scholarly journals Nutritional Profile of Patients with Colorretal Cancer Candidates for Big Surgery (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

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.

2019 ◽  
Vol 3 (2) ◽  
pp. 66-80
Author(s):  
Anil Evrim Gungor ◽  
Perihan Arslan ◽  
Osman Abbasoglu

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 (2.6±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


2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Javier Páramo-Zunzunegui ◽  
Araceli Ramos-Carrasco ◽  
Marcos Alonso-García ◽  
Rosa Cuberes-Montserrat ◽  
Gil Rodríguez-Caravaca ◽  
...  

Introduction. Malnutrition and weight loss in cancer patients is a common problem that affects the prognosis of the disease. In the case of CRC, malnutrition rates range between 30 and 60%. Objectives. Description of the preoperative nutritional status of patients diagnosed with colorectal neoplasia who will undergo surgery. Materials and Methods. A prospective observational study is performed. Results. Of 234 patients studied, we observed that 139 (59%) had some degree of nutritional risk. Of all of them, 44.9% (N = 47) had 1-2 points according to MUST and 25% (N = 27) had more than 2 points. No differences were found when studying nutritional risk according to the location of the neoplasm. It was observed that 2.15% of the patients were underweight, 51% overweight, and 23% obese. 19.4% of patients lost less than 5 kg in the 3–6 months prior to diagnosis, 20.7% lost between 5 and 10 kg, and 2.1% lost more than 10 kg. In asymptomatic patients, the weight loss was lower than in symptomatic patients, loss <5 kg, 8.2% vs. 22.8%, and loss 5–10 kg, 16.2% vs. 29.3%, with a value of p = 0.016 . 5% (N = 7) of the patients had hypoalbuminemia record. 16.5% (N = 23) had some degree of prealbumin deficiency and 20.9% (N = 29) of hypoproteinemia. Symptomatic patients had more frequent analytical alterations, 1-2 altered parameters in 48.8% (N = 20) of asymptomatic vs. 61.2% (N = 22) in the symptomatic, p = 0.049 .


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Wei Chen ◽  
Shengnan Zhou

Abstract Objectives This study investigated the use of standardized phase angle (SPA), determined by bioelectrical impedance analysis (BIA), as a nutrition status tool and prognostic factor for complications associated with pancreaticoduodenectomy (PD) in pancreatic cancer patients. Methods A cross-sectional study was conducted with 49 participants. All participants were assessed for nutritional risk and nutritional status using Nutritional Risk Screening 2002 (NRS-2002), Subjective Global Assessment (SGA) tools, Global Leadership Initiative on Malnutrition (GLIM) tool and BIA. The Clavien-Dindo classification method for surgical complications was used to identify and classify postoperative complications. Independent-samples T-tests, chi-square tests and Spearman correlation analyses were used to evaluate the association between SPA, nutrition and postoperative complications. Results A total of 49 patients were enrolled, and 20 patients (40%) had postoperative complications. The SPA value for the nourished group was significantly higher than the SPA value for the malnourished group (P = 0.021, 0.019, 0.023). Patients who were below the SPA cut-off values (−1.015, −1.065, and −0.69) were more likely to have postoperative complications (P = 0.009), whereas NRS-2002, SGA, and GLIM scores were not associated with postoperative complications. The SPA value of the group with complications was significantly lower than that of the group without complications (P = 0.004). The SPA threshold value for predicting postoperative complications in pancreatic cancer was −1.095 (AUC 0.737; 95% CI, 0.59, 0.88; P = 0.005). Conclusions The SPA is a prognostic indicator of postoperative complications in pancreatic cancer patients undergoing PD and is an effective tool for assessing nutritional status in pancreatic cancer patients. Funding Sources none. Supporting Tables, Images and/or Graphs


2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Leah Cox

Abstract Background The prevalence of malnutrition amongst pancreatic cancer patients is widely reported. This is due to reduced nutritional intake, increased energy expenditure and increased nutrient losses secondary to malabsorption. A Whipple's procedure or pancreaticoduodenectomy is the only potentially curable intervention for pancreatic cancer patients. Malnutrition is associated with increased peri and post-operative complications including delayed wound healing, longer hospital admission and higher mortality rate. Dietetic prehabilitation is a proactive intervention to assess patients’ nutritional status in preparation for elective surgery and, through early dietetic intervention, has the potential to improve perioperative outcomes. This pilot study reviewed the severity of nutritional risk in both the pre and post-operative stages to understand the need for dietetic prehabilitation in this patient group. Methods All patients referred were nutritionally assessed as part of a dietetic cancer prehabilitation pathway, which includes pre-surgical nutritional assessment within one week of referral and early post discharge nutritional assessment. Nutritional assessment was carried out using the PG-SGA short form and patients were triaged as requiring either a universal, targeted or specialist dietetic intervention dependent on severity of nutritional risk. Patients who scored &lt;4 were triaged as universal, and were low nutritional risk. Patients who scored 5-9 were triaged as targeted and were medium nutritional risk, and patients who scored &gt;9 were triaged as specialist, and were high nutritional risk. Results 35 patients were referred for dietetic prehabilitation assessment. 71% of patients were triaged as requiring either a targeted or specialist prehabilitiation intervention. BMI ranged from 15.7kg/m² to 35.9kg/m² and median weight loss was 10.0%. 23 patients received early post surgical nutritional assessment, within 12 days of discharge from hospital. All 23 patients required targeted or specialist dietetic intervention. 22 patients reported post-operative weight loss, with a median weight loss of 7.5%. There was no correlation between pre-surgical and post-surgical nutritional risk. Conclusions Patients undergoing pancreaticoduodenectomy are at high nutritional risk in both the pre and post-operative periods. Patients without evidence of malnutrition in the pre-operative stage remain at high risk of malnutrition and the associated complications in the post operative stage. A prehabilitation programme can identify patients at nutritional risk and institute interventions to optimise perioperative nutritional status.  Findings from this review will form the basis of a study examining the effects of a prehabilitation programme on outcomes following pancreaticoduodenectomy.


