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 High neutrophil to lymphocytes ratio is associated with nutritional risk in hospitalised, unselected cancer patients: a cross-sectional study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jéssika M Siqueira ◽  
Jéssika D P Soares ◽  
Thaís C Borges ◽  
Tatyanne L N Gomes ◽  
Gustavo D Pimentel
Keyword(s):  
Logistic Regression ◽  
Cancer Patients ◽  
Systemic Inflammation ◽  
Roc Curve ◽  
Cross Sectional Study ◽  
Nutritional Risk ◽  
Sectional Study ◽  
Cross Sectional ◽  
Cut Point ◽  
Nrs 2002

AbstractCancer patients possess metabolic and pathophysiological changes and an inflammatory environment that leads to malnutrition. This study aimed to (i) determine whether there is an association between neutrophil-to-lymphocyte ratio (NLR) and nutritional risk, and (ii) identify the cut-off value of NLR that best predicts malnutrition by screening for nutritional risk (NRS 2002). This cross-sectional study included 119 patients with unselected cancer undergoing chemotherapy and/or surgery. The NRS 2002 was applied within 24 h of hospitalisation to determine the nutritional risk. Systemic inflammation was assessed by blood collection, and data on C-reactive protein (CRP), neutrophils, and lymphocytes were collected for later calculation of NLR. A receiver operating characteristic (ROC) curve was used to identify the best cut-point for NLR value that predicted nutritional risk. Differences between the groups were tested using the Student’s t-, Mann–Whitney U and Chi-Square tests. Logistic regression analyses were performed to assess the association between NLR and nutritional risk. The ROC curve showed the best cut-point for predicting nutritional risk was NLR > 5.0 (sensitivity, 60.9%; specificity, 76.4%). The NLR ≥ 5.0 group had a higher prevalence of nutritional risk than the NLR < 5.0 group (NLR ≥ 5.0: 73.6% vs. NLR < 5.0: 37.9%, p = 0.001). The NLR group ≥ 5.0 showed higher values of CRP and NLR than the NLR < 5.0 group. In addition, patients with NLR ≥ 5.0 also had higher NRS 2002 values when compared to the NLR < 5.0 group (NLR ≥ 5.0: 3.0 ± 1.1 vs. NLR < 5.0: 2.3 ± 1.2, p = 0.0004). Logistic regression revealed an association between NRS and NLR values. In hospitalised unselected cancer patients, systemic inflammation measured by NLR was associated with nutritional risk. Therefore, we highlight the importance of measuring the NLR in clinical practice, with the aim to detect nutritional risk.

scholarly journals Standardized Phase Angle as a Prognostic and Nutritional Status Tool for Pancreatic Cancer Patients Undergoing Pancreaticoduodenectomy: A Cross-sectional Study (P12-025-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Wei Chen ◽  
Shengnan Zhou
Keyword(s):  
Pancreatic Cancer ◽  
Postoperative Complications ◽  
Nutritional Status ◽  
Cancer Patients ◽  
Phase Angle ◽  
Cross Sectional Study ◽  
Nutritional Risk ◽  
Sectional Study ◽  
Cross Sectional ◽  
Nrs 2002

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

scholarly journals Comparison of two malnutrition risk screening tools with nutritional biochemical parameters, BMI and length of stay in Chinese geriatric inpatients: a multicenter, cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e022993 ◽  
Author(s):  
Jian-Ping Miao ◽  
Xiao-Qing Quan ◽  
Cun-Tai Zhang ◽  
Hong Zhu ◽  
Mei Ye ◽  
...  
Keyword(s):  
Biochemical Parameters ◽  
Mini Nutritional Assessment ◽  
Cross Sectional Study ◽  
Screening Tools ◽  
Nutritional Risk ◽  
Secondary Outcome ◽  
Sectional Study ◽  
Cross Sectional ◽  
Risk Screening ◽  
Geriatric Inpatients

ObjectivesThe aims of this study were to assess malnutrition risk in Chinese geriatric inpatients using Nutritional Risk Screening 2002 (NRS2002) and Mini-Nutritional Assessment (MNA), and to identify the most appropriate nutritional screening tool for these patients.DesignCross-sectional study.SettingEight medical centres in Hubei Province, China.ParticipantsA total of 425 inpatients aged ≥70 years were consecutively recruited between December 2014 and May 2016.Primary and secondary outcome measuresNutritional risk was assessed using NRS2002, MNA, anthropometric measurements and biochemical parameters within 24 hours of admission. Comorbidities and length of hospitalisation were recorded. Nutritional parameters, body mass index (BMI) and length of hospital stay (LOS) were employed to compare MNA and NRS2002. Kappa analysis was used to evaluate the consistency of the two tools.ResultsThe average age was 81.2±5.9 years (range, 70–98). The prevalence of undernutrition classified by NRS2002 and MNA was 40.9% and 58.6%, respectively. Patients undergoing malnutrition had lower BMI, haemoglobin, albumin and prealbumin (p<0.05), and longer LOS (p<0.05). The NRS2002 showed moderate agreement (κ=0.521, p<0.001) with MNA. Both tools presented significant correlation with age, BMI and laboratory parameters (p<0.001). In addition, a significant association between both tools and LOS was found (p<0.05). In addition, the NRS2002 was not different from MNA in predicting nutritional risk in terms of the area under the receiver operating characteristic curve (p>0.05).ConclusionsThe results show a relatively high prevalence of malnutrition risk in our sample cohort. We found that NRS2002 and MNA were both suitable in screening malnutrition risk among Chinese geriatric inpatients.

