disease; the body weight of patients with benign bone diseases was decreased (t=2.12, P=0.033); the body weight, grip strength and upper arm circumference were decreased in patients with benign thyroid and breast disease (t=2.79-10.18, all P<0.01); nutritional risk incidence rate (from NRS-2002) of patients with malignant tumor was significantly higher(χ2=21.275, P=0.000); moderate malnutrition (from SGA) incidence rate was significantly higher(χ2=62.318, P=0.000; χ2=11.312, P<0.01) in patients with malignant tumor and with orthopedics diseases. Compared with that of admission, records of the patients with other diseases had no statistically difference at discharge, no more than 50% of the patients under risk of nutritional deficiency(except those with digestive benign diseases )received nutritional support, while the proportion of non-parenteral nutrition application was higher.@*Conclusion@#The patients with malignant tumor have higher incidence rate of malnutrition on admission and 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.