P267 Outstanding abstract THE ATTITUDE OF THE GERIATRIC NUTRITIONAL RISK INDEX IN ASSESSING THE NUTRITIONAL STATE AND PREDICTING THE OUTCOME OF HOME-CARE RESIDENT ELDERLY: A COMPARISON WITH THE MINI NUTRITIONAL ASSESSMENT

Protein-energy malnutrition is a notable problem in the management of patients with chronic pancreatitis. The effect of malnutrition on pancreatic surgery is not well known. The records of 313 consecutive patients who underwent lateral pancreaticojejunostomy (LPJ, n = 152), pancreaticoduodenectomy (PD, n = 78), or distal pancreatectomy (DP, n = 83) for chronic pancreatitis were retrospectively reviewed and analyzed. Subjective Global Assessment, Nutritional Risk Index, and Instant Nutritional Assessment were used to assess the nutritional state. An average of all three nutritional indexes was established, and patients were categorized into well nourished (n = 101) as well as mild (n = 91), moderate (n = 94), and severe malnourished (n = 27). Poor nutritional state was associated with an increase in postoperative complication rate (LPJ: well nourished 14%, mild 25%, moderate 31%*, severe 50%*; PD: well nourished 44%, mild 44%, moderate 60%, severe 88%*; DP: well nourished 17%, mild 13%, moderate 30%, severe 55%*; * P < 0.045 vs well nourished). Low serum albumin levels also increased operative morbidity. The increase in morbidity was reflected by a higher rate of infectious complications as well as increased ICU stay. Body mass index and weight loss did not contribute to change in outcome. Malnutrition was associated with a higher incidence of postoperative complications after surgery for chronic pancreatitis. An increase in operative morbidity might be related to decreased protein synthesis and impaired immunocompetence.

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AN EVALUATION OF NUTRITIONAL INDEXES FOR TO PREDICTION THE HOSPITALIZATION DURATION IN ELDERLY CHRONIC KIDNEY DISEASE PATIENTS

Journal of Aging Research and Lifestyle ◽

10.14283/jarcp.2016.106 ◽

2016 ◽

pp. 1-4

Author(s):

B. Buyukaydin ◽

A.T. Isik ◽

P. Soysal ◽

M. Alay ◽

R. Kazancioglu

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Nutritional Assessment ◽

Short Form ◽

Risk Index ◽

Mini Nutritional Assessment ◽

Nutritional Risk ◽

Control Group ◽

Dialysis Patients ◽

Nutritional Risk Index

Objective: Chronic kidney disease and malnutrition are serious and frequently encountered co-morbidities among older patients. We evaluated nutritional status of older pre-dialysis patients and the effect of malnutrition on length of stay (LOS) in hospital. Materials and Methods: 65 years and over 33 hospitalized pre-dialysis patients with glomerular filtration rate between 10-30ml/min/1.73m2 were included. There is no control group. For all patients, biochemical analysis was performed. The malnutrition risk was evaluated with Mini Nutritional Assessment Short-Form (MNA-SF) and Geriatric Nutritional Risk Index (GNRI) and LOS in hospital was recorded. Results: Mean GNRI was 98.4±12.9 and the mean MNA-SF was 8±3.15. For all patients, mean LOS was 10.58±9 days. According to MNA-SF, malnourished patients’ LOS was longer and a difference was observed between MNA-SF and GNRI in terms of LOS prediction (p=0.005, p=0.230). Conclusion: For older pre-dialysis patients, MNA-SF is probably a more sensitive index in terms of LOS in hospital prediction.

