648 APPLICATION OF THE GLOBAL LEADERSHIP INITIATIVE ON MALNUTRITION (GLIM) CRITERIA IN PERIOPERATIVE MANAGEMENT OF ESOPHAGEAL CANCER PATIENTS

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Peiyu Wang ◽  
Yin Li ◽  
Xianben Liu
Keyword(s):  
Esophageal Cancer ◽  
Cancer Patients ◽  
Perioperative Management ◽  
Screening Tool ◽  
Short Form ◽  
Global Leadership ◽  
Screening Tools ◽  
Nutritional Risk ◽  
Severe Malnutrition ◽  
Nutritional Risk Index

Abstract   In 2019, the Global Leadership Initiative on Malnutrition (GLIM) established global malnutrition diagnostic criteria and classification methods. This study aimed to investigate the application of GLIM criteria in nutrition assessment and perioperative management in esophageal cancer patients undergoing esophagectomy. Methods A prospective institutional database of 212 esophageal cancer patients was reviewed. The property of the GLIM criteria in diagnosing malnutrition and predicting adverse therapeutic outcomes were evaluated. The two-step approach of initially screening malnutrition risk with conventional tools and then establishing diagnosis and classification with the GLIM criteria was investigated. The candidate malnutrition screening tools include the Malnutrition Universal Screening Tool (MUST), the Nutritional Risk Screening 2002, the Short-Form of Mini Nutritional Assessment, and the Geriatric Nutritional Risk Index. Results Among the included 192 patients, the proportions of moderate and severe malnutrition diagnosed by the GLIM criteria were 42.7% and 30.2% before surgery. In multivariable analyses, severe malnutrition was predictive of perioperative overall complications and major complications (both P < 0.001). Among the four candidates, malnutrition screened by the MUST showed highest sensitivity (90.7%), specificity (92.3%) and diagnosis consistency with the GLIM criteria. The two-step approach of MUST-GLIM showed comparable performance with pure GLIM criteria in predicting perioperative morbidities and survival outcomes, better than the conjunction of other three malnutrition screening tools with the GLIM criteria. Conclusion The GLIM criteria should be highlighted in perioperative management of esophageal cancer patients. The MUST is the recommended initial malnutrition screening tool in implementing the GLIM criteria.

scholarly journals Omitting the First Step of GLIM Framework Yielded Better Accordance With PG-SGA in Chinese Ambulatory Cancer Patients: a Prospective Cross-sectional Study

2021 ◽  
Author(s):  
Yanfei Wang ◽  
Ziqi Liu ◽  
yunyi Wang ◽  
Xiaoyan Chen ◽  
Zhongfen Liu ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Screening Tool ◽  
Cross Sectional Study ◽  
Screening Tools ◽  
Nutritional Risk ◽  
Severe Malnutrition ◽  
Sectional Study ◽  
Cross Sectional ◽  
Nutrition Screening ◽  
Predictive Values

Abstract Background and Aims: The Global Leadership Initiative on Malnutrition (GLIM) criteria is a new framework for diagnosing malnutrition in combination of phenotypic and etiologic criteria after nutrition screening using validated screening tools. The aim of this study was to evaluate the efficacy of malnutrition screening tool (MST), malnutrition universal screening tool (MUST) and nutritional risk screening 2002 (NRS2002) as the first step of GLIM framework in comparison to Patients-Generated Subjective Global Assessment (PG-SGA) in Chinese ambulatory cancer patients.Methods: A single-center prospective cross-sectional study was conducted. Nutritional screening and assessment were performed within 4h after admission to the hospital using a structured questionnaire including MST, MUST, NRS2002, PG-SGA and GLIM, with supplement information of calf circumference (CC) measurement and body composition measurement using bioelectrical impedance analysis (BIA). Malnutrition diagnosis made by GLIM framework using MST, MUST or NRS2002 as the first step or without screening step were compared to PG-SGA separately. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values and κ values were used to evaluate performance of the screening tools.Results: Of the 562 included patients, Of the participants 62.8% (355/562) were male and 37.2% (210/562) were female, with a male to female radio of 1.69:1. The median age of the patients was 59.0 years (range, 21-82y; interquels range 52.0-65.0y). From the 562 patients included in the study, 41.8% of patients were evaluated as malnutrition (PG-SGA≥4) and 11.9% were diagnosed as severe malnutrition (PG-SGA D). For GLIM criteria, omitting the screening step yielded fair accordance with PG-SGA in diagnosing malnutrition (κ=0.623) and severe malnutrition (κ=0.515). Using MUST as the first step of GLIM framework has better performance (κ=0.614; κ=0.515) than using MST (κ=0.504, κ=0.496) or NRS2002 (κ=0.363, κ=0.503) as the screening tool regardless of severity gradings.Conclusions: Using PG-SGA as the standard, GLIM framework omitting first step has better performance compared with using MST, MUST or NRS2002 as the screening tool. Among the screening tools validated to be used in the first step of GLIM framework, MUST may be the better choice for ambulatory cancer patients.

