Patient-Generated Subjective Global Assessment (PG-SGA) predict Length of hospital stay in lung adenocarcinoma patients

The prevalence of malnutrition is high among oncology patients in Northern China. Malnutrition is related to the longer hospital stay, and it can be used to predict the prognostic outcome of patients. This work focused on investigating the relationship of nutritional condition with the length of hospital stay (LOS) in Northern Chinese patients with lung adenocarcinoma. The PG-SGA, Nutritional Risk Screening 2002 (NRS 2002) score, recent weight loss and BMI were assessed in a probabilistic sample of 389 lung adenocarcinoma patients without EGFR mutations. This study collected the demographic and clinical features of patients in a prospective manner. Then, we examined the association of nutritional status with LOS among the population developing lung adenocarcinoma. According to the PG-SGA, 63 (16.3%), 174 (44.7%) and 78 (20.1%) patients were at risk for undernutrition, moderate undernutrition and severe undernutrition, respectively. Nutritional risk was found in 141 (36.2%) patients based on the NRS 2002. The average LOS for tumor patients in Northern China was 12.5 days. At admission, a risk of undernutrition or undernutrition according to the PG-SGA (P<0.001), NRS 2002 (P<0.001), and latest weight loss (P<0.001) predicted the longer LOS. Length of stay was related to nutritional status and hospitalization expenses (P<0.001). Lung adenocarcinoma patients who stayed in the ICU had a poorer nutritional status and a longer LOS (P<0.001). In Northern Chinese patients with lung adenocarcinoma, a risk for undernutrition evaluated by the PG-SGA, the NRS2002 and recent weight loss, but not BMI, could predict a longer LOS.

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A study of nutritional status, development of malnutrition and food consumption in hospitalized patients

International Journal of Emerging Trends in Health Sciences ◽

10.18844/ijeths.v3i2.4487 ◽

2019 ◽

Vol 3 (2) ◽

pp. 66-80

Author(s):

Anil Evrim Gungor ◽

Perihan Arslan ◽

Osman Abbasoglu

Keyword(s):

Weight Loss ◽

Nutritional Status ◽

Hospitalized Patients ◽

Nutritional Risk ◽

Food Services ◽

Hospital Malnutrition ◽

Arm Circumference ◽

Nrs 2002 ◽

Mid Upper Arm Circumference ◽

Nutritional Risk Screening

Purpose: To investigate the nutritional status of patients on admission and during hospital stay, the factors leading to weight loss, and to evaluate patient satisfaction of hospital food. Methods: On admission, Nutritional Risk Screening (NRS-2002), weight, height, Body Mass Index (BMI), mid upper arm circumference (MAC) measurements were carried out; serum total protein and albumin levels were recorded. Upon discharge, measurements of weight, MAC were repeated, along with a food satisfaction questionnaire. Results: Patients with NRS-2002>3, BMI<20, were classified as nutrionally at risk which were 43.6% and 9.4% respectively. Of the patients, 77% lost weight (2.6Â±1.9 kg). Patients who were determined to be malnourished on admission by BMI and NRS-2002 stayed longer in hospital (p<0.0 and p<0.001, respectively). The relationships between weight loss and lenght of stay, use of medications and period of starvation were significant (p<0.0001, for each). Of the patients, 49.9% did not satisfy with the hospital food. Conclusions: Nutritional status of hospitalized patients should be screened with NRS-2002, assessed and monitored. Keywords: NRS-2002, hospital malnutrition, hospital food services

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Acute Diverticulitis Is at Significant Risk of Malnutrition: an Analysis of Hospitalized Patients in a Medicine Department

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld-561 ◽

2020 ◽

Vol 28 ◽

pp. 53-56

Author(s):

GianMarco Giorgetti ◽

Federica Fabiocchi ◽

Giovanni Brandimarte ◽

Antonio Tursi

Keyword(s):

