Main Article Content
Gastrointestinal system cancers, NRS-2002, nutritional status, screening tools, SGA
Background & Aims: To determine the nutritional status of gastrointestinal cancer patients with two different nutritional screening tools and compare the tools.
Methods: This study was held in 110 patients (female; 41.8% male: 58.2%), aged 19-65 years, admitted to hospital, diagnosed with gastrointestinal system cancer (not operated). The objective was to determine the nutritional status of the patients with nutrition screening tools (Subjective Global Assessment-SGA, Nutritional Risk Screening-NRS 2002), compare the tools, and describe the malnutrition status of patients. Socio-demographic characteristics, anthropometric measurements, biochemical parameters and 24- hour dietary recalls, frequency of foods consumed were determined.
Results: Out of total, 54.7% of males and 56.5% of females had normal Body Mass Index-BMI. Using SGA, 49.1% of the patients had serious, 41.8% had moderate degree of malnutrition. According to NRS-2002, percentages of severely, moderately and mildly undernourished patients were 54.6%, 33.6% and 11.8%, respectively. The percentage of patients meeting the recommended Daily allowances was 47.2% and 58.1%, respectively for males and females. According to NRS and SGA tools, statistically significant differences with current weight, ideal body weight, usual body weight, percentage of weight loss, body mass index (BMI), mid-upper arm circumference (MUAC), triceps skinfold thickness (TST), mid-upper arm muscle area, mid-upper arm muscle circumference and mid-upper arm fat area (p<0.05) were found. Nutritional status of patients with SGA and NRS tests showed consistent similarity (κ=0.671, p<0.001).Similar changes were found between SGA and NRS scores. Consistency was found statistically significant (r=0.786 and p=<0.001).
Conclusion: One of the malnutrition screening tools could be preoperatively applied in gastrointestinal system cancer patients. Nutritional support should be planned and administered, when needed.
2. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians. 2018;68(6):394-424.
3. Ruiz RB, Hernández PS. Diet and cancer: risk factors and epidemiological evidence. Maturitas. 2014;77(3):202-8.
4. Arı M, Öğüt S, Kaçar Döğer F. Kanserin önlenmesinde antioksidanlarin rolü. Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi. 2017;1(2):67-74.
5. Winters S, Martin C, Murphy D, Shokar NK. Breast cancer epidemiology, prevention, and screening. Progress in Molecular Biology and Translational Science. 151: Elsevier; 2017. p. 1-32.
6. Hanf V, Gonder U. Nutrition and primary prevention of breast cancer: foods, nutrients and breast cancer risk. Eur J Obstet Gynecol Reprod Biol. 2005;123(2):139-49.
7. Wu G-H, Liu Z-H, Wu Z-H, Wu Z-G. Perioperative artificial nutrition in malnourished gastroin-testinal cancer patients. World journal of gastroenterology: WJG. 2006;12(15):2441.
8. Weimann A, Braga M, Harsanyi L, Laviano A, Ljungqvist O, Soeters P, et al. ESPEN guidelines on enteral nutrition: surgery including organ transplantation. Clinical nutrition. 2006;25(2):224-44.
9. von Meyenfeldt M. Cancer-associated malnutrition: an introduction. European Journal of Oncology Nursing. 2005;9:S35-S8.
10. Chi J, Yin S, Zhu Y, Gao F, Song X, Song Z, et al. A comparison of the nutritional risk screening 2002 tool with the subjective global assessment tool to detect nutritional status in Chinese patients undergoing surgery with gastrointestinal cancer. Gastroenterology Nursing. 2017;40(1):19-25.
11. Parenteral ASf, Nutrition E. Guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients. Journal of Parenteral and Enteral Nutrition. 2002;26(1_suppl):1SA-138SA.
12. Kondrup J, Rasmussen HH, Hamberg O, STANGA Z, Group AahEW. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clinical nutrition. 2003;22(3):321-36.
13. Kyle UG, Genton L, Pichard C. Hospital length of stay and nutritional status. Current Opinion in Clinical Nutrition & Metabolic Care. 2005;8(4):397-402.
14. Pekcan G. Hastalıklarda beslenme durumunun saptanması, Diyet El Kitabı. Editör: Baysal, A, Bozkurt, N, Pekcan, G, Besler, T, Aksoy, M, Merdol Kutluay, Türkan, Keçecioğlu, S ve Mercangil, S, M) Ankara: Hatipoğlu Yayınevi. 2008.
15. Türkiye’ye Özgü Beslenme Rehberi. In: Müdürlüğü TSBTSHG, editor. Ankara2004.
16. Alıcı S, İzmirli M, Doğan E. Yüzüncü Yıl Üniversitesi Tıp Fakültesi Tıbbi Onkoloji Bilim Dalı'na başvuran kanser hastalarının epidemiyolojik değerlendirilmesi. Türk Onkoloji Dergisi. 2006;21(2):87-97.
17. Ryu SW, Kim IH. Comparison of different nutritional assessments in detecting malnutrition among gastric cancer patients. World journal of gastroenterology: WJG. 2010;16(26):3310.
18. Santarpia L, Contaldo F, Pasanisi F. Nutritional screening and early treatment of malnutrition in cancer patients. Journal of cachexia, sarcopenia and muscle. 2011;2(1):27-35.
19. Nicolini A, Ferrari P, Masoni MC, Fini M, Pagani S, Giampietro O, et al. Malnutrition, anorexia and cachexia in cancer patients: a mini-review on pathogenesis and treatment. Biomedicine & Pharmacotherapy. 2013;67(8):807-17.
20. Caccialanza R, Pedrazzoli P, Cereda E, Gavazzi C, Pinto C, Paccagnella A, et al. Nutritional support in cancer patients: a position paper from the Italian Society of Medical Oncology (AIOM) and the Italian Society of Artificial Nutrition and Metabolism (SINPE). Journal of Cancer. 2016;7(2):131.