scholarly journals Selection and optimization of nutritional risk screening tools for esophageal cancer patients in China

2020 ◽  
Vol 14 (1) ◽  
pp. 20 ◽  
Author(s):  
Wen Dong ◽  
Xiguang Liu ◽  
Shunfang Zhu ◽  
Di Lu ◽  
Kaican Cai ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Cancer Patients ◽  
Screening Tools ◽  
Nutritional Risk ◽  
Risk Screening ◽  
Nutritional Risk Screening

scholarly journals Evaluation of the effectiveness of eight screening tools in detecting risk of malnutrition in cirrhotic patients: the KIRRHOS study

2019 ◽  
Vol 122 (12) ◽  
pp. 1368-1376 ◽  
Author(s):  
Alexandra Georgiou ◽  
Georgios V. Papatheodoridis ◽  
Alexandra Alexopoulou ◽  
Melanie Deutsch ◽  
Ioannis Vlachogiannakos ◽  
...  
Keyword(s):  
Liver Disease ◽  
Screening Tool ◽  
Nutritional Assessment ◽  
Risk Index ◽  
Screening Tools ◽  
Nutritional Risk ◽  
Risk Screening ◽  
Nutritional Risk Index ◽  
Nrs 2002 ◽  
Cirrhotic Patients

AbstractMalnutrition risk screening in cirrhotic patients is crucial, as poor nutritional status negatively affects disease prognosis and survival. Given that a variety of malnutrition screening tools is usually used in routine clinical practice, the effectiveness of eight screening tools in detecting malnutrition risk in cirrhotic patients was sought. A total of 170 patients (57·1 % male, 59·4 (sd 10·5) years, 50·6 % decompensated ones) with cirrhosis of various aetiologies were enrolled. Nutritional screening was performed using the Malnutrition Universal Screening Tool, Nutritional Risk Index, Malnutrition Screening Tool, Nutritional Risk Screening (NRS-2002), Birmingham Nutritional Risk Score, Short Nutritional Assessment Questionnaire, Royal Free Hospital Nutritional Prioritizing Tool (RFH-NPT) and Liver Disease Undernutrition Screening Tool (LDUST). Malnutrition diagnosis was defined using the Subjective Global Assessment (SGA). Data on 1-year survival were available for 145 patients. The prevalence of malnutrition risk varied according to the screening tools used, with a range of 13·5–54·1 %. RFH-NPT and LDUST were the most accurate in detecting malnutrition (AUC = 0·885 and 0·892, respectively) with a high sensitivity (97·4 and 94·9 %, respectively) and fair specificity (73·3 and 58 %, respectively). Malnutrition according to SGA was an independent prognostic factor of within 1-year mortality (relative risk was 2·17 (95 % CI 1·0, 4·7), P = 0·049) after adjustment for sex, age, disease aetiology and Model for End-stage Liver Disease score, whereas nutrition risk according to RFH-NPT, LDUST and NRS-2002 showed no association. RFH-NPT and LDUST were the only screening tools that proved to be accurate in detecting malnutrition in cirrhotic patients.

scholarly journals Malnutrition and cancer, diagnosis and treatment

2021 ◽  
Author(s):  
Angelika Beirer
Keyword(s):  
Weight Loss ◽  
Cancer Patients ◽  
Cancer Cachexia ◽  
Screening Tool ◽  
Psychological Treatment ◽  
Early Stage ◽  
Nutritional Therapy ◽  
German Society ◽  
Fat Free Mass ◽  
Nutritional Risk

