Preoperative NRS2002 Assessment of Nutritional Risk of Patients with Esophagus Cancer and Postoperative Results_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

SUNZhi-yong ,  CAOZi-ang , YEQing , LIANGEr-kang , FUHao-bai , QIANXiao-zhe

Department of Thoracic Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, P. R. China;

Corresponding author：

CAOZi-ang, Email: dr_cao@163.com

Keywords：

Nutritional risk screening 2002; Nutritional risk; Esophagus cancer; Complications

DOI：

10.7507/1007-4848.20150089

Video：

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Objective To evaluate nutritional risk of patients with esophagus cancer before operation using nutritional risk screening 2002 (NRS2002), and explore the relationship between nutritional risk score and postoperative results. Methods We prospectively evaluated the nutritional risk of 225 patients with esophagus carcinoma patients who were admitted in Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine between March 2012 and March 2013 using NRS2002, in accordance with disease severity score, nutritional status score and age score(age≥70 years old score was 1 point, < 70 years old for 0 point). There were 136 males and 89 females with age of 64.0±8.2 years (ranged from 41 to 85 years). Postoperative results include postoperative complications, mortality, and length of hospital stay. Results The number of patients with preoperative score≥3 points was 75 (33.3%), < 3 points was 150 (66.7%). The incidence rate of postoperative complications was 26.7% in the patients with NRS2002 score≥3 points, and was 12.0% in those with NRS2002 score < 3 points(P < 0.05). And the total hospital stay time was longer in the patients with NRS2002 score≥3 points than that with NRS2002 score < 3 points(29.80±7.94 d vs. 15.30±2.05 d, P < 0.05). Logistic regression analysis showed that the preoperative NRS2002, the underlying diseases, and surgical method were risk factors for postoperative complications. Conclusions Preoperative NRS2002 score≥3 points can predict more postoperative complications and longer hospital stay time in patients with esophagus carcinoma. It indicates that scientific nutrition support is necessary for esophagus carcinoma patients with NRS2002 score≥3 points. NRS2002 can be used as a predictive index of nutritional risk after operation of esophagus carcinoma.

Citation： SUNZhi-yong, CAOZi-ang, YEQing, LIANGEr-kang, FUHao-bai, QIANXiao-zhe. Preoperative NRS2002 Assessment of Nutritional Risk of Patients with Esophagus Cancer and Postoperative Results. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(4): 323-326. doi: 10.7507/1007-4848.20150089 Copy

1.	Kondrup J, Allison SP, Elia M, et al.ESPEN guidelines for nutrition screening 2002.Clin Nutr, 2003, 22(4):415-421.
2.	Kondrup J, Rasmussen HH, Hamberg O, et al.Nutritional Risk Screening (NRS 2002):a new method based on an analysis of controlled clinical trials.Clin Nutr, 2003, 22:321-336.
3.	中华医学会, 主编.临床诊疗指南:肠外肠内营养学分册.北京:人民卫生出版社, 2008.16-18.
4.	周脉耕, 王小风, 胡建平.2004-2005年中国主要恶性肿瘤死亡的地理分布特点.中华预防医学杂志, 2010, 44(4):303-308.
5.	赫捷, 邵康.中国食管癌流行病学现状、诊疗现状及未来对策.中国癌症杂志, 2011, 21(7):501-504.
6.	顾恺时, 主编.顾恺时胸心外科手术学.上海:上海科学技术出版社, 2003.935-936.
7.	吴国豪.肿瘤病人营养不良的原因与危害.中国实用外科杂志, 2002, 22(11):644-646.
8.	Schiesser M, Müller S, Kirchhoff P, et al.Assessment of a novel screening score for nutritional risk in predicting complications in gastro-intestinal surgery.Clin Nutr, 2008, 27(4):565-570.
9.	Haldun G, Eren E, Recep A, et al.Evaluation of nutritional risk on admission to the general surgery department.Bratisl Lek Listy, 2008, 109(2):57-60.
10.	Bauer JM, Sieber CC.Significance and diagnosis of malnutrition in the elderly.Z Arztl Fortbild Qualitatssich, 2007, 101(9):605-609.
11.	姚玉春, 胥永忠, 赵雍凡.食管癌患者围手术期死亡的高危因素分析.中国胸心血管外科临床杂志, 2002, 9(4):311-312.
12.	龚太乾, 蒋耀光, 王如文, 等.食管癌术后早期并发症及死亡原因分析.中国胸心血管外科临床杂志, 2005, 12(3):173-176.
13.	Morgan MA, Lewis WG, Hopper AN, et al.Prognostic significance of body mass indices for patients undergoing esophagectomy for cancer.Dis Esophagus, 2007, 20(1):29-35.
14.	Melis M, Weber JM, McLoughlin JM, et al.An elevated body mass index does not reduce survival after esophagectomy for cancer.Ann Surg Oncol, 2011, 18(3):824-831.
15.	Scarpa M, Cagol M, Bettini S, et al.Overweight patients operated on for cancer of the esophagus survive longer than normal-weight patients.J Gastrointest Surg, 2013, 17(2):218-227.
16.	Jie B, Jiang ZM, Nolan MT, et al.Impact of nutritional support on clinical outcome in patients at nutritional risk:a multicenter, prospective cohort study in Baltimore and Beijing teaching hospitals.Nutrition, 2010, 26(11-12):1088-1093.
17.	Sorensen J, Kondrup J, Prokopowicz J, et al.EuroOOPS:an international, multicentre study to implement nutritional risk screening and evaluate clinical outcome.Clin Nutr, 2008, 27(3):340-349.
18.	Gheorghe C, Pascu O, Iacob R, et al.Nutritional risk screening and prevalence of malnutrition on admission to gastroenterology departments:a multicentric study.Chirurgia (Bucur), 2013, 108(4):535-541.
19.	Johansen N, Kondrup J, Plum LM, et al.Effect of nutritional support on clinical outcome in patients at nutritional risk.Clin Nutr, 2004, 23(4):539-550.
20.	Amaral TF, Matos LC, Tavares MM, et al.The economic impact of disease-related malnutrition at hospital admission.Clin Nutr, 2007, 26(6):778-784.

