scholarly journals Associations between Nutritional and Immune Status and Clinicopathologic Factors in Patients with Pancreatic Cancer: A Comprehensive Analysis

Cancers ◽  
2021 ◽  
Vol 13 (20) ◽  
pp. 5041
Author(s):  
Beata Jabłońska ◽  
Krzysztof Pawlicki ◽  
Sławomir Mrowiec
Keyword(s):  
Weight Loss ◽  
Postoperative Complications ◽  
Neoadjuvant Chemotherapy ◽  
Immune Status ◽  
Tumor Location ◽  
Nutritional Risk ◽  
Serum Total Protein ◽  
Lower Serum ◽  
Duration Of Hospitalization ◽  
Nrs 2002

The aim of this study was to assess and analyze the nutritional status (NS) and immune status of pancreatic cancer (PC) patients. The retrospective analysis included 80 PC patients undergoing curative pancreatic resection in the Department of Digestive Tract Surgery of the Medical University (Katowice, Poland). Patients were divided by the tumor location (proximal vs. distal), age (≤65 years vs. >65 years), Nutritional Risk Score 2002 (NRS 2002) (<3 vs. ≥3), prognostic nutritional index (PNI) (<45 vs. ≥45), and the presence of postoperative complications (no-complication vs. complication) as well as the use of neoadjuvant chemotherapy (no neoadjuvant chemotherapy vs. neoadjuvant chemotherapy) into two subgroups, which were compared. Significantly higher weight loss was related to the proximal tumor location (p = 0.0104). Significantly lower serum total protein (p = 0.0447), albumin (p = 0.0468), hemoglobin (p = 0.0265) levels, and PNI (p = 0.03) were reported in older patients. The higher nutritional risk according to NRS 2002 was significantly associated with higher age (p = 0.0187), higher weight loss (p < 0.01), lower body mass index (BMI) (p = 0.0293), lower total lymphocyte count (p = 0.0292), longer duration of hospitalization (p = 0.020), neoadjuvant chemotherapy (p < 0.01), and preoperative biliary drainage (p = 0.0492). The lower PNI was significantly associated with higher weight loss (p = 0.0407), lower serum total protein and albumin concentration, lymphocyte count (p < 0.01) and higher neutrophil/lymphocyte (NLR), monocyte/lymphocyte (MLR), platelet/lymphocyte (PLR) ratios, and duration of hospitalization (p < 0.01). In the multiple logistic regression analysis, BMI ≥ 30 kg/m2 (OR: 8.62; 95%CI: 1.24–60.04; p = 0.029521) and NRS 2002 ≥ 3 (OR: 2.87; 95%CI: 0.88–9.33; p = 0.048818) predicted postoperative complications. In the multiple linear regression analysis, the higher NRS 2002 score was linked with the longer duration of hospitalization (b = 7.67948; p = 0.043816), and longer duration of postoperative hospitalization was associated with a higher complication rate (b = 0.273183; p = 0.003100). Nutritional impairment correlates with a systemic inflammatory response in PC patients. Obesity (BMI ≥ 30 kg/m2) and malnutrition (NRS 2002 ≥ 3) predict postoperative complications, which are associate with a longer hospital stay. Assessment of nutritional and immune status using basic diagnostic tools and PNI and immune ratio (NLR, MLR, PLR) calculation should be the standard management of PC patients before surgery to improve the postoperative outcome.

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

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

<p><b>Background:</b> 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.</p><p><b>Methods:</b> 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.</p><p><b>Results:</b> 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 (<i>P</i> = 0.136) and greater loss of weight of 13.0% � 3.2% versus 10.6% � 3% (<i>P</i> = 0.005), respectively. Increased nutritional risk correlated significantly with creatinine concentrations (rho = 0.359; <i>P</i> = 0.034 versus 0.584; <i>P</i> = 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; <i>P</i> = 0.009), the increase in glucose concentrations (cc = 0.600; <i>P</i> < 0.001), and the decrease in erythrocyte counts (cc = -0.520; <i>P</i> = 0.001) during the colder season.</p><p><b>Conclusion:</b> 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.</p>

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

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 (2.6±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

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 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
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.

