Zhihong Zhang1, Zhong Wan2, Yu Zhu1, Lijuan Zhang1, Lili Zhang3, Hongwei Wan4. 1. Department of Nursing, Shanghai Proton and Heavy Ion Center, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China. 2. Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institution, Liaoning, China. 3. School of Nursing, Southern Medical University, Guangzhou, China. 4. Department of Nursing, Shanghai Proton and Heavy Ion Center, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China. Electronic address: Hong_whw@aliyun.com.
Abstract
OBJECTIVES: This study aimed to evaluate the diagnostic capacity of the Nutritional Risk Screening 2002 (NRS2002), Malnutrition Universal Screening Tool (MUST), and Patient-generated Subjective Global Assessment (PG-SGA) in light of the Global Leader Initiative on Malnutrition (GLIM) criteria in adult patients with cancer. METHODS: A multicenter observational study was conducted. Nutritional screening and assessment were performed at the time of admission to hospitals with the NRS2002, MUST, PG-SGA, and GLIM criteria. Sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratio, and Kappa (K) values were used to evaluate the performance of these tools. RESULTS: Of the 637 included patients, 24.8% and 15.4% of patients were at moderate and high risk of malnutrition, respectively, using the NRS2002 and MUST. The NRS2002 was better correlated to the GLIM criteria with a higher value of Kappa (K = 0.823 vs. 0.596) and area under the receiver operating characteristic curve (K = 0.896 vs. 0.757) than the MUST. Meanwhile, 28.3% of patients were diagnosed as malnourished at the time of admission per the GLIM criteria, and 43.3% were malnourished per the PG-SGA. The PG-SGA had a fair agreement with the GLIM criteria (K = 0.453), revealing a positive predictive value of 52.9% and negative predictive value of 90.6%. CONCLUSIONS: The NRS2002 was better correlated with the GLIM diagnostic criteria of malnutrition than the MUST. The PG-SGA was too sensitive to detect nutrition-related deteriorations, leading to a low positive predictive value in the malnutrition diagnosis. Thus, the GLIM criteria could be used to confirm the presence of malnutrition identified by the PG-SGA in adults with cancer.
OBJECTIVES: This study aimed to evaluate the diagnostic capacity of the Nutritional Risk Screening 2002 (NRS2002), Malnutrition Universal Screening Tool (MUST), and Patient-generated Subjective Global Assessment (PG-SGA) in light of the Global Leader Initiative on Malnutrition (GLIM) criteria in adult patients with cancer. METHODS: A multicenter observational study was conducted. Nutritional screening and assessment were performed at the time of admission to hospitals with the NRS2002, MUST, PG-SGA, and GLIM criteria. Sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratio, and Kappa (K) values were used to evaluate the performance of these tools. RESULTS: Of the 637 included patients, 24.8% and 15.4% of patients were at moderate and high risk of malnutrition, respectively, using the NRS2002 and MUST. The NRS2002 was better correlated to the GLIM criteria with a higher value of Kappa (K = 0.823 vs. 0.596) and area under the receiver operating characteristic curve (K = 0.896 vs. 0.757) than the MUST. Meanwhile, 28.3% of patients were diagnosed as malnourished at the time of admission per the GLIM criteria, and 43.3% were malnourished per the PG-SGA. The PG-SGA had a fair agreement with the GLIM criteria (K = 0.453), revealing a positive predictive value of 52.9% and negative predictive value of 90.6%. CONCLUSIONS: The NRS2002 was better correlated with the GLIM diagnostic criteria of malnutrition than the MUST. The PG-SGA was too sensitive to detect nutrition-related deteriorations, leading to a low positive predictive value in the malnutrition diagnosis. Thus, the GLIM criteria could be used to confirm the presence of malnutrition identified by the PG-SGA in adults with cancer.
Authors: Carlos Serón-Arbeloa; Lorenzo Labarta-Monzón; José Puzo-Foncillas; Tomas Mallor-Bonet; Alberto Lafita-López; Néstor Bueno-Vidales; Miguel Montoro-Huguet Journal: Nutrients Date: 2022-06-09 Impact factor: 6.706