1. Kondrup J, Allison SP, Elia M, et al.ESPEN guidelines for nutrition screening 2002.Clin Nutr, 2003, 22(4):415-421.
2. Kondrup J, Rasmussen HH, Hamberg O, et al.Nutritional Risk Screening (NRS 2002):a new method based on an analysis of controlled clinical trials.Clin Nutr, 2003, 22:321-336.
3. 中华医学会, 主编.临床诊疗指南:肠外肠内营养学分册.北京:人民卫生出版社, 2008.16-18.
4. 周脉耕, 王小风, 胡建平.2004-2005年中国主要恶性肿瘤死亡的地理分布特点.中华预防医学杂志, 2010, 44(4):303-308.
5. 赫捷, 邵康.中国食管癌流行病学现状、诊疗现状及未来对策.中国癌症杂志, 2011, 21(7):501-504.
6. 顾恺时, 主编.顾恺时胸心外科手术学.上海:上海科学技术出版社, 2003.935-936.
7. 吴国豪.肿瘤病人营养不良的原因与危害.中国实用外科杂志, 2002, 22(11):644-646.
8. Schiesser M, Müller S, Kirchhoff P, et al.Assessment of a novel screening score for nutritional risk in predicting complications in gastro-intestinal surgery.Clin Nutr, 2008, 27(4):565-570.
9. Haldun G, Eren E, Recep A, et al.Evaluation of nutritional risk on admission to the general surgery department.Bratisl Lek Listy, 2008, 109(2):57-60.
10. Bauer JM, Sieber CC.Significance and diagnosis of malnutrition in the elderly.Z Arztl Fortbild Qualitatssich, 2007, 101(9):605-609.
11. 姚玉春, 胥永忠, 赵雍凡.食管癌患者围手术期死亡的高危因素分析.中国胸心血管外科临床杂志, 2002, 9(4):311-312.
12. 龚太乾, 蒋耀光, 王如文, 等.食管癌术后早期并发症及死亡原因分析.中国胸心血管外科临床杂志, 2005, 12(3):173-176.
13. Morgan MA, Lewis WG, Hopper AN, et al.Prognostic significance of body mass indices for patients undergoing esophagectomy for cancer.Dis Esophagus, 2007, 20(1):29-35.
14. Melis M, Weber JM, McLoughlin JM, et al.An elevated body mass index does not reduce survival after esophagectomy for cancer.Ann Surg Oncol, 2011, 18(3):824-831.
15. Scarpa M, Cagol M, Bettini S, et al.Overweight patients operated on for cancer of the esophagus survive longer than normal-weight patients.J Gastrointest Surg, 2013, 17(2):218-227.
16. Jie B, Jiang ZM, Nolan MT, et al.Impact of nutritional support on clinical outcome in patients at nutritional risk:a multicenter, prospective cohort study in Baltimore and Beijing teaching hospitals.Nutrition, 2010, 26(11-12):1088-1093.
17. Sorensen J, Kondrup J, Prokopowicz J, et al.EuroOOPS:an international, multicentre study to implement nutritional risk screening and evaluate clinical outcome.Clin Nutr, 2008, 27(3):340-349.
18. Gheorghe C, Pascu O, Iacob R, et al.Nutritional risk screening and prevalence of malnutrition on admission to gastroenterology departments:a multicentric study.Chirurgia (Bucur), 2013, 108(4):535-541.
19. Johansen N, Kondrup J, Plum LM, et al.Effect of nutritional support on clinical outcome in patients at nutritional risk.Clin Nutr, 2004, 23(4):539-550.
20. Amaral TF, Matos LC, Tavares MM, et al.The economic impact of disease-related malnutrition at hospital admission.Clin Nutr, 2007, 26(6):778-784.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Preoperative NRS2002 Assessment of Nutritional Risk of Patients with Esophagus Cancer and Postoperative Results

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