21. Borges NP, Silva BA, Cohen C, Portari Filho P, Medeiros F. Comparison of the nutritional diagnosis, obtained through different methods and indicators, in patients with cancer. Nutrición hospitalaria. 2009;24(1):51-5.
22. Bozzetti F, Arends J, Lundholm K, Micklewright A, Zurcher G, Muscaritoli M. ESPEN guidelines on parenteral nutrition: non-surgical oncology. Clinical nutrition. 2009;28(4):445-54.
23. R Ç. HIV ve kanser. In: Besler T İN, editor. Diyetisyen el kitabı: Enteral ve parenteral nütrisyon. İstanbul: Nobel Tıp Ktabevi; 2014. p. 199-216.
24. Fund WCR, Research AIfC. Food, nutrition, physical activity, and the prevention of cancer: a global perspective: Amer Inst for Cancer Research; 2007.
25. Beslenme HÜSBF, Bölümü D. Türkiye’ye özgü besin ve beslenme rehberi. Ankara: Hacettepe Üniversitesi. 2015.
26. Robien K, Demark-Wahnefried W, Rock CL. Evidence-based nutrition guidelines for cancer survivors: current guidelines, knowledge gaps, and future research directions. Journal of the Academy of Nutrition and Dietetics. 2011;111(3):368-75.
27. dos Santos CA, Rosa CdOB, Ribeiro AQ, Ribeiro RdCL. Patient-generated subjective global assessment and classic anthropometry: comparison between the methods in detection of malnutrition among elderly with cancer. Nutricion hospitalaria. 2015;31(1):384-92.
28. Garth A, Newsome C, Simmance N, Crowe T. Nutritional status, nutrition practices and post‐operative complications in patients with gastrointestinal cancer. Journal of human nutrition and dietetics. 2010;23(4):393-401.
29. Song M, Garrett WS, Chan AT. Nutrients, foods, and colorectal cancer prevention. Gastroenterology. 2015;148(6):1244-60. e16.
30. Masri OA, Chalhoub JM, Sharara AI. Role of vitamins in gastrointestinal diseases. World Journal of Gastroenterology: WJG. 2015;21(17):5191.
31. Dawsey SP, Hollenbeck A, Schatzkin A, Abnet CC. A prospective study of vitamin and mineral supplement use and the risk of upper gastrointestinal cancers. Plos One. 2014;9(2).
32. Samur G. Vitaminler, mineraller ve sağlığımız. TC Sağlık Bakanlığı Temel Sağlık Hizmetleri Genel Müdürlüğü Beslenme ve Fiziksel Aktiviteler Daire Başkanlığı, Ankara: Klasmat Matbaacılık. 2008.
33. Lipworth L, Bender TJ, Rossi M, Bosetti C, Negri E, Talamini R, et al. Dietary vitamin D intake and cancers of the colon and rectum: a case-control study in Italy. Nutrition and cancer. 2008;61(1):70-5.
34. Correa P, Fontham ET, Bravo JC, Bravo LE, Ruiz B, Zarama G, et al. Chemoprevention of gastric dysplasia: randomized trial of antioxidant supplements and anti-Helicobacter pylori therapy. Journal of the National Cancer Institute. 2000;92(23):1881-8.
35. Charney P, Cranganu A, rD L. Nutrition screening and assessment in oncology. Clinical Nutrition for Oncology Patients Sudbury, MA: Jones & Bartlett. 2010:21-43.
36. Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, Bozzetti F, et al. ESPEN guidelines on nutrition in cancer patients. Clinical nutrition. 2017;36(1):11-48.
37. Copland L, Liedman B, Rothenberg E, Bosaeus I. Effects of nutritional support long time after total gastrectomy. Clinical Nutrition. 2007;26(5):605-13.
38. Gavazzi C, Colatruglio S, Sironi A, Mazzaferro V, Miceli R. Importance of early nutritional screening in patients with gastric cancer. British journal of nutrition. 2011;106(12):1773-8.
39. Bauer J, Capra S. Comparison of a malnutrition screening tool with subjective global assessment in hospitalised patients with cancer—sensitivity and specificity. Asia Pacific journal of clinical nutrition. 2003;12(3).
40. Aydin N, Karaöz S. Nutritional assessment of patients before gastrointestinal surgery and nurses’ approach to this issue. Journal of clinical nursing. 2008;17(5):608-17.
41. Wakahara T, Shiraki M, Murase K, Fukushima H, Matsuura K, Fukao A, et al. Nutritional screening with Subjective Global Assessment predicts hospital stay in patients with digestive diseases. Nutrition. 2007;23(9):634-9.
42. Wu B-W, Yin T, Cao W-X, Gu Z-D, Wang X-J, Yan M, et al. Clinical application of subjective global assessment in Chinese patients with gastrointestinal cancer. World Journal of Gastroenterology: WJG. 2009;15(28):3542.
43. Filipović BF, Gajić M, Milinić N, Milovanović B, Filipović BR, Cvetković M, et al. Comparison of two nutritional assessment methods in gastroenterology patients. World Journal of Gastroenterology: WJG. 2010;16(16):1999.
44. Raslan M, Gonzalez MC, Dias MCG, Nascimento M, Castro M, Marques P, et al. Comparison of nutritional risk screening tools for predicting clinical outcomes in hospitalized patients. Nutrition. 2010;26(7-8):721-6.
45. Kyle ÚG, Kossovsky MP, Karsegard VL, Pichard C. Comparison of tools for nutritional assessment and screening at hospital admission: a population study. Clinical Nutrition. 2006;25(3):409-17.