Nutritional Status ◽

Hospital Stay ◽

Large Scale ◽

Acute Diverticulitis ◽

Significant Risk ◽

Length Of Hospital Stay ◽

Tertiary Hospital ◽

Hospitalized Patients ◽

Nutritional Risk ◽

Medicine Department

Background and Aim: The Nutritional Risk Security (NRS2002) System is recommended for hospitalized patients in order to assess their nutritional status. However, studies assessing large-scale systematic screening policies are lacking. The aim of this study was to assess the feasibility of implementing a screening strategy concerning all admissions for diverticular disease (DD) of the colon in the Department of Medicine of a Tertiary Hospital. Methods: All patients suffering from acute diverticulitis (AD) and admitted to the Medicine Department from January 1st to 31 December 2017, were pre-screened by NRS2002 System by the nursing staff of the Nutritional team at the day of the admission. If the pre-screening was positive, the patients were referred to a supplementary assessment performed by a dietician. Results: The global number of admissions in the observational period was 4,667 and 133 patients suffered from AD. A positive pre-screening test was recorded in 97 (72.9%) patients: a NRS2002 score > 3, describing a severe impaired nutritional status was found in 61 patients (62.9%). All 97 patients with a NRS2002 positive screening received initial nutritional support by oral supplements (17 patients, 17.52%) or enteral nutrition (22 patients, 22.68%) or total parenteral nutrition (58 patients, 59.8%). The mean length of hospital stay for all 133 patients was 6,9 days. However, the length of hospital stay was significantly longer for patients with a positive NRS2002, with a mean of 18 days (p= 0.01) Conclusions: A large number of hospitalized patients due to AD are at nutritional risk and have a significantly longer hospital stay.

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Nutritional Profile of Patients with Colorretal Cancer Candidates for Big Surgery (P05-035-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz030.p05-035-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Ana Paula Rocha Trotte ◽

Rosana Oliveira Macedo ◽

Thaiza Fragoso Nunes ◽

Danielly Rodrigues Wassita da Rocha ◽

Maria Eliza De Gouvêa Marti Ferrão

Keyword(s):

Colorectal Cancer ◽

Weight Loss ◽

Nutritional Status ◽

Nutritional Assessment ◽

Nutritional Risk ◽

Cross Sectional ◽

Nutritional Profile ◽

Funding Sources ◽

Nrs 2002

Abstract Objectives To identify the nutritional profile of adult and elderly patients with colorectal cancer admitted to a Proctology ward for large elective surgeries. Methods A cross-sectional and retrospective study was performed with 31 patients of both genders, aged 39 to 77 years with colorectal cancer. The nutritional screening parameters used were the percentage of weight loss and Nutrition Risck Screening (NRS 2002). The data (percentage of weight loss and NRS 2002) were collected through a nutritional assessment form completed in the care routine, applied within 72 hours after the patient's hospitalization. Results The study included 13 adults (41.9%) and 18 elderly (58.1%). The evaluation of the percentage of weight loss showed that 7 patients (22.5%) had weight loss greater than 15% in a period of less than or equal to 6 months. In the nutritional risk assessment based on the NRS 2002, we observed that 9 patients (29%) scored 2, while 22 patients (71%) achieved a score equal to or greater than 3. Conclusions The nutritional profile of the evaluated patients showed a considerable prevalence of malnutrition, considering a weight loss of more than 15% in a period of 6 months, which is associated to a decrease in survival in patients with cancer, and is a very relevant data to help in the classification of nutritional status. The classification by the NRS 2002, showed a high prevalence of patients at nutritional or malnourished risk. Variation in the classification of nutritional status using several parameters reinforces the need for them to be used in a complementary way. Funding Sources Hospital Federal dos Servidores do Estado, Ministerio da Saude.

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Clinical and nutritional status of surgical patients with and without malignant diseases: cross-sectional study

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032011000100012 ◽

2011 ◽

Vol 48 (1) ◽

pp. 58-61 ◽

Cited By ~ 9

Author(s):

Vânia Aparecida Leandro-Merhi ◽

José Luiz Braga de Aquino ◽

José Gonzaga Teixeira de Camargo ◽

Patrícia Baston Frenhani ◽

Júlia Laura Delbue Bernardi ◽

...

Keyword(s):

