Clinical outcomes associated with computed tomography‐based body composition measures in lung transplantation: a systematic review

2020 ◽  
Vol 33 (12) ◽  
pp. 1610-1625
Author(s):  
Dmitry Rozenberg ◽  
Camila E. Orsso ◽  
Karan Chohan ◽  
Ani Orchanian‐Cheff ◽  
Sahar Nourouzpour ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Systematic Review ◽  
Body Composition ◽  
Lung Transplantation ◽  
Clinical Outcomes

scholarly journals An Evaluation of the Nutritional Value and Physical Properties of Blenderised Enteral Nutrition Formula: A Systematic Review and Meta-Analysis

Nutrients ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1840
Author(s):  
Omorogieva Ojo ◽  
Amanda Rodrigues Amorim Adegboye ◽  
Osarhumwese Osaretin Ojo ◽  
Xiaohua Wang ◽  
Joanne Brooke
Keyword(s):  
Systematic Review ◽  
Body Composition ◽  
Enteral Nutrition ◽  
Nutritional Status ◽  
Physical Properties ◽  
Clinical Outcomes ◽  
Nutritional Value ◽  
Energy Content ◽  
Meta Analysis ◽  
Nutritional Values

Background: Although there are merits in using commercial “enteral nutrition formula” (ENF) compared with blended ENF, there is a growing preference for the use of blended ENF in many countries globally. However, the nutritional value and physical properties of blended ENF compared with commercial ENF may be limiting its use. We have not found any evidence of a meta-analysis on the nutritional value of blended diets in the adult population. Aim: The aim of this review was to compare the nutritional value, physical properties, and clinical outcomes of blended ENF with commercial ENF. Methods: The preferred reporting items for systematic reviews and meta-analyses were used for this review. The search strategy was based on a Population, Intervention, Comparator, Outcome framework. The following databases; Pubmed, EMBASE, PSYCInfo, and Google scholar were searched for articles of interest using keywords, Medical Subject Heading (MeSH) and Boolean operators (AND/OR) from the inception of each database until 23 February 2020. The articles were evaluated for quality. Results: Based on the systematic review and meta-analysis, four distinct themes were identified; Nutritional value, Physical properties, Clinical outcomes; and Adverse events. The findings of this review showed inconsistencies in the macronutrient and micronutrient values of the blenderised ENF compared with the commercial ENF. The results of the meta-analysis demonstrated that there were no significant differences (p > 0.05) between the blenderised ENF and the commercial ENF in relation to the fat and protein contents of the diets. However, the blenderised ENF was significantly lower (p < 0.05) than the commercial ENF regarding the energy content of the diets, with an overall mean difference of −29.17 Kcal/100 mL (95% CI, −51.12, −7.22) and carbohydrate content with an overall mean difference of -5.32 g/100 mL (95% CI, −7.64, −3.00). In terms of sodium, potassium, and vitamin A, there were no significant differences (p > 0.05) between the blenderised and commercial ENF, although significant differences (p < 0.05) were observed between the two diets with respect to calcium, phosphorus, magnesium, zinc, iron, and vitamin C contents. Furthermore, the blenderised ENF showed significantly higher levels (p < 0.05) of viscosity and osmolality than the commercial ENF. The significantly lower levels of some of the macro-nutrients and micro-nutrients in the blenderised ENF compared with the commercial ENF and the difference in the expected nutritional values may be due to the fact blenderised ENF is produced from common foods. Thus, the type of foodstuffs, cooking, and processing methods may lead to loss of nutrients and energy density. The deficits in the energy content and some of the macro- and micro-nutrients in the blenderised ENF compared with commercial ENF may have implications for patients’ health and clinical outcomes. The clinical implications of the underdelivering of nutrients may include increased risk of undernutrition, including energy malnutrition, which could have a negative effect on body composition and anthropometric parameters, morbidity, mortality, length of hospital stay, and costs. For outpatient care, this could increase the risk of hospital re-admission and homecare costs. Additionally, the higher viscosity and osmolality of the blenderised ENF compared with the commercial ENF can increase the risk of complications, including tube blockage, and impaired delivery of feed, water, and medications, with significant implications for patients’ nutritional status and health outcomes. Conclusion: The results of this systematic review and meta-analysis identified significant variability in the nutritional value of blenderised ENF compared with commercial ENF. Furthermore, the nutritional values of the blenderised ENF do not meet the expected recommended levels compared with commercial ENF and these may have implications for patients’ nutritional status and health outcomes, including the effect on body composition, morbidity, mortality, hospital re-admission, and costs. Further studies are needed to elucidate the nutritional value of blenderised ENF on patients’ clinical outcomes.

