scholarly journals Objective Assessment of Superiority of Enteral Feeding by Traditional Home Kitchen-Based Feed V/S Commercial Formula Feed in Patients of Esophagogastric Corrosive Injury

2022 ◽  
Vol 8 (1) ◽  
pp. 98-105
Author(s):  
Maulik S. Bhadania ◽  
Hasmukh B. Vora ◽  
Nikhil Jillawar ◽  
Premal R. Desai
Keyword(s):  
Enteral Nutrition ◽  
Nutritional Status ◽  
Nutritional Assessment ◽  
Risk Index ◽  
Objective Assessment ◽  
Cost Effective ◽  
Nutritional Risk ◽  
Home Based ◽  
Nutritional Risk Index ◽  
Commercial Feeds

Background: Corrosive ingestion can cause severe chemical injury to upper gastrointestinal tract which leads to dysphagia, malnutrition and weight loss. Early nutritional assessment and support through feeding jejunostomy is important and it should be nutritionally optimum and economically balanced. The aim is to compare cost and nutritional status after nutritional support with traditional home kitchen made and commercial formula feed through feeding jejunostomy.Methods:A prospective study included patients on enteral nutrition based on traditional home kitchen feed (cohort-1) and on commercial formula feed (cohort-2). Patient’s body weight, BMI, haemoglobin, serum albumin, nutritional risk index, controlling nutritional status score were checked at the admission, 3rd and 6th month follow up.Results: In cohort 1 mean albumin and haemoglobin raised by 33.13% & 14.60% at 3rd month and 47.23% & 22.3% at 6th month respectively; In cohort 2 it was 9.12% & 2.69% at 3rd month and 17.62% & 6.53% at 6th month respectively. At 6th month in cohort 1 and 2 mean weight gain was 7.56% & 4.0%; mean increase in NRI was 34.78% & 11.5% respectively. Mean CONUT score at six months was better improved in cohort 1 which is 6 to 1 as compared to cohort 2 which was 6 to 3. Mean monthly cost of home-based feeds was significantly lower as compared to commercial feeds (62.14 Rs v/s 682-2354 Rs/day).Conclusions:In corrosive GI tract injury patient enteral nutrition with traditional home kitchen-based feeds is safe, cost effective and associated with better improvement in nutritional status objective parameters.

scholarly journals Preoperative Nutritional Status and Its Consequences on Abdominal Surgery in Wolaita Zone, Southern Ethiopia: An Institution-Based Observational Study

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Leila Hussen ◽  
Elazar Tadesse ◽  
Dereje Yohannes Teferi
Keyword(s):  
Wound Healing ◽  
Observational Study ◽  
Nutritional Status ◽  
Abdominal Surgery ◽  
Nutritional Assessment ◽  
Risk Index ◽  
Nutritional Risk ◽  
Southern Ethiopia ◽  
Increased Risk ◽  
Nutritional Risk Index

This study aimed to determine the prevalence of malnutrition and its association with wound healing and length of hospitalization among patients undergoing abdominal surgery admitted to hospitals in the Wolaita zone in southern Ethiopia. Methods. An institution-based prospective observational study was conducted in three hospitals in the Wolaita zone from August to October 2016. All eligible individuals aged between 19 and 55 years were recruited in this study. Anthropometric and biochemical analyses, such as serum albumin (Alb) and total lymphocyte count (TLC), were taken for nutritional assessment during the preoperative period. Quantitative variables were compared using Student’s t test. Cox’s regression was employed to determine which variables were possible risk factors for poor wound healing. Results. A total of 105 patients aged 19 to 55 with a mean age (±SD) of 34 ± 9.6 years were included, and the prevalence of preoperative malnutrition was 27.6%, 87%, according to BMI and nutritional risk index, respectively. Poor wound healing was significantly associated with underweight patients (BMI < 18.5 kg/m2) (AHR: 6.5 : 95%CI: 3.312.9), postoperative weight loss (AHR: 4.9; 95%CI: 2.8–8.5), and nutritional risk index (NRI) less than 97.5 (AHR 1.8; 95% CI: 1.09–3.1). Conclusion. The prevalence of malnutrition is high in our study setup; this is associated with an increased risk of adverse postoperative outcomes. Therefore, our results emphasize the need of routine preoperative nutritional assessment, optimizing nutritional status of patients and postoperative nutritional support.