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 &lt; 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 Body Composition Measurement Improved Performance of GLIM Criteria in Diagnosing Malnutrition Compared to PG-SGA in Ambulatory Cancer Patients: A Prospective Cross-Sectional Study

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2744
Author(s):  
Yanfei Wang ◽  
Xiaoyan Chen ◽  
Yunyi Wang ◽  
Ziqi Liu ◽  
Yu Fang ◽  
...  
Keyword(s):  
Body Composition ◽  
Cancer Patients ◽  
Cross Sectional Study ◽  
Anthropometric Measurement ◽  
Severe Malnutrition ◽  
Sectional Study ◽  
Cross Sectional ◽  
Skeletal Muscle Index ◽  
Body Composition Measurement ◽  
Composition Measurement

Background and aims: Muscle mass reduction (MMR) is one of the three etiologic criteria in the Global Leadership Initiative on Malnutrition (GLIM) framework. This study aimed to evaluate the value of MMR in GLIM criteria among ambulatory cancer patients. Methods: A single-center prospective cross-sectional study was conducted. All participants underwent calf circumference (CC) measurement and body composition measurement by bioelectrical impedance analysis (BIA). MMR was identified by CC, fat-free mass index (FFMI), appendicular skeletal muscle index (ASMI), or combinations of the above three indicators. Patients-generated Subjective Global Assessment (PG-SGA) was used as the comparator. Results: A total of 562 cancer patients receiving intravenous treatment were evaluated. Of the participants, 62.8% (355/562) were male. The median age of the patients was 59.0 years (range, 21–82 y). The median BMI was 22.8 kg/m2 (range, 14.6–34.5 kg/m2). A total of 41.8% of patients were evaluated as malnutrition (PG-SGA ≥ 4), and 11.9% were diagnosed with severe malnutrition (PG-SGA ≥ 9). For the GLIM criteria, the prevalence of malnutrition was 26.9%, and severe malnutrition was 12.3%. For all criteria combinations of GLIM together versus PG-SGA, sensitivity was 60.4% (53.8–66.7), specificity was 97.9% (95.4–99.1), while the accordance between GLIM and PG-SGA was moderate (κ = 0.614). The performance of the GLIM worsened when MMR was excluded (κ = 0.515), with reduced sensitivity (50.2% (43.7–56.8)) and the same specificity (97.9% (95.4–99.1)). Including FFMI and ASMI by BIA can further improve the performance of GLIM than using CC alone (κ = 0.614 vs. κ = 0.565). Conclusions: It is important to include MMR in the GLIM framework. Using body composition measurement further improves the performance of the GLIM criteria than using anthropometric measurement alone.

scholarly journals Out-of-Pocket Costs and Perceived Financial Burden Associated with Prostate Cancer Treatment in a Quebec Remote Area: A Cross-Sectional Study

2020 ◽  
Vol 28 (1) ◽  
pp. 26-39
Author(s):  
Abir El-Haouly ◽  
Anais Lacasse ◽  
Hares El-Rami ◽  
Frederic Liandier ◽  
Alice Dragomir
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Financial Burden ◽  
Cross Sectional Study ◽  
University Education ◽  
School Level ◽  
Sectional Study ◽  
Cross Sectional ◽  
Perceived Burden ◽  
Out Of Pocket Costs

Background: In publicly funded healthcare systems, patients do not pay for medical visits but can experience costs stemming from travel or over-the-counter drugs. We lack information about the extent of this burden in Canadian remote regions. This study aimed to: (1) describe prostate cancer-related out-of-pocket costs and perceived financial burden, and (2) identify factors associated with such a perceived burden among prostate cancer patients living in a remote region of the province of Quebec (Canada). Methods: A cross-sectional study was conducted among 171 prostate cancer patients who consulted at the outpatient clinic of the Centre Hospitalier de Rouyn-Noranda. Results: The majority of patients (83%) had incurred out-of-pocket costs for their cancer care. The mean total cost incurred in the last three months was $517 and 22.3% reported a moderate, considerable or unsustainable burden. Multivariable analysis revealed that having incurred higher cancer-related out-of-pocket costs (OR: 1.001; 95%CI: 1.001–1.002) private drug insurance (vs. public, OR: 5.23; 95%CI: 1.13–24.17) was associated with a greater perceived financial burden. Having better physical health-related quality of life (OR: 0.95; 95%CI: 0.913–0.997), a university education (vs. elementary/high school level, OR: 0.03; 95%CI: 0.00–0.79), and an income between $40,000 and $79,999 (vs. ≤ $39,999, OR: 0.15; 95%CI: 0.03–0.69) were associated with a lower perceived burden. Conclusion: Prostate cancer patients incur out-of-pocket costs even if they were diagnosed many years ago and the perceived burden is significant. Greater attention should be paid to the development of services to help patients manage this burden.

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