Body Mass Index ◽

Weight Loss ◽

Nutritional Status ◽

Hospital Stay ◽

Body Mass ◽

Lymphocyte Count ◽

Length Of Hospital Stay ◽

Surgical Patients ◽

Malignant Diseases ◽

Hospital Stays

CONTEXT: Malnutrition is frequently observed in inpatients with malignant diseases and may contribute to longer hospital stays. OBJECTIVE: To compare the nutritional status, lymphocyte count, hemoglobin values and length of hospital stay of patients with and without malignant diseases. METHODS: This comparative study assessed indicators of nutritional status, namely body mass index, recent weight loss, lymphocyte count, hemoglobin and length of hospital stay, of 928 surgical patients with and without malignant diseases (50.2% females and 49.8% males). The chi-square test was used to compare proportions and the Mann-Whitney test was used to compare continuous measurements between two groups. The significance level was set at 5%. RESULTS: Patients with malignant diseases had longer hospital stays (P<0.0001), furthermore, a higher percentage of patients with malignant diseases had body mass index <18.5 (P<0.0001) and experienced recent weight changes (P<0.0002). Lymphocyte count also differed statistically between the groups (P = 0.0131), which lower levels were identified among patients with malignant diseases. CONCLUSION: The lymphocyte count, hemoglobin values and weight loss are important findings of nutritional depletion in patients with malignant diseases.

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Length of stay in surgical patients: nutritional predictive parameters revisited

British Journal Of Nutrition ◽

10.1017/s0007114512001134 ◽

2012 ◽

Vol 109 (2) ◽

pp. 322-328 ◽

Cited By ~ 16

Author(s):

Ana Isabel Almeida ◽

Marta Correia ◽

Maria Camilo ◽

Paula Ravasco

Keyword(s):

Weight Loss ◽

Length Of Stay ◽

Nutritional Status ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Nutritional Risk ◽

Surgical Patients ◽

Anthropometric Parameters ◽

Predictive Parameters ◽

Nrs 2002

Nutritional evaluation may predict clinical outcomes, such as hospital length of stay (LOS). We aimed to assess the value of nutritional risk and status methods, and to test standard anthropometry percentilesv.the 50th percentile threshold in predicting LOS, and to determine nutritional status changes during hospitalisation and their relation with LOS. In this longitudinal prospective study, 298 surgical patients were evaluated at admission and discharge. At admission, nutritional risk was assessed by Nutritional Risk Screening-2002 (NRS-2002), Malnutrition Universal Screening Tool (MUST) and nutritional status by Subjective Global Assessment (SGA), involuntary % weight loss in the previous 6 months and anthropometric parameters; % weight loss and anthropometry were reassessed at discharge. At admission, risk/undernutrition results by NRS-2002 (P< 0·001), MUST (P< 0·001), % weight loss (P< 0·001) and SGA (P< 0·001) were predictive of longer LOS. A mid-arm circumference (MAC) or a mid-arm muscle circumference (MAMA) under the 15th and the 50th percentile, which was considered indicative of undernutrition, did predict longer LOS (P< 0·001); conversely, there was no association between depleted triceps skinfold (TSF) and longer LOS. In-hospital, there was a high prevalence of weight, muscle and fat losses, associated with longer LOS. At discharge, patients with a simultaneous negative variation in TSF+MAC+MAMA (n158, 53 %) had longer LOS than patients with a TSF+MAC+MAMA positive variation (11 (8–15)v.8 (7–12) d,P< 0·001). We concluded that at risk or undernutrition evaluated by all methods, except TSF and BMI, predicted a longer LOS. Moreover, MAC and MAMA measurements and their classification according to the 50th percentile threshold seem reliable undernutrition indicators.

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Nutritional risk in hospitalized patients: impact of nutritional status on serum prealbumin

Revista de Nutrição ◽

10.1590/s1415-52732011000100009 ◽

2011 ◽

Vol 24 (1) ◽

pp. 89-98 ◽

Cited By ~ 8

Author(s):

Bulent Saka ◽

Gulistan Bahat Ozturk ◽

Sami Uzun ◽

Nilgun Erten ◽

Sema Genc ◽

...

Keyword(s):