Prognosis in Head and Neck Cancer: Importance of Nutritional and Biological Inflammatory Status

2021 ◽  
pp. 019459982110045
Author(s):  
Nicolas Saroul ◽  
Mathilde Puechmaille ◽  
Céline Lambert ◽  
Achraf Sayed Hassan ◽  
Julian Biau ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Prognostic Factors ◽  
Inflammatory Response ◽  
Nutritional Status ◽  
Head And Neck ◽  
Neck Cancer ◽  
Risk Index ◽  
Nutritional Risk ◽  
Inflammatory Status ◽  
Nutritional Risk Index

Objectives To determine the importance of nutritional status, social status, and inflammatory status in the prognosis of head and neck cancer. Study Design Single-center retrospective study of prospectively collected data. Setting Tertiary referral center. Methods Ninety-two consecutive patients newly diagnosed for cancer of the upper aerodigestive tract without metastases were assessed at time of diagnosis for several prognostic factors. Nutritional status was assessed by the nutritional risk index, social status by the EPICES score, and inflammatory status by the systemic inflammatory response index. The primary endpoint was overall survival. Results In multivariable analysis, the main prognostic factors were the TNM classification (hazard ratio [HR] = 3.34, P = .002, for stage T3-4), malnutrition as assessed by the nutritional risk index (HR = 3.64, P = .008, for severe malnutrition), and a systemic inflammatory response index score ≥1.6 (HR = 3.32, P = .02). Social deprivation was not a prognostic factor. Conclusion Prognosis in head and neck cancer is multifactorial; however, malnutrition and inflammation are important factors that are potentially reversible by early intervention.

Abstract 12880: Malnutrition Assessed by Geriatric Nutritional Risk Index Provides the Long-term Prognostic Information in Patients Admitted for Acute Decompensated Heart Failure, Regardless of Reduced or Preserved Left Ventricular Ejection Fraction; A Comparison With Prognostic Nutritional Index and CONUT Score

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Takahisa Yamada ◽  
Takashi Morita ◽  
Yoshio Furukawa ◽  
Shunsuke Tamaki ◽  
Yusuke Iwasaki ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Serum Albumin ◽  
Risk Index ◽  
Left Ventricular ◽  
Nutritional Risk ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Nutritional Index ◽  
Nutritional Risk Index ◽  
Conut Score

Backgrounds: Malnutrition is associated with increased mortality risk in patients (pts) with acute decompensated heart failure(ADHF). Nutritional status is assessed by several indices, such as Geriatric Nutritional Risk Index (GNRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) score. However, there is no information available on the comparison of prognostic significance of these indices in ADHF pts, relating to reduced or preserved left ventricular ejection fraction (HFrEF or HFpEF). Methods and Results: We studied 303 consecutive pts admitted for ADHF and discharged alive (HFrEF(LVEF<50%);n=163, HFpEF(LVEF≥50%);n=140). Nutritional status was evaluated at the discharge by GNRI calculated as follows: 14.89 • serum albumin (g/dl) + 41.7 • BMI/22, PNI calculated as follows: 10 • serum albumin (g/dl) + 0.005 • total lymphocyte count (/ml) and CONUT score calculated by serum albumin, total cholesterol levels and lymphocyte count. During a follow-up period of 5.0±4.3 yrs, 75 pts had cardiovascular death (CVD). At multivariate Cox analysis, GNRI (p<0.0001) was significantly associated with CVD, independently of systolic blood pressure, serum sodium level and eGFR, although PNI and CONUT score showed a significant association with CVD at univariate analysis. ROC analysis revealed that GNRI of 88 was a fair discriminator for CVD (AUC 0.70(95%CI 0.63-0.77), p<0.0001). In group with HFrEF, CVD was significantly more frequently observed in pts with than without low GNRI <88 (48% vs 25%, p<0.0001, adjusted HR 3.5[1.8-6.6]). Furthermore, in group with HFpEF, pts with low GNRI had the significantly increased risk, compared to those with high GNRI>88 (36% vs 10%, p<0.0001, adjusted HR 3.8[1.4-10.2]). Conclusion: Malnutrition assessed by Geriatric Nutritional Index provides more valuable long-term prognostic information than PNI and CONUT score in pts admitted for ADHF, regardless of HFrEF or HFpEF.

Abstract 12986: Geriatric Nutritional Risk Index Provides the Additional Long-term Prognostic Information to Gwtg Heart Failure Risk Score in Acute Decompensated Heart Failure Patients With and Without Reduced LVEF

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Takahisa Yamada ◽  
Tetsuya Watanabe ◽  
Takashi Morita ◽  
Yoshio Furukawa ◽  
Shunsuke Tamaki ◽  
...  
Keyword(s):  
Heart Failure ◽  
Nutritional Status ◽  
Risk Score ◽  
Risk Index ◽  
Nutritional Risk ◽  
Geriatric Nutritional Risk Index ◽  
Prognostic Information ◽  
Poor Outcome ◽  
Nutritional Risk Index

