BACKGROUND/OBJECTIVE

Although nutritional assessment tools have been available internationally, local data for their use in foreseeing adverse outcomes among admitted patients are currently unavailable. The primary objective of this study was to determine the association of nutritional status using Short Nutritional Assessment Questionnaire (SNAQ) and malnutrition risk using the MST (Malnutrition Screening Tool) with ICU admission and in-hospital mortality.

METHODOLOGY

This was a prospective-cohort study which included 122 purposively-selected adult participants who were non-intubated, admitted for medical and surgical managements, stayed for at least 24 hours, had no COVID-19 infection, and were not admitted in any critical care unit. The SNAQ and MST questionnaires, which are validated tools and consists of  two to three easy-to-answer questions, were used among the participants and their scores were tallied in order to get their nutritional status and malnutrition risk. Primary endpoints measured were length of hospital stay, incidence of mortality, and ICU admission rate. Comorbidities were taken into account using the Charlson Comorbidity Index.

RESULT

Categorizing the SNAQ scores showed 33.61% were severely malnourished which was similar when using the MST classification, wherein 34.43% were at risk of malnutrition. None of the participants were admitted to the intensive care unit (ICU). Malnutrition risk and nutritional status was not significantly associated with 30-day in-hospital mortality (p >0.05). On the other hand, results of the Cox proportional hazards showed that SNAQ and MST significantly predicted the hazard of 30-day in-hospital mortality, increasing the hazard of mortality by 2.58 times and 3.67 times, respectively, for every 1-unit increase in SNAQ and MST scores. Similarly, nutritional status using the SNAQ classification indicated the severely malnourished category significantly predicted the hazard of mortality, increasing it by 9.22 times for those who are severely malnourished. Also, malnutrition risk using the MST classification indicated that those who were at risk of malnutrition were 9.80 times at greater hazard of mortality than those who were not at risk of malnutrition.

CONCLUSION

The MST and SNAQ classification are screening tools for nutritional status (SNAQ) and malnutrition risk (MST) that can be administered at the onset of the patient’s hospital course and have been demonstrated in this study to predict 30-day in-hospital mortality. It is important to note that none of the patients included in this study required intensive care unit admission.

Human ; Malnutrition ; Netherlands ; Eating ; Surveys And Questionnaires ; Mortality

Introduction: Low-risk papillary thyroid microcarcinomas (PTMC) have an indolent course and favorable prognosis. In the Philippines, radioactive iodine (RAI) remnant ablation is frequently given to patients with low-risk PTMC because of studies showing that Filipinos have more aggressive thyroid cancers. This study aims to determine if RAI remnant ablation prevents thyroid cancer recurrence among Filipino patients with low-risk PTMC who underwent thyroidectomy at a tertiary hospital in the Philippines. Methods: A retrospective cohort study was conducted among adult patients with low-risk PTMC who underwent total thyroidectomy from 2006 to 2016. Outcomes were classified as positive or negative for disease recurrence based on imaging results and serum thyroglobulin levels during each follow-up visit. Recurrence-free curves were estimated using Kaplan-Meier method and compared using Cox regression analysis. Results: A total of 90 cases of low-risk PTMC were included in the analysis with a mean follow-up duration of 41.88 months (range, 12-129 months). Forty eight patients (53.33%) underwent RAI remnant ablation (RAI group) and 42 patients (46.67%) did not (No RAI group). Six patients (6.67%) had disease recurrence at a median of 18 months (range, 12-70 months). The recurrence rates in the No RAI group were 2.8% at one year and 10.84% in five years and the recurrence rates in the RAI group were 0% at one year and 9.84% at five years. (HR, 5.34; 95% CI, 0.86 to 33.02; P=0.07). Conclusion This study did not provide sufficient evidence that RAI remnant ablation prevents disease recurrence in Filipino patients with low-risk PTMC. Future randomized, prospective trials involving larger sample sizes and longer follow-up duration are necessary to confirm our findings.
Thyroid Neoplasms