Weight Loss ◽

Nutritional Status ◽

Hospital Stay ◽

Predictive Value ◽

Global Assessment ◽

Nutritional Support ◽

Length Of Hospital Stay ◽

Subjective Global Assessment ◽

Risk Screening ◽

Nutrition Risk

OBJECTIVE: Poor recognition and monitoring of nutritional status is the most important cause of malnutrition in hospitalized patients. The aim of this study was to assess the nutritional status of a group of patients and compare the results with their serum prealbumin levels. METHODS: Ninety-seven patients admitted consecutively to the hospital were enrolled in the study. The risk of malnutrition was assessed according to anthropometric data and the Subjective Global Assessment and Nutrition Risk Screening 2002 tools. The nutritional statuses of the patients were compared with their age, gender, body mass index, medical history, weight loss and routine biochemical analyses, including prealbumin and length of hospital stay. RESULTS: According to the Nutrition Risk Screening 2002, 57% of the patients were malnourished or at risk of malnutrition, correlating well with the Subjective Global Assessment (p<0.001, r=0.700). Multivariate analysis revealed positive correlations between malnutrition and age, weight loss, malignancy and serum C-reative protein (p=0.046, p=0.001, p=0.04 and p=0.002). Nutrition Risk Screening 2002 score ³3 was associated with prolonged length of hospital stay (p=0.001). Serum prealbumin correlated with nutritional status, regardless of the number of chronic diseases and inflammation biomarkers (p=0.01). Serum prealbumin sensitivity, specificity, positive predictive value, negative predictive value and diagnostic value in the assessment of risk of malnutrition were 94%, 32%, 0.67, 0.78 and 69 respectively. After 7 days of nutritional support, the risk of malnutrition decreased by 12% (p<0.001) and serum prealbumin levels increased by 20% (p=0.003). CONCLUSION: Instead of reflecting overall nutritional status, low serum prealbumin may be regarded as a sign of increased risk of malnutrition, requiring further nutritional assessment. It can be used for monitoring patients receiving nutritional support.

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Clinical and Seasonal Variations of Nutritional Risk Screening in Patients Scheduled for Rehabilitation after Heart Surgery

The Heart Surgery Forum ◽

10.1532/hsf98.2013240 ◽

2013 ◽

Vol 16 (6) ◽

pp. 336

Author(s):

Marko Boban ◽

Viktor Persic ◽

Zeljko Jovanovic ◽

Niksa Drinkovic ◽

Milan Milosevic ◽

...

Keyword(s):

Weight Loss ◽

Heart Surgery ◽

Nutritional Risk ◽

Risk Scores ◽

Risk Screening ◽

Climate Effects ◽

Seasonal Climate ◽

Nrs 2002 ◽

The Impact ◽

Nutritional Risk Screening

Background: Current knowledge on the pervasiveness of increased nutritional risk in cardiovascular diseases is limited. Our aim was to analyze the characteristics of nutritional risk screening in patients scheduled for rehabilitation after heart surgery. Prevalence and extent of nutritional risk were studied in connection with patients' characteristics and seasonal climate effects on weight loss dynamics.Methods: The cohort included 65 consecutive patients with an age range of 25-84 years, 2-6 months after surgical treatment for ischemic or valvular heart disease. Nutritional risk screening was appraised using a standardized NRS-2002 questionnaire. Groups were analyzed according to a timeline of rehabilitation according to the "cold" and "warm" seasons of the moderate Mediterranean climate in Opatija, Croatia.Results: Increased nutritional risk scores (NRS-2002) of >3 were found in 96% of studied patients. Mean NRS-2002 of patients was 5.0 � 1.0, with a percentage weight loss history of 11.7% � 2.2% (4.6-19.0). Risk was found to be more pronounced during the warmer season, with NRS-2002 scores of 5.3 � 0.7 versus 4.8 � 1.1 (P = 0.136) and greater loss of weight of 13.0% � 3.2% versus 10.6% � 3% (P = 0.005), respectively. Increased nutritional risk correlated significantly with creatinine concentrations (rho = 0.359; P = 0.034 versus 0.584; P = 0.001, respectively). Significant discordance in correlations was found between NRS-2002 and the decrease in left ventricle systolic function (rho correlation coefficient [rho-cc] = -0.428; P = 0.009), the increase in glucose concentrations (cc = 0.600; P < 0.001), and the decrease in erythrocyte counts (cc = -0.520; P = 0.001) during the colder season.Conclusion: Increased nutritional risk was found to be frequently expressed in the course of rehabilitation after heart surgery. Although seasonal climate effects influenced the weight loss dynamics, the impact on reproducibility of NRS-2002 was clinically less important. Further studies on the connection of nutritional risk with composited end points might offer improvements in overall quality of treatment.

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565 POST-OPERATIVE WEIGHT LOSS AND OUTCOMES FOLLOWING ESOPHAGECTOMY

Diseases of the Esophagus ◽

10.1093/dote/doaa087.148 ◽

2020 ◽

Vol 33 (Supplement_1) ◽

Author(s):

R Khaw ◽

S Munro ◽

J Sturrock ◽

H Jaretzke ◽

S Kamarajah ◽

...

