Validation of the efficacy of the NUTRISCORE for the nutritional screening of cancer patients in China

Background Malnutrition is common in cancer patients. The NUTRISCORE is a newly developed cancer-specific nutritional screening tool and was validated by comparison with the Patient-Generated Subjective Global Assessment (PG-SGA) and Malnutrition Screening Tool (MST) in Spain. We aimed to evaluate the performance of the NUTRISCORE, MST, and PG-SGA in estimating the risk of malnutrition in Chinese cancer patients. Methods Data from an open parallel and multicenter cross-sectional study in 29 clinical teaching hospitals in 14 Chinese cities were used. Cancer patients were assessed for malnutrition using the PG-SGA, NUTRISCORE, and MST. The sensitivity, specificity, and areas under the receiver operating characteristic curve were estimated for the NUTRISCORE and MST using the PG-SGA as a reference. Results A total of 1000 cancer patients were included. The mean age was 55.9 (19 to 92 years), and 47.5% were male. Of these patients, 450 (45.0%) had PG-SGA B and C, 29 (2.9%) had a NUTRISCORE ≥5, and 367 (36.7%) had an MST ≥ 2. Using the PG-SGA as a reference, the sensitivity, specificity, and area under the curve values of the NUTRISCORE were found to be 6.2, 99.8%, and 0.53, respectively. The sensitivity, specificity, and area under the curve values of the MST were 50.9, 74.9%, and 0.63, respectively. The kappa index between the NUTRISCORE and PG-SGA was 0.066, and that between the MST and PG-SGA was 0.262 (P < 0.05). Conclusions The NUTRISCORE had an extremely low sensitivity in cancer patients in China compared with the MST when the PG-SGA was used as a reference.

Nutritional Risk Screening (NRS 2002) as a tool to predict clinical outcomes in hospitalized patients: a literature review

The presence of malnutrition in hospitalized patients is prevalent and studies show its association with a higher incidence of complications, mortality, length of stay, costs, and increased frequency of hospital readmission. Routine use of simple tracking procedures is recommended. Nutritional screening detects individuals who are malnourished or at risk of developing malnutrition, and who can receive specific nutritional support. Nutritional Risk Screening (NRS 2002) is a nutritional screening method recommended by the European Society for Clinical and Metabolism (ESPEN) and identifies the risk of developing malnutrition in hospitalized patients. The aim of this paper is to review the literature on the NRS screening method (2002) and its relationship with clinical outcomes in hospitalized patients.

Research on Associations of MiR-149 with Nutritional Risk Assessment and Postoperative Complications of Patients with Colorectal Cancer

Background: MiRNAs play an important role in the development of colorectal cancer, however, there’s few evidence of miRNAs in the screening of nutritional risks of patients with colorectal cancer. Objectives: To explore the role of preoperative miR-149 in nutritional screening of patients with CRC, and its associations with clinicopathological characteristics and postoperative complications of patients with CRC. Methods: The associations of serum miR-149 with clinicopathological characteristics and postoperative complications of patients were analyzed. The ROC curves were plotted with miR-149 as the test variable, and the grouping results of patients with nutritional risks [total NRS2002 score ≥3 points] and no nutritional risks (total NRS2002 score <3 points) based on the preoperative NRS2002 score as the state variables. The consistency of miR-149 and NRS2002 in nutritional screening of CRC was analyzed using Kappa test. Results: MiR-149 was low in patients with CRC. There was a statistically significant difference in the miR-149 expression among patients with different tumor diameters and TNM stages in the two groups. The preoperative total NRS2002 score of CRC patients was <3 points (without nutritional risks) in 271 cases, and ≥3 points (with nutritional risks) in 129 cases. The sensitivity and specificity of miR-149 in the diagnosis of nutritional risks were 76.74% and 84.50%. The Kappa value was 0.622 with miR-149 =3.095 as the critical value. Conclusions: MiR-149 can reflect the perioperative nutritional status of patients with CRC, and miR-149 =3.095 can be used as the cut-off point for nutritional risk screening of patients with CRC, which is an important index for assessing the nutritional risk in the perioperative period. The expression of miR-149 has a certain association with postoperative complications.

Relationship between Nutritional Screening Tools and GLIM in Complicated IBD Requiring Surgery

Background: Accurate identification of malnutrition and preoperative nutritional care in Inflammatory Bowel Disease (IBD) surgery is mandatory. There is no validated nutritional screening tool for IBD patients. We developed a novel nutritional screening tool for IBD patients requiring surgery and compared it with other tools. Methods: we included 62 consecutive patients scheduled for elective surgery. The IBD Nutritional Screening tool (NS-IBD) was developed to screen patients for further comprehensive assessment. NRS-2002, MUST, MST, MIRT, SaskIBD-NR are compared with the new test. All screening tests were subsequently related to new GLIM criteria. Results: according to GLIM criteria, 25 (40%) IBD patients were malnourished (15 CD and 10 UC, 33% vs. 63%, p = 0.036). Stage 1 malnutrition was reported in ten patients, while stage 2 was detected in 15 patients. The comparison of each nutritional risk tool with GLIM criteria showed sensitivity of 0.52, 0.6, 0.6, 0.84, 0.84 and 0.92 for SASKIBD-NR, MUST, MST, NRS-2002, MIRT, and the new NS-IBD, respectively. Conclusions: in IBD, currently adopted nutritional screening tools are characterized by a low sensitivity when malnutrition diagnosis is performed with recent GLIM criteria. Our proposed tool to detect malnutrition performed the best in detecting patients that may require nutritional assessment and preoperative intervention.

Taste disorders in children with hemoblastosis and malignant CNS tumors after treatment

Despite significant achievements in oncopediatrics there is an increasing amount of children with remote consequences of anticancer treatment. Nutritional disorders are one of the key consequences, the main factors of which are taste disorders. Despite the interest in this issue, an increase in the number of studies, the exact genesis and causal relationships of these violations have not yet been established.Objective. To study the characteristics of taste perception in children with hemoblastosis and CNS tumors after treatment. Material and methods. The authors carried out a cross-sectional study, which included 110 children with hematological malignancies (42 patients) and CNS tumors (68 patients) aged from 10 to 17 years. The after – treatment period was 2–5 years. They analyzed the nutritional screening data (body mass index and survey data). A test for the identification of four tastes (sour, bitter, salty, sweet) was carried out with the solutions in a regulated concentration according to the standard GOST ISO 3972-2014.Results. The majority of children had violations of taste: to bitter taste – 64,6%, sweet – 40%, sour – 43,7%, salty – 33,6%. Children with hemoblastosis had more disorders.Parageusia was more common in children with CNS tumors. Obese children have a greater proportion of these disorders compared to children with malnutrition and normal nutritional status. There is no relationship with the frequency of food intake, its regularity andappetite.Conclusion. The authors have confirmed the presence of nutritional disorders and problems with taste perception that persist for a long time after the end of treatment. Apparently, a significant part of them has a peripheral genesis.