Summary Background The prevalence of malnutrition in cancer patients ranges from about 20% to more than 70%. However, 10–20% of cancer patients’ deaths are related to malnutrition, not the malignancy itself. To reverse the pattern of weight loss, improve the patients’ quality of life, reduce the treatment toxicity, the psychological stress and the risk of mortality, the diagnosis of malnutrition should be made as early as possible to facilitate the best possible treatment. Methods A systematic literature search was conducted following guidelines of ESPEN (European Society for Clinical Nutrition), DGEM (German Society for Nutritional Medicine) and ASPEN (American Society for Parenteral and Enteral Nutrition). Results and conclusion To assess the risk of malnutrition, all cancer patients should be screened regularly with a valid screening tool (e.g., MUST [Malnutrition Universal Screening Tool], NRS [Nutritional Risk Screening] or PG-SGA [Scored Patient-Generated Subjective Global Assessment]). If risk of malnutrition is present, adequate nutritional therapy is recommended to stop involuntary weight loss. Patients should engage in exercise to maintain and improve muscle mass, strength and function. They should be offered regular dietetic counselling, and their muscle depletion should be monitored by determining fat-free mass. As cachectic patients in particular are at risk, the presence of cachexia should also be recognized at an early stage. Three consensus-based definitions are widely accepted: Fearon et al. and the EPCRC (European Palliative Care Research Collaborative) propose definitions specifically for cancer cachexia, while Evans et al. put forward a definition for cachexia associated with all types of underlying chronic diseases. However, if there is a cancer cachexia diagnosis, additional pharmacological and psychological treatment should be considered.

scholarly journals Use of Double-Lumen Peripherally Inserted Central Catheters for Safer Perioperative Management of Esophageal Cancer Patients

2015 ◽  
Vol 16 (4) ◽  
pp. 338-343 ◽  
Author(s):  
Shuichi Fukuda ◽  
Kiyokazu Nakajima ◽  
Yasuhiro Miyazaki ◽  
Tsuyoshi Takahashi ◽  
Yukinori Kurokawa ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Cancer Patients ◽  
Perioperative Management ◽  
Double Lumen ◽  
Peripherally Inserted Central Catheters ◽  
Central Catheters

scholarly journals Systemic inflammation and nutritional insufficiency in palliative cancer patients

2021 ◽  
Vol 102 (4) ◽  
pp. 446-452
Author(s):  
O V Kurchenkova ◽  
U V Kharlamova ◽  
A V Vazhenin ◽  
A O Abdalov
Keyword(s):  
Cancer Patients ◽  
Body Mass ◽  
Systemic Inflammation ◽  
Risk Index ◽  
Nutritional Risk ◽  
Albumin Concentration ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Nutritional Risk Index ◽  
Nutritional Insufficiency

Aim. To study the relationship between the symptoms of nutritional insufficiency and systemic inflammation in cancer palliative patients. Methods. 106 palliative cancer patients were examined at Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine: 54 (50.9%) men and 52 (49.1%) women aged 61 [54; 67] years. All patients underwent laboratory and instrumental examination within the approved standards of specialized medical care. Systemic inflammation was assessed by the levels of acute phase proteins (C-reactive protein, fibrinogen). The study of integrated clinical and laboratory, somatometric parameters was carried out. The nutritional risk index was assessed. Results. Palliative cancer patients showed a statistically significant decrease in the concentration of hemoglobin, lymphocytes, and albumin. The activation of systemic inflammation that manifested by hyperfibrinogenemia and an increase in the level of C-reactive protein was revealed. The study of somatometric parameters revealed a statistically significant decrease in body mass index, shoulder circumference, subscapular skinfold thickness, and a tendency to reduce lean body mass. The nutritional risk index assessment showed mild nutritional insufficiency in 22 (20.8%) of the examined patients and severe nutritional insufficiency in 28 (26.4%) patients. The maximum diagnostic significance of the level of C-reactive protein for prediction the nutritional insufficiency was achieved at 80.4% sensitivity and 52.7% specificity (AUC=0.671, 95% confidence interval [0.573; 0.759], p=0.001), which corresponded to a C-reactive protein threshold of 31 mg/l. Conclusion. 50 (47.2%) of the examined patients showed signs of nutritional insufficiency, a statistically significant decrease in hemoglobin and albumin concentration, as well as lymphocyte count, activation of systemic inflammation, manifested by hyperfibrinogenemia, and an increase in the level of C-reactive protein; it was revealed a statistically significant relationship between C-reactive protein level and malnutrition.

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