Keyword(s):

Weight Loss ◽

Length Of Stay ◽

Hospital Stay ◽

Enhanced Recovery ◽

Length Of Hospital Stay ◽

Failure To Thrive ◽

Post Discharge ◽

Postoperative Weight Loss ◽

Poor Outcomes ◽

The Impact

Abstract Oesophageal cancer is the 11th most common cancer worldwide, with oesophagectomy remaining the mainstay curative treatment, despite significant associated morbidity and mortality. Postoperative weight loss remains a significant problem and is directly correlated to poor prognosis. Measures such as the Enhanced Recovery After Surgery (ERAS) programme and intraoperative jejunostomy feed have looked to tackle this. This study investigates the impact of these on mortality, length of hospital stay and postoperative weight loss. Methods Patients undergoing oesophagectomy between January 1st 2012—December 2014 and 28th October 2015–December 31st 2019 in a national tertiary oesophagogastric unit were included retrospectively. Variables measured included comorbidities, operation, histopathology, weights (pre- and post-operatively), length of hospital stay, postoperative complications and mortality. Pre-operative body weight was measured at elective admission, and further weights were identified from a prospectively maintained database, during further clinic appointments. Other data was collected through patient notes. Results 594 patients were included. Mean age at diagnosis was 65.9 years (13–65). Majority of cases were adenocarcinoma (63.3%), with varying stages of disease (TX-4, NX-3). Benign pathology accounted for 8.75% of cases. Mean weight loss post-oesophagectomy exceeded 10% at 6 months (SD 14.49). Majority (60.1%) of patients were discharged with feeding jejunostomy, and 5.22% of these required this feed to be restarted post-discharge. Length of stay was mean 16.5 days (SD 22.3). Complications occurred in 68.9% of patients, of which 13.8% were infection driven. Mortality occurred in 26.6% of patients, with 1.83% during hospital admission. 30-day mortality rate was 1.39%. Conclusion Failure to thrive and prolonged weight-loss following oesophagectomy can contribute to poor recovery, with associated complications and poor outcomes, including increased length of stay and mortality. Further analysis of data to investigate association between weight loss and poor outcomes for oesophagectomy patients will allow for personalised treatment of high-risk patients, in conjunction with members of the multidisciplinary team, including dieticians.

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Recognising anaemia and malnutrition in vascular patients with critical limb ischaemia

Annals of The Royal College of Surgeons of England ◽

10.1308/003588410x12664192075738 ◽

2010 ◽

Vol 92 (6) ◽

pp. 495-498 ◽

Cited By ~ 6

Author(s):

M Shah ◽

A Martin ◽

B Myers ◽

S MacSweeney ◽

T Richards

Keyword(s):

Nutritional Status ◽

Hospital Stay ◽

Nutritional Assessment ◽

Length Of Hospital Stay ◽

Critical Limb Ischaemia ◽

Limb Ischaemia ◽

Patient Demographics ◽

Laboratory Markers ◽

Bed Days ◽

Poor Nutrition

INTRODUCTION Anaemia is a common problem in surgical patients. Patients with critical limb ischaemia (CLI) suffer chronic inflammation, repeated infection, require intervention, and can have a protracted hospital stay. The aims of this study were to assess anaemia and nutritional status in patients presenting with CLI. PATIENTS AND METHODS Two observational studies were undertaken, initially a retrospective series of 27 patients with CLI. Patient demographics, clinical details, transfusion status and in-patient laboratory haemoglobin values (Hb) were recorded. In a prospective series of 32 patients, laboratory markers to identify the cause for anaemia were assessed. Further nutritional status was assessed by records of height, weight, body mass index and a validated scoring system. RESULTS In the retrospective series, 15 patients (56%) were anaemic. Ten (37%) were transfused a median of 2 units (range, 2–13), a total of 35 units. Patients who were transfused had lower Hb on admission (P = 0.0019), most were anaemic on admission (90%). At discharge, most patients were anaemic (n = 23; 83%). In the prospective series of 32 patients, 20 (63%) were anaemic. Nutritional assessment was performed on 18, only seven patients were scored undernourished. This was increased to 23 by an independent assessor. Anaemia was associated with malnutrition (n = 17; P = 0.049) and an increased hospital stay (mean 25 days [SD 16] vs mean 12 days [SD 8], P = 0.0125; total 513 vs 144 bed days). CONCLUSIONS Anaemia and poor nutrition are common and not recognised in vascular patients presenting with critical limb ischaemia. Anaemia is associated with and increased length of hospital stay.

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