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

2021 ◽  
pp. 1-20
Author(s):  
Jilu Lang ◽  
Yanan Shao ◽  
Jiehao Liao ◽  
Jia Chen ◽  
Xuewen Zhou ◽  
...  
Keyword(s):  
Weight Loss ◽  
Nutritional Status ◽  
Lung Adenocarcinoma ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Northern China ◽  
Nutritional Risk ◽  
Chinese Patients ◽  
Nrs 2002 ◽  
Northern Chinese

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.

scholarly journals Length of stay in surgical patients: nutritional predictive parameters revisited

2012 ◽  
Vol 109 (2) ◽  
pp. 322-328 ◽  
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.

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 Effect of nutritional risk on cognitive function in patients with chronic obstructive pulmonary disease

2021 ◽  
Vol 49 (2) ◽  
pp. 030006052199012
Author(s):  
Yiben Huang ◽  
Jiedong Ma ◽  
Bingqian Jiang ◽  
Naiping Yang ◽  
Fangyi Fu ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Pulmonary Disease ◽  
Nutritional Risk ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Nrs 2002

Objective We aimed to clarify the cognitive function of patients with chronic obstructive pulmonary disease (COPD) and different nutritional status. Methods Among 95 patients with COPD in this retrospective study, we administered the Nutritional Risk Screening 2002 (NRS 2002) and Mini-Mental State Examination (MMSE). We recorded patients’ clinical characteristics, comorbidities, and laboratory measurements. According to NRS 2002 scores, patients were divided into two groups: no nutritional risk with NRS 2002 < 3 ( n = 54) and nutritional risk, with NRS 2002 ≥ 3 ( n = 41). Results We found a negative correlation between NRS 2002 and MMSE scores in participants with COPD ( r = −0.313). Patients with nutritional risk were more likely to be cognitively impaired than those with no nutritional risk. Multivariate logistic regression analysis indicated that malnutrition was an independent risk factor for cognitive impairment, after adjusting for confounders (odds ratio [OR] = 4.120, 95% confidence interval [CI]: 1.072–15.837). We found a similar association between NRS 2002 and MMSE scores at 90-day follow-up using a Pearson’s correlation test ( r = −0.493) and logistic regression analysis (OR = 7.333, 95% CI: 1.114–48.264). Conclusions Patients with COPD at nutritional risk are more likely to have cognitive impairment.

Does Neoadjuvant Chemotherapy contribute to Breast Cancer Postoperative Complications?

2021 ◽  
Vol 47 (2) ◽  
pp. e42
Author(s):  
Jorge Nogueiro ◽  
André Pereira ◽  
Hugo Santos Sousa ◽  
Gonçalo Gandra ◽  
André Magalhães ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Postoperative Complications ◽  
Neoadjuvant Chemotherapy

scholarly journals Evaluation of Nutritional Risk and Prevalence of Obesity in Patients with Covid-19 in A Reference Hospital in Salvador, Bahia, Brazil: A Cross-Sectional Study

2021 ◽  
Vol 14 (01) ◽  
pp. 011-015
Author(s):  
Rodrigo Fernandes Weyll Pimentel ◽  
Gilson Cruz de Moraes ◽  
Shalla Gomes Cavalcanti Barcelos ◽  
Pedro Carlos Muniz de Figueiredo ◽  
Magno Conceição Das Merces
Keyword(s):  
Cross Sectional Study ◽  
Nutritional Risk ◽  
Sectional Study ◽  
Cross Sectional ◽  
High Prevalence ◽  
Reference Hospital ◽  
Prevalence Of Obesity ◽  
Nrs 2002 ◽  
Study Type ◽  
Nutritional Risk Screening

Abstract Introduction The Coronavirus has spread to almost every country in the world, causing the coronavirus disease (COVID-19). The coronavirus stands out among the other infections especially by it's high contagious power and important effects on the respiratory system. The COVID-19 has differents ways of presentation and these are influenced by the patient's previous nutricional status, correlated with the patient's lifestyle and comorbities. Objective this survey seeks to analyze the nutritional status and the prevalence of obesity in patients hospitalized with SARS-CoV-2. Methods: this is a descriptive, prospective and cross-sectional study type, which 41 patients affected by COVID-19 were interviewed. Patient's weight and height were used to assess the BMI, and nutritional risk assessment was performed using the Nutritional Risk Screening tool (NRS 2002). For the analysis, Absolute (AF) and Relative Frequency (RF), the mean and the standard deviation were calculated. Results It was observerd that 78% of the participants had a high nutritional risk, while only 22% had a low nutritional risk. Besides that, 34% showed overweight and 41.4% showed obesity. Conclusion the existence of a high prevalence of increased nutritional risk was evidenced, in addition to the high frequency of overweight in patients affected by SARS-CoV-2.

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