Applicability of five nutritional screening tools in Chinese patients undergoing colorectal cancer surgery: a cross-sectional study

Xie, Bingxin; Sun, Yefei; Sun, Jian; Deng, Tingting; Jin, Baodi; Gao, Jia

doi:10.1136/bmjopen-2021-057765

Cited by 2 publications

(1 citation statement)

References 42 publications

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“…Due to similar results obtained in patients from the two various departments, the GNRI may have a general application value for nutritional risk screening in elderly surgical patients. Recently, the NRS2002, MNA-SF, Malnutrition Universal Screening Tool (MUST), Malnutrition Screening Tool (MST) and Nutritional Risk Index (NRI) were compared in a Chinese colorectal cancer surgery population (31). Multivariate logistic regression analysis revealed that NRS 2002 ≥ 3 was an independent risk factor for postoperative complications and the strongest predictor of postoperative complications.…”

Section: Discussionmentioning

confidence: 99%

Comparison of four nutritional screening tools in perioperative elderly patients: Taking orthopedic and neurosurgical patients as examples

et al. 2023

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Background and aimsMalnutrition is widely present in elderly surgical patients and is highly correlated with prognosis after surgery. However, studies comparing the effectiveness of comprehensive nutritional screening tools in geriatric surgical patients have not yet been published. The nutritional risk among elderly orthopedic and neurosurgical patients and their associated clinical indicators and outcomes was assessed using four screening tools. The aim of this study was to explore suitable tools for screening the nutritional status and identify their potential to act as prognostic indicators.MethodsThe Nutritional Risk Score 2002 (NRS2002), Mini Nutritional Assessment - Short Form (MNA-SF), Geriatric Nutritional Risk Index (GNRI), and Prognostic Nutritional Index (PNI) were all performed within two days of admission and before surgery. The relationships between nutritional risk classifications and conventional nutritional markers, complications and length of hospital stay (LOS) were evaluated.ResultsIn this study, a total of 167 orthopedic patients and 103 neurosurgical patients were evaluated. In neurosurgical patients, the rates of malnutrition or patients at risk of malnutrition according to the MNA-SF, GNRI, NRS2002 and PNI were 26.4, 24.6, 8.4, and 12.6%, respectively. According to the NRS2002 and PNI, the rates of old neurosurgical patients who were malnourished or at risk of malnutrition were 14.6 and 3.9%, respectively, which were lower than the results assessed by the MNA-SF (24.3%) and GNRI (15.5%). Multiple regression analysis revealed a significant relationship between the PNI (malnourished vs.well-nourished, OR = 5.39, 95% CI:1.11-26.18, P = 0.037), GNRI (at risk vs.no risk, OR = 3.96, 95% CI: 1.01-15.45, P = 0.048) and the complications in orthopedic patients. Only GNRI was significantly related to LOS > 7 days (at risk vs.no risk, OR = 4.01, 95% CI: 1.64-9.80, P = 0.002). For neurosurgical patients, an association between GNRI and LOS > 8 days was discovered (at risk vs.no risk, OR = 3.35, 95% CI: 1.03-10.86, P = 0.002).ConclusionAmong the four nutritional risk screening tools, the GNRI exhibited better predictive value for short-term outcomes in elderly perioperative orthopedic and neurosurgical patients, thereby suggesting that it might be a more suitable tool for nutritional risk screening. Additional studies are required to determine the applicability of GNRI in other surgical fields.

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Section: Discussionmentioning

confidence: 99%

Comparison of four nutritional screening tools in perioperative elderly patients: Taking orthopedic and neurosurgical patients as examples

et al. 2023

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Diagnostic test accuracy of preoperative nutritional screening tools in adults for malnutrition: a systematic review and network meta-analysis

Cheung,

Joynt,

Lee

2023

International Journal of Surgery

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Background: Good nutritional screening tests can triage malnourished patients for further assessment and management by dietitians before surgery to reduce the risk of postoperative complications. We assessed the diagnostic test accuracy of common nutritional screening tools for preoperative malnutrition in adults undergoing surgery and determined which test had the highest accuracy. Methods: MEDLINE, EMBASE, CINAHL and Web of Science were searched for relevant titles with no language restriction from inception till January 1, 2023. Studies reporting on the diagnostic test accuracy of preoperative malnutrition in adults using one or more of the following index nutritional screening tools were included: Malnutrition Screening Tool (MST), Malnutrition Universal Screening Tool (MUST), Mini Nutritional Assessment (MNA), short-form Mini Nutritional Assessment (MNA-SF), Nutritional Risk Index (NRI), Nutrition Risk Screening Tool 2002 (NRS-2002), and Preoperative Nutrition Screening (PONS). The reference standard was the Subjective Global Assessment (SGA) before surgery. Random-effects bivariate binomial model meta-analyses, meta-regressions and a network meta-analysis were used to estimate the pooled and relative sensitivities and specificities. Results: Of 16 included studies (5695 participants with 11,957 index and 11,957 SGA tests), all were conducted after hospital admission before surgery. Eleven studies (n=3,896) were at high risk of bias using the Quality Assessment of Diagnostic Accuracy Studies tool due to a lack of blinded assessments. MUST had the highest overall test accuracy performance (sensitivity 86%, 95% CI 75% to 93%; specificity 89%, 95% CI 83% to 93%). Network meta-analysis showed NRI had similar relative sensitivity (0.93, 95% CI 0.77 to 1.13) but lower relative specificity (0.75, 95% CI 0.61 to 0.92) than MUST. Conclusions: Of all easy-to-use tests applicable at the bedside, MUST had the highest test accuracy performance for screening preoperative malnutrition. However its predictive accuracy is likely insufficient to justify the application of nutritional optimization interventions without additional assessments.

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Applicability of five nutritional screening tools in Chinese patients undergoing colorectal cancer surgery: a cross-sectional study

Cited by 2 publications

References 42 publications

Comparison of four nutritional screening tools in perioperative elderly patients: Taking orthopedic and neurosurgical patients as examples

Comparison of four nutritional screening tools in perioperative elderly patients: Taking orthopedic and neurosurgical patients as examples

Diagnostic test accuracy of preoperative nutritional screening tools in adults for malnutrition: a systematic review and network meta-analysis

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