NUTRISCORE: A new nutritional screening tool for oncological outpatients.

OBJECTIVES: The aim of this study was to design a new nutritional screening tool (NUTRISCORE) to detect nutritional risk in outpatients with cancer. METHODS: A multicenter, cross-sectional study was conducted. We randomly selected outpatients receiving onco-specific, palliative, or symptomatic treatment for malignant neoplasms (including solid tumors and hematologic malignancies). These patients were assessed using the NUTRISCORE tool, the Malnutrition Screening Tool (MST), and the Patient-Generated Subjective Global Assessment (PG-SGA) to detect risk for malnutrition. The new tool included questions regarding the cancer site and active treatment. Sensitivity, specificity, and positive and negative predictive values were calculated for NUTRISCORE and MST using the PG-SGA as a reference method. RESULTS: We evaluated 394 patients. According to NUTRISCORE, 22.6% were at risk for malnutrition. The MST detected a risk in 28.2%, and the PG-SGA found that 19% were malnourished or at nutritional risk. Using the PG-SGA as a reference method, the MST had a sensitivity of 84% and a specificity of 85.6%, whereas NUTRISCORE exceeded these values, at 97.3% sensitivity and 95.9% specificity. The better performance of NUTRISCORE as compared with MST was confirmed by the receiver operating characteristic curve analysis, with area under the curve values of 0.95 (95% confidence interval, 0.92-0.98) for NUTRISCORE and 0.84 (95% confidence interval, 0.79-0.89) for the MST. CONCLUSIONS: NUTRISCORE has been found to be a novel, fast, and valid nutritional screening tool for outpatients with cancer. Its simplicity and high level of accuracy in detecting nutritional risk facilitates its applicability.

De tot (el) cor : volúmen 2

Publicación compuesta por 4 volúmenes que pretende informar sobre las preguntas que normalmente se hacen los enfermos del corazón y sus familiares. Este volúmen se centra en la alimentación y su relación con las enfermedades cardiovasculares : comidas, dietas, vinculación con otras enfermedades, etc.

Complicaciones nutricionales después del tratamiento quirúrgico de la obesidad: ¿qué ocurre en el bypass gástrico? / Nutritional deficiencies following bariatric surgery: what happens with gastric bypass?

Fundamento y objetivos: Las deficiencias en macronutrientes y micronutrientes son complicaciones frecuentes de la cirugía de la obesidad. El objetivo de este trabajo es estudiar la repercusión del bypass gástrico en la evolución ponderal y las concentraciones de proteínas, vitaminas y minerales, así como documentar el porcentaje de pacientes que precisan suplementación nutricional. Material y método: Se estudió a 109 pacientes a los que se practicó bypass gástrico antes del 1 de marzo de 2004 y se siguió durante al menos 2 años. Se valoró la evolución del peso, el índice de masa corporal (IMC), la albúmina, la ferritina, el ácido fólico, la vitamina B12, la 25-OH-vitamina D3, vitamina A y vitamina E, a los 0, 6, 12, 18 y 24 meses tras la cirugía. Resultados: El peso y el IMC se estabilizan entre 12 y 18 meses tras la intervención. El porcentaje de sobrepeso perdido a los 6, 12, 18 y 24 meses fue del 53, el 66, el 70 y el 69%, respectivamente. Las concentraciones de ferritina y 25-OH-vitamina D3 fueron significativamente menores que las basales a partir de los 6 meses tras cirugía. El 54,7% de los pacientes requirió ferroterapia oral y el 9,5% recibió hierro vía intravenosa. Al 31,1% se le prescribió vitamina B12 intramuscular y al 31,7%, hidroferol oral a dosis altas. El 10,4% de los pacientes requirió suplementación proteínica y el 7,6%, suplementos de vitamina A. Conclusiones: El bypass gástrico consigue unos buenos resultados ponderales durante los primeros 24 meses después de la intervención. Este período coincide con el de mayores carencias nutricionales, y la ferropenia, la depleción de vitamina B12 y 25-OH-vitamina D3 son las complicaciones nutricionales más frecuentes (AU)

Background and objectives: Deficiencies of vitamins and other nutrients are common complications following bariatric surgery. The aim of this study was to analyze the impact of gastric bypass on weight reduction and analyze protein, vitamin and mineral depletion. Material and method: We studied 109 obese patients in whom gastric bypass was performed before March 2004 and were followed for more than 2 years. We determined weight, body mass index (BMI), serum albumin, ferritin, vitamin B12, folate, 25-OH-vitamin D3, vitamin A and vitamin E at 0, 6, 12, 18 and 24 months following surgery. Results: Weight and BMI nadir occurred at 12 to18 months after gastric bypass. The percentage excess weight loss at 6, 12 18 and 24 months was of 53%, 66%, 70% and 69% respectively. Mean levels of ferritin and 25-OH-vitamin D3 were significantly lower than baseline levels after 6 months following surgery. Oral and parenteral iron supplements were needed in 54.7% and 9.5% of patients respectively. 31.1% of patients received parenteral vitamin B12 and 31.7% high doses of vitamin D supplements. Oral protein supplements and vitamin A supplements were prescribed to 10.4% and 7.6% patients respectively. Conclusions: Gastric bypass showed good weight loss results in the 24 months following surgery. Iron, vitamin B12 and vitamin D3 deficiencies, are the more frequent nutritional complications (AU)