Evaluation of body Computed Tomography-determined sarcopenia in breast cancer patients and clinical outcomes: A systematic review

2019 ◽  
Vol 21 ◽  
pp. 100154 ◽  
Author(s):  
Federica Rossi ◽  
Francesca Valdora ◽  
Bianca Bignotti ◽  
Lorenzo Torri ◽  
Giulia Succio ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Computed Tomography ◽  
Systematic Review ◽  
Cancer Patients ◽  
Clinical Outcomes ◽  
Breast Cancer Patients

scholarly journals The relation between Malnutrition Universal Screening Tool (MUST), computed tomography–derived body composition, systemic inflammation, and clinical outcomes in patients undergoing surgery for colorectal cancer

2019 ◽  
Vol 110 (6) ◽  
pp. 1327-1334 ◽  
Author(s):  
Arwa S Almasaudi ◽  
Stephen T McSorley ◽  
Ross D Dolan ◽  
Christine A Edwards ◽  
Donald C McMillan
Keyword(s):  
Colorectal Cancer ◽  
Computed Tomography ◽  
Body Composition ◽  
Nutritional Status ◽  
Hospital Stay ◽  
Clinical Outcomes ◽  
Universal Screening ◽  
Screening Tool ◽  
Length Of Hospital Stay ◽  
Malnutrition Universal Screening Tool

ABSTRACT Background Nutritional status is an important factor affecting a patient's clinical outcomes. Early identification of patients who are at risk of malnutrition is important to improve clinical outcomes and reduce health cost. The Malnutrition Universal Screening Tool (MUST) has been recommended as part of the routine nursing assessment for all patients at hospital admission. Objective The aim of this study was to examine the association between nutritional status (MUST), systemic inflammatory response (SIR), body composition, and clinical outcomes in patients undergoing surgery for colorectal cancer. Methods The malnutrition risk was examined using MUST in patients admitted for surgery for colorectal cancer between March 2013 and June 2016. Preoperative computed tomography scans were used to define the body composition. The presence of SIR was evidenced by the modified Glasgow prognostic score and the neutrophil to lymphocyte ratio. Postoperative complications, severity of complication, length of hospital stay, and mortality were considered as outcome measures. Results The study included 363 patients (199 males, 164 females); 21% of the patients presented with a medium or high nutritional risk. There were significant associations between MUST and subcutaneous adiposity (P < 0.001), visceral obesity (P < 0.001), and low skeletal muscle index (P < 0.001). No statistically significant association was identified between MUST score and presence of any complication or severity of complication. On multivariate analysis, MUST remained independently associated with the length of hospital stay (OR: 2.17; 95% CI: 1.45, 3.26; P < 0.001). Kaplan–Meier survival curves showed an increased number of deaths for patients at medium or high risk of malnutrition (P < 0.001). This association was found to be independent of other confounding factors (HR: 1.45; 95% CI: 1.06, 1.99; P = 0.020). Conclusions MUST score is an independent marker of risk in those undergoing surgery for colorectal cancer and should remain a key part of preoperative assessment.

scholarly journals Body Composition in Relation to Clinical Outcomes in Renal Cell Cancer: A Systematic Review and Meta-analysis

2018 ◽  
Vol 4 (3) ◽  
pp. 420-434 ◽  
Author(s):  
Alina Vrieling ◽  
Ellen Kampman ◽  
Nathalja C. Knijnenburg ◽  
Peter F. Mulders ◽  
J.P. Michiel Sedelaar ◽  
...  
Keyword(s):  
Systematic Review ◽  
Body Composition ◽  
Clinical Outcomes ◽  
Renal Cell Cancer ◽  
Renal Cell ◽  
Meta Analysis ◽  
Cell Cancer
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