Analysis on value of preoperative nutritional risk screening and malnutrition diagnosis in postoperative prediction in gastrointestinal tract malignant tumor
10.3969/j.issn.1671-8348.2024.21.010
- VernacularTitle:术前营养风险筛查和营养不良评定在胃肠道恶性道肿瘤术后预测中的价值分析
- Author:
Xi LUO
1
;
Weiwei JIN
Author Information
1. 浙江省立同德医院营养科,杭州 310012
- Keywords:
NRS-2002;
GLIM;
gastrointestinal malignant tumor;
postoperative complications;
predictive value
- From:
Chongqing Medicine
2024;53(21):3250-3256,3263
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the value of preoperative nutritional risk screening and malnutrition on postoperative prediction in the patients with gastrointestinal tract malignant tumor.Methods A total of 428 patients with gastrointestinal tract malignant tumors receiving elective operation in the gastrointestinal surgery department and proctology department of this hospital from January 2017 to October 2023 were se-lected as the study subjects.The patients were classified by postoperative complications Clavien-Dindo classifi-cation and divided into non-complication group(n=288)and complication group(n=140)according to whether or not having complications.The Nutritional Risk Screening 2002(NRS2002)and Global Leadership Initiative on Malnutrition(GLIM)were adopted to evaluate the nutritional status of the patients.The postop-erative complications during the hospitalization period,hospitalization duration,hospitalization expenses,30 d and 60 d non-planed readmission were recorded.Results Compared with the non-complication group,the age,complications ≥2,NRS2002 score ≥3 points,severe malnutrition proportion,urea level,hospitalization dura-tion,hospitalization expenses,ICU admission ratio,30 d and 60 d non-planned readmission rate in the compli-cation group were higher,BMI,KPS score,albumin,total calcium,low density lipoprotein,RBC count,Hb and HCT level were lower,and the differences were statistically significant(P＜0.05).The logistic regression a-nalysis results showed that after adjusting the relevant confounding factors,nutritional risk in NRS2002 screening,malnutrition in GLIM assessment and moderate to severe malnutrition in GLIM classification were all risk factors for postoperative complications occurrence in the patients with gastrointestinal malignant tumors(P＜0.05).None of them were the risk factors for unplanned readmission on 30,60 d(P＞0.05).The receiver operating characteristic(ROC)curve analysis results showed that the arae under the curve(AUC)of NRS2002 was greater than that of GLIM(0.733 vs.0.704),and the difference was statistically significant(P＜0.05).There was no statistically significant difference in the comparison among the GLIM grading(0.710)in NRS2002 and GLIM(P＞0.05).Conclusion The predictive ability of NRS2002 for postoperative complications in the patients with gastrointestinal tract maliganat tumors is slightly superior to that of GLIM.