2014 ◽  
Vol 51 (4) ◽  
pp. 331-336 ◽  
Author(s):  
Luiza Regina L S BARBOSA ◽  
Antonio LACERDA-FILHO ◽  
Livia Cristina L S BARBOSA

Context Weight loss and malnutrition are disorders observed in colorectal cancer patients. Objectives We sought to evaluate the immediate preoperative nutritional status of patients with colorectal cancer. Methods This is a cross-sectional clinical study conducted at a single center. Sixty-six consecutive patients in preoperative for elective surgical treatment were studied. The clinical history, socio-demographic data and nutritional status of the patients were evaluated using Subjective Global Assessment and objective (anthropometry) methods. The primary outcome measures were nutritional status classification as nourished or malnourished and the relationship between nutritional status and socio-demographic and clinical features. Results Most of patients exhibited left colon tumors and disease stage II. According to the Subjective Global Assessment, 36.4% of patients were malnourished. Malnutrition ranged from 7.6% to 53% depending on the evaluation method used, with poor correlation to Subjective Global Assessment. The prevalence of malnutrition was significantly greater in females and non-married patients and in those with two or more symptoms of colorectal cancer. Conclusions More than a third of patients in the immediate preoperative period for colorectal cancer exhibited malnutrition. Therefore, routine nutritional assessment is highly advisable so that appropriate measures may be taken to minimize the potential postoperative complications.


Author(s):  
Thalita Morgana Guimarães SILVEIRA ◽  
Juliana Barbosa de SOUSA ◽  
Maria Luiza Ferreira STRINGHINI ◽  
Ana Tereza Vaz de Souza FREITAS ◽  
Paulla Guimarães MELO

BACKGROUND: The assessment of nutritional status in clinical practice must be done with simple, reliable, low cost and easy performance methods. The power of handshake is recognized as a useful tool to evaluate muscle strength, and therefore, it is suggested that can detect malnutrition. AIM: To evaluate the nutritional status by subjective global assessment and power of handshake preoperatively in patients going to gastrointestinal surgeries and to compare the diagnosis obtained by subjective global assessment with traditional anthropometric methods and power of handshake. METHODS: A cross-sectional study was conducted with patients for surgery in the gastrointestinal tract and related organs. Socioeconomic and anthropometric data, applied to subjective global assessment and checked the power of handshake, were collected. The force was obtained by the average of three measurements of the dominant and non-dominant hand and thus compared with reference values of the population by sex and age, for the classification of nutritional risk. RESULTS: The sample consisted of 40 patients, 24-83 years, and most women (52.5%) housewives (37,5%) and diagnosed with cancer (45%). According to subjective global assessment, 37.5% were classified as moderately malnourished; 15% were underweight by BMI measurements; 25% had arm circumference at risk for malnutrition (<percentil 5); 60% reported recent weight loss; and 37.5% low clamping force in power of handshake on non-dominant hand (left). CONCLUSION: A significant association was observed for the diagnosis of nutritional subjective assessment with anthropometric methods and strength of the handshake only at the non-dominant limb.


2020 ◽  
Vol 2 (35) ◽  
pp. 160-165
Author(s):  
Ludiane Alves do Nascimento ◽  
Grasiela K. P. Andrade ◽  
Juliana Bonfleur Carvalho ◽  
Ana Lucia Chalhoub Chediac Rodrigues ◽  
Ariane Nadólskis Severine