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Triagem nutricional em adultos hospitalizados

Revista de Nutrição ◽

10.1590/s1415-52732008000500011 ◽

2008 ◽

Vol 21 (5) ◽

pp. 589-601 ◽

Cited By ~ 9

Author(s):

Mariur Gomes Beghetto ◽

Bibiana Manna ◽

Andréia Candal ◽

Elza Daniel de Mello ◽

Carisi Anne Polanczyk

Keyword(s):

Screening Tool ◽

Nutritional Assessment ◽

Risk Index ◽

Mini Nutritional Assessment ◽

Nutritional Risk ◽

Nutritional Screening ◽

Nutrition Risk ◽

Nutritional Risk Index ◽

Assessment Questionnaire ◽

Nutritional Risk Screening

Em hospitais, o objetivo de um procedimento de triagem nutricional é identificar indivíduos desnutridos ou em risco de desnutrição, possibilitando intervenção nutricional precoce e melhor alocação de recursos. Diferentes métodos são apresentados na literatura para esta finalidade: Malnutrition Screening Tool, Short Nutritional Assessment Questionnaire, Nutritional Risk Index, Nutrition Risk Score, Nutritional Risk Screening, Mini Nutritional Assessment, Malnutrition Universal Screening Tool, Nutritional Screening Tool, Nutritional Screening Equation. No entanto, o emprego de muitos destes instrumentos está limitado pela inadequada metodologia empregada na derivação e/ou validação, pela seleção de grupos específicos de pacientes, pela pouca praticidade ou por necessidade de um especialista para seu emprego. Na ausência de um padrão de referência para emitir o diagnóstico nutricional, desfechos clínicos relevantes devem balizar a derivação e a validação de novos instrumentos. Este trabalho descreve os instrumentos de triagem nutricional acima referidos e apresenta considerações quanto ao seu emprego para adultos hospitalizados não selecionados.

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Relationship between Low Pretreatment Geriatric Nutritional Risk Index and Poor Tolerability of Azacitidine in Patients with Myelodysplastic Syndromes

Annals of Nutrition and Metabolism ◽

10.1159/000513542 ◽

2020 ◽

Vol 76 (6) ◽

pp. 405-412

Author(s):

Dan Kanehira ◽

Masayoshi Koinuma ◽

Toshiaki Kato ◽

Tomoya Abe ◽

Atsunobu Sagara ◽

...

Keyword(s):

Myelodysplastic Syndromes ◽

Assessment Tool ◽

Nutritional Assessment ◽

Risk Index ◽

Nutritional Risk ◽

International Prognostic Scoring System ◽

Geriatric Nutritional Risk Index ◽

Factors Associated ◽

Number Of Patients ◽

Nutritional Risk Index

Background: Predicting tolerability and treatment-related risks associated with azacitidine (AZA) in patients with myelodysplastic syndromes (MDS) before the initiation of therapy is required for appropriate treatment. Thus, in this study, the nutritional status of patients with MDS prior to AZA treatment was evaluated using the geriatric nutritional risk index (GNRI). Tolerability and overall survival (OS) after AZA initiation were also investigated. Methods: This was a single-center retrospective observational study. A total of 59 patients with MDS treated with AZA were assessed using GNRI, and a comparison of undernourished (GNRI <92, n = 27) and non-undernourished (GNRI ≥92, n = 32) patients was performed. Results: The undernourished group had a significant reduction in the number of patients that successfully completed 4 cycles of AZA treatment compared with the non-undernourished group (undernourished group, 11/27 patients, 40.7% vs. non-undernourished group, 24/32 patients, 75.0%; p = 0.009). Factors associated with the difference included karyotype and GNRI. There was also a significant increase in the rate of infectious complications in the undernourished group compared with the non-undernourished group (undernourished group, 33/60 cycles, 55.0% vs. non-undernourished group, 31/92 cycles, 33.7%; p = 0.012). Lastly, a significant reduction in OS was observed in the undernourished group compared with the non-undernourished group (undernourished group, 11.5 months; 95% CI, 5.2–16.7 vs. non-undernourished group, 21.9 months; 95% CI, 13.8–24.0; p = 0.026). Factors associated with OS included both the revised International Prognostic Scoring System (IPSS-R) and GNRI. Conclusions: These results indicate that predicting treatment completion and adverse events in patients with MDS prior to AZA treatment is important. This study suggests GNRI may be a valuable nutritional assessment tool for determining tolerability and OS of AZA treatment.

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