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

Abstract

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, cutoff points for all three tools were redefined 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 cutoff 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 cutoff point is modified according to the results obtained using MedCalc software.

Clinical nutrition as part of the treatment pathway of pancreatic cancer patients: an expert consensus

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Development and psychometric evaluation of a Chinese version of auditory hallucination risk assessment scale in patients with a diagnosis of schizophrenia

“…According to the classification of PSYRATS-AH score, there were 96 patients who had high voice-related risk and 60 patients who had low voice-related risk. The area under the curve was then calculated, and the best cut-off score was determined by Youden index (sensitivity + specificity − 1) (Dong et al, 2020). The results showed that the area under the curve was 0.90, the standard error was 0.03, and the 95% confidence interval was 0.85-0.95 (p < .001).…”

Development and Validation of a Nomogram Based on Geriatric Nutritional Risk Index to Predict Surgical Site Infection Among Gynecologic Oncology Patients

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