Introduction: In 2050, we estimate that the population of individuals who are 90 years of age or older will be five times higher than that in 2010. Among elderly people, the disease process can contribute to a worsening nutritional status. This article aims to examine the associations among nutritional status and initial diagnoses, muscle mass, routes of feeding, and clinical outcomes. Despite the progressive increase in this population and their particularities, few studies have been conducted among nonagenarians. Methods: This was a cross-sectional study that included patients over 90 years old admitted to Hospital Sírio Libanês. The following parameters were assessed: calf circumference (CC), body mass index (BMI), routes of feeding and medical diagnosis. Nutritional screening was performed using the Mini Nutritional Assessment (MNA). Results: A total of 79 patients were assessed, and they had a median age of 92 years, a median BMI of 22.6 kg/m2 and median hospital stay of 13 days. A total of 59.5% of the patients (n=47) were female. The frequency of malnutrition (as assessed by the BMI) was 54.4%. There was a positive relationship (71.4%) between CC <31 cm and underweight (as assessed by the BMI) (p=0.032). Malnutrition (classified using the MNA) was significantly associated with dysphagia (77.4%) (p=0,003), the use of supplements (p=0.002) and enteral nutrition therapy (p=0.005). Mortality (25.8%) was also significantly related to malnutrition, showing that nutritional status contributed to poor clinical outcomes in patients (p=0.042). Conclusion: Dysphagia had a positive relationship with malnutrition because it is a condition that affects food intake. The use of supplements and a higher indication for enteral nutritional therapy both had a positive relationship with malnutrition because they are conducts indicated to improve nutritional status, showing that specific nutrition assistance strategies for this age group can contribute to improved nutritional status in nonagenarians.


Author(s):  
V. Aparecida Leandro-Merhi ◽  
J.L. Braga de Aquino ◽  
R. Marmiroli ◽  
L. Oliveira Reis

Introduction: The present study is justified by the interest of investigating the impact of nutritional status on urology patients. Objective: To investigate the nutritional status of urology patients and identify the risk factors associated with type of kidney stone. Method: This cross-sectional study assessed the nutritional status and energy and nutrient intakes of 175 hospitalized adult urology patients stratified as follows: patients submitted to percutaneous nephrolithotripsy (PN), patients submitted to endoscopic ureterolithotripsy (EU), and patients without kidney stones. All study variables were investigated as possible predictors of urologic diseases. Multinomial logistic regression analysis and the proportional odds model identified the factors associated with kidney stones. The significance level was set at 5%. Results: Kidney stones were more common in females (p<0.0001), EU patients without nutritional risk according to the Nutritional Risk Screening (NRS) (p=0.0061), patients with normal triceps skinfold thickness (p=0.015), and younger patients (p=0.0001). Patients hospitalized for longer periods (p=0.0038) and older patients (p=0.0001) did not have kidney stones. In EU patients kidney stones were associated with being female (p<0.0001; OR: 3.699; CI: 2.001; 6.838), having mid-upper arm muscle circumference between the 10th and 90th percentiles (p=0.0477; OR: 3.164; CI: 1.012; 9.895), not being at nutritional risk according to the NRS (p=0.0308; OR: 3.265; IC: 1.116; 9.557), and being younger (p=0.0008; OR: 0.966; CI: 2.001; 6.838). Conclusion: PN patients seem to need nutritional assessment and follow-up, while patients with kidney stones smaller than one centimeter do not seem to need routine nutritional assessment.


Parasite ◽  
2020 ◽  
Vol 27 ◽  
pp. 74
Author(s):  
Zhan Wang ◽  
Jin Xu ◽  
Ge Song ◽  
MingQuan Pang ◽  
Bin Guo ◽  
...  

Background: Echinococcosis is a chronic consumptive liver disease. Little research has been carried out on the nutritional status of infected patients, though liver diseases are often associated with malnutrition. Our study investigated four different nutrition screening tools, to assess nutritional risks of hospitalized patients with echinococcosis. Methods: Nutritional Risk Screening 2002 (NRS 2002), Short Form of Mini Nutritional Assessment (MNA-SF), Malnutrition Universal Screening Tool (MUST), and the Nutrition Risk Index (NRI) were used to assess 164 patients with alveolar echinococcosis (AE) and 232 with cystic echinococcosis (CE). Results were then compared with European Society for Clinical Nutrition and Metabolism (ESPEN) criteria for malnutrition diagnosis. Results: According to ESPEN standards for malnutrition diagnosis, 29.2% of CE patients and 31.1% of AE patients were malnourished. The malnutrition risk rates for CE and AE patients were as follows: NRS 2002 – 40.3% and 30.7%; MUST – 51.5% and 50.9%; MNA-SF – 46.8% and 44.1%; and NRI – 51.1% and 67.4%. In patients with CE, MNA-SF and NRS 2002 results correlated well with ESPEN results (k = 0.515, 0.496). Area-under-the-curve (AUC) values of MNA-SF and NRS 2002 were 0.803 and 0.776, respectively. For patients with AE, NRS 2002 and MNA-SF results correlated well with ESPEN (k = 0.555, 0.493). AUC values of NRS 2002 and MNA-SF were 0.776 and 0.792, respectively. Conclusion: This study is the first to analyze hospitalized echinococcosis patients based on these nutritional screening tools. Our results suggest that NRS 2002 and MNA-SF are suitable tools for nutritional screening of inpatients with echinococcosis.


2021 ◽  
pp. 1-20
Author(s):  
Jilu Lang ◽  
Yanan Shao ◽  
Jiehao Liao ◽  
Jia Chen ◽  
Xuewen Zhou ◽  
...  

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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