Backgrounds: The Get with The Guidelines (GWTG) heart failure (HF) risk score was developed in the GWTG inpatient HF registry to predict in-hospital mortality and has been recently reported to be associated with post-discharge long-term outcomes. Malnutrition is associated with poor outcome in ADHF patients. However, there is no information available on the long-term prognostic significance of the combination of GWTG-HF risk score and malnutrition in patients admitted for ADHF, relating to reduced left ventricular ejection fraction (LVEF). Methods: We studied 303 ADHF patients discharged with survival (HFrEF(LVEF<40%); n=180, HFpEF(LVEF≥40%;n=123). At the admission, we evaluated GWTG-HF score and nutritional status. Variables required for the GWTG-HF risk score were race, age, systolic blood pressure, heart rate, serum levels of blood urea nitrogen and sodium, and the presence of chronic obstructive pulmonary disease. Nutritional status was evaluated by Geriatric Nutritional Risk Index (GNRI) calculated as follows: 14.89 · serum albumin (g/dl) + 41.7 · BMI/22, and malnutrition was defined as GNRI<92. The study endpoint was cardiovascular-renal poor outcome (CVR), defined as cardiovascular death and the development of end-stage renal disease requiring renal replacement therapy. Results: During a follow-up period of 4.2±3.3 yrs, 86 patients had CVR. At multivariate Cox analysis, GWTG-HF risk score and GNRI were significantly and independently associated with CVR, in both HFrEF and HFpEF groups. The patients with both greater GWTG-HF score (>median value=35) and malnutrition had a significantly increased risk of CVR than those with either and none of them ([HFrEF] 60% vs 32% vs 16%, p<0.0001, [HFpEF] 45% vs 18% vs 12%, p<0.0001, respectively) Conclusion: Malnutrition assessed by GNRI would provide the additional long-term prognostic information to GWTG-HF risk score in patients admitted for ADHF, irrespective of the presence of reduced LV function.

The Effect of Malnutrition on Morbidity after Surgery for Chronic Pancreatitis

2005 ◽  
Vol 71 (6) ◽  
pp. 466-473 ◽  
Author(s):  
Thomas Schnelldorfer ◽  
David B. Adams
Keyword(s):  
Chronic Pancreatitis ◽  
Nutritional Assessment ◽  
Risk Index ◽  
Protein Energy Malnutrition ◽  
Infectious Complications ◽  
Nutritional State ◽  
Nutritional Risk ◽  
Operative Morbidity ◽  
Lateral Pancreaticojejunostomy ◽  
Nutritional Risk Index

Protein-energy malnutrition is a notable problem in the management of patients with chronic pancreatitis. The effect of malnutrition on pancreatic surgery is not well known. The records of 313 consecutive patients who underwent lateral pancreaticojejunostomy (LPJ, n = 152), pancreaticoduodenectomy (PD, n = 78), or distal pancreatectomy (DP, n = 83) for chronic pancreatitis were retrospectively reviewed and analyzed. Subjective Global Assessment, Nutritional Risk Index, and Instant Nutritional Assessment were used to assess the nutritional state. An average of all three nutritional indexes was established, and patients were categorized into well nourished (n = 101) as well as mild (n = 91), moderate (n = 94), and severe malnourished (n = 27). Poor nutritional state was associated with an increase in postoperative complication rate (LPJ: well nourished 14%, mild 25%, moderate 31%*, severe 50%*; PD: well nourished 44%, mild 44%, moderate 60%, severe 88%*; DP: well nourished 17%, mild 13%, moderate 30%, severe 55%*; * P < 0.045 vs well nourished). Low serum albumin levels also increased operative morbidity. The increase in morbidity was reflected by a higher rate of infectious complications as well as increased ICU stay. Body mass index and weight loss did not contribute to change in outcome. Malnutrition was associated with a higher incidence of postoperative complications after surgery for chronic pancreatitis. An increase in operative morbidity might be related to decreased protein synthesis and impaired immunocompetence.

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 Nutritional screening based on objective indices at admission predicts in-hospital mortality in patients with COVID-19

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Feier Song ◽  
Huan Ma ◽  
Shouhong Wang ◽  
Tiehe Qin ◽  
Qing Xu ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Hospital Mortality ◽  
Critically Ill ◽  
Risk Index ◽  
Screening Tools ◽  
Nutritional Risk ◽  
Hospital Death ◽  
Nutritional Screening ◽  
Nutritional Risk Index ◽  
Conut Score

Abstract Background Could nutritional status serve as prognostic factors for coronavirus disease 2019 (COVID-19)? The present study evaluated the clinical and nutritional characteristics of COVID-19 patients and explored the relationship between risk for malnutrition at admission and in-hospital mortality. Methods A retrospective, observational study was conducted in two hospitals in Hubei, China. Confirmed cases of COVID-19 were typed as mild/moderate, severe, or critically ill. Clinical data and in-hospital death were collected. The risk for malnutrition was assessed using the geriatric nutritional risk index (GNRI), the prognostic nutritional index (PNI), and the Controlling Nutritional Status (CONUT) via objective parameters at admission. Results Two hundred ninety-five patients were enrolled, including 66 severe patients and 41 critically ill patients. Twenty-five deaths were observed, making 8.47% in the whole population and 37.88% in the critically ill subgroup. Patients had significant differences in nutrition-related parameters and inflammatory biomarkers among three types of disease severity. Patients with lower GNRI and PNI, as well as higher CONUT scores, had a higher risk of in-hospital mortality. The receiver operating characteristic curves demonstrated the good prognostic implication of GNRI and CONUT score. The multivariate logistic regression showed that baseline nutritional status, assessed by GNRI, PNI, or CONUT score, was a prognostic indicator for in-hospital mortality. Conclusions Despite variant screening tools, poor nutritional status was associated with in-hospital death in patients infected with COVID-19. This study highlighted the importance of nutritional screening at admission and the new insight of nutritional monitoring or therapy.

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