期刊
NUTRITION
卷 83, 期 -, 页码 -出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.nut.2020.111072
关键词
Cancer; Malnutrition; Screening; Nutrition assessment; Diagnostic criteria
资金
- Science and Technology Commission of Shanghai Municipality [18495810700]
- Pudong New Area Health and Family Planning Commission [PW2018D-12]
- Shanghai Health and Family Planning Commission [201940113]
The study found that NRS2002 was better correlated with the GLIM diagnostic criteria of malnutrition than MUST, while PG-SGA was too sensitive in detecting nutrition-related deteriorations, resulting in a lower positive predictive value in malnutrition diagnosis.
Objectives: This study aimed to evaluate the diagnostic capacity of the Nutritional Risk Screening 2002 (NRS2002), Malnutrition Universal Screening Tool (MUST), and Patient-generated Subjective Global Assessment (PG-SGA) in light of the Global Leader Initiative onMalnutrition (GLIM) criteria in adult patients with cancer. Methods: A multicenter observational study was conducted. Nutritional screening and assessment were performed at the time of admission to hospitals with the NRS2002, MUST, PG-SGA, and GLIM criteria. Sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratio, and Kappa (K) values were used to evaluate the performance of these tools. Results: Of the 637 included patients, 24.8% and 15.4% of patients were at moderate and high risk of malnutrition, respectively, using the NRS2002 and MUST. The NRS2002 was better correlated to the GLIM criteria with a higher value of Kappa (K = 0.823 vs. 0.596) and area under the receiver operating characteristic curve (K = 0.896 vs. 0.757) than the MUST. Meanwhile, 28.3% of patients were diagnosed as malnourished at the time of admission per the GLIM criteria, and 43.3% were malnourished per the PG-SGA. The PG-SGA had a fair agreement with the GLIM criteria (K = 0.453), revealing a positive predictive value of 52.9% and negative predictive value of 90.6%. Conclusions: The NRS2002 was better correlated with the GLIM diagnostic criteria of malnutrition than the MUST. The PG-SGA was too sensitive to detect nutrition-related deteriorations, leading to a low positive predictive value in the malnutrition diagnosis. Thus, the GLIM criteria could be used to confirm the presence of malnutrition identified by the PG-SGA in adults with cancer. (C) 2020 Elsevier Inc. All rights reserved.
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