J Korean Soc Parenter Enter Nutr.  2011 Dec;4(1):7-15.

Comparison of the Impact of Malnutrition by Nutritional Assessment and Screening Tools on Operative Morbidity after Gastric Cancer Surgery

• Kim Y
• Kim WG
• Lee HJ
• Park MS
• Lee YH
• Kong SH
• Yang HK

Abstract

PURPOSE
This study aimed to evaluate the agreement of Seoul National University Hospital-Nutrition Screening Index (SNUH-NSI) and Nutrition Risk Screening-2002 (NRS-2002) with patient generated-Subjective Global Assessment (PG-SGA) and the association between nutrition risk determined by these screening tools and operative morbidity after a gastrectomy for gastric cancer.
METHODS
This study enrolled 174 patients who had undergone a gastrectomy for gastric cancer at Seoul National University Hospital from March to July 2009. We assessed a nutrition risk by two nutrition screening tools (SNUH-NSI, NRS-2002) and a nutrition assessment tool (PG-SGA) at hospital admission. We collected general patient information, serum albumin level, cholesterol amount, total lymphocyte count, hemoglobin, and body mass index, operative method, hospital stay, and operative morbidity.
RESULTS
The mean age was 59.1+/-11.6 years, and 8.6% (n=15) of patients were assessed as having severe malnutrition by the PG-SGA. Agreement between the PG-SGA, SNUH-NSI (kappa=0.498, P<0.001), and NRS-2002 (kappa=0.439, P<0.001) was moderate. Patients with a high risk of malnutrition by PG-SGA, SNUH-NSI, or those with advanced gastric cancer showed more operative morbidity (P<0.05). There were no relationships between a high risk of malnutrition by NRS-2002 and operative morbidity. On multivariate analysis, malnutrition by PG-SGA (OR 2.159, 95% CI 0.693~6.721) or SNUH-NSI (OR 2.630, 95% CI 0.906~7.638) had a tendency to show higher operative morbidity, but it was not a significant independent risk factor.
CONCLUSION
Both SNUH-NSI and NRS-2002 had moderate agreement with PG-SGA. Severe malnutrition risk as assessed by SNUH-NSI had an association with operative morbidity as PG-SGA did. SNUH-NSI was expected to be a valuable and efficient screening tool to detect malnutrition risk as much as PG-SGA.

Keyword

Malnutrition; Nutrition screening; Nutrition assessment; Agreement; Operative morbidity

MeSH Terms

Body Mass Index
Cholesterol
Gastrectomy
Humans
Length of Stay
Lymphocyte Count
Malnutrition*
Mass Screening*
Multivariate Analysis
Nutrition Assessment*
Risk Factors
Seoul
Serum Albumin
Stomach Neoplasms*
Cholesterol
Serum Albumin