Research on Nutritional Risk and Application of Nutrition Support in Hospitalized Patients with Gastric Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YANG Ping , CHEN Bo , WU Xiaoting.

Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China;

Corresponding author：

Keywords：

Nutritional risk screening; Malnutrition; Body mass index; Nutritional support; Gastric cancer

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ObjectiveTo investigate the nutritional risk, incidence of malnutrition, and clinical application of nutrition support in hospitalized patients with gastric cancer by the nutritional risk screening (NRS) 2002 score summary table. MethodsFrom June 2009 to February 2010, nutritional risk screen and application of clinical nutritional support were carried out in the hospitalized patients with gastric cancer in this hospital. Nutritional risk was assessed case-by-case according to the severity of illness, nutritional status 〔including body mass index (BMI), recent changes in body weight and eating〕 and patients age. NRS ≥3 was accepted as nutritionally at-risk, while NRS lt;3 no nutritional risk; BMI lt;18.5 kg/m2 (or albumin lt;30 g/L) combined with clinical conditions was judged to be malnourished. Results Three hundreds and eighty-six patients were included, 329 of which completed the NRS2002 screening. One hundred and sixty-five patients (50.15%) were at nutritional risk, while another 164 (49.85%) were no nutritional risk. Malnutrition was found in 57 patients (17.33%). By gender, male malnourished patients and nutritionally at-risk patients were accounting for 16.45% (38/231) and 48.05% (111/231) respectively, while female nutritionally at-risk patients and malnourished patients were accounting for 55.1% (54/98) and 19.39% (19/98) respectively, 72.04% (237/329) of the screened patients accepted clinical nutrition support, among which, 115 patients were at nutritional risk, accounting for 69.70% in that group, and 122 patients were no nutritional risk, accounting for 74.39% in that group. ConclusionsThe incidences of malnutrition and nutritionally at-risk in hospitalized gastric cancer patients are high. And irrationality of clinical nutrition support exists. Evidence-based guidelines are required to improve the nutritional status of support.

Citation： YANG Ping,CHEN Bo,WU Xiaoting.. Research on Nutritional Risk and Application of Nutrition Support in Hospitalized Patients with Gastric Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(6): 620-624. doi: Copy

1.	Kondrup J, Rasmussen HH, Hamberg O, et al; Ad Hoc ESPEN Working Group. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials [J]. Clin Nutr, 2003, 22(3): 321336.
2.	Gur AS, Atahan K, Aladag I, et al. The efficacy of Nutrition Risk Screening2002 (NRS2002) to decide on the nutritional support in general surgery patients [J]. Bratisl Lek Listy, 2009, 110(5): 290292.
3.	Kondrup J, Allison SP, Elia M, et al. ESPEN Guidelines for nutrition screening 2002 [J], Clin Nutr, 2003, 22 (4): 415421.
4.	Raslan M, Gonzalez MC, Dias MC, et al. Comparison of nutritional risk screening tools for predicting clinical outcomes in hospitalized patients [J]. Nutrition, 2010, 26(78): 721726.
5.	蒋朱明, 陈伟, 朱赛楠, 等. 我国东、中、西部大城市三甲医院营养不良(不足)、营养风险发生率及营养支持应用状况调查 [J]．中国临床营养杂志, 2008, 16(6): 335337.
6.	蒋朱明, 于康, 朱赛楠, 等. 我国东中西部中小医院住院患者营养不足、营养风险、超重和肥胖发生率及营养支持应用状况调查 [J]. 中国临床营养杂志, 2008, 16(6): 338340.
7.	中华人民共和国卫生部疾病控制司. 中国成人超重和肥胖症预防控制指南 [M]. 北京: 人民卫生出版社, 2006: 146.
8.	Bruce RS, Blackburn GI， Joseph Vitale， et al． Prevalence of malnutrition in general medical patients [J]． JAMA, 1976, 235(4): 15671570.
9.	Twomey C, Briet F, Jeejeebhoy KN. Adeverse effect of malnutrition on lymphocyte mitochondrialcomplex I activity in humans [J]. Clin Nutr, 1994,18（1）: 48.
10.	van der Hulst RR, von Meyenfeldt MF, van Kreel BK, et al. Gut permeability, intestinal morphology, and nutritional depletion [J]. Nutrition, 1998, 14(1): 16.
11.	张明鸣, 周勇, 伍晓汀. 生长激素短期应用对胃肠外科手术后患者营养状况和血清IGF1的影响 [J]. 中国普外基础与临床杂志, 2009, 16(12): 968973.
12.	Schwegler I, von Holzen A, Gutzwiller JP, et al. Nutritional risk is a clinical predictor of postoperative mortality and morbidity in surgery for colorectal cancer [J]. Br J Surg, 2010, 97(1): 9297.
13.	Burden ST, Hill J, Shaffer JL, et al. Nutritional status of preoperative colorectal cancer patients [J]. J Hum Nutr Diet， 2010, 23(4): 402407.
14.	Caccialanza R, Klersy C, Cereda E, et al. Nutritional parameters associated with prolonged hospital stay among ambulatory adult patients [J]. CMAJ, 2010, 182(17): 18431849.
15.	Schiesser M, Müller S, Kirchhoff P, et al. Assessment of a novel screening score for nutritional risk in predicting complications in gastrointestinal surgery [J]. Clin Nutr, 2008, 27(4): 565570.
16.	袁琮韦华, 李俊生, 嵇振岭, 等. 全肠外营养及早期肠内营养在胃癌全胃切除术后患者中的对比研究 [J]. 中国普外基础与临床杂志, 2010, 17（4）: 357362.
17.	中华医学会．住院患者营养风险筛查．临床诊疗指南肠外肠内营养学分册(2008版) [M]．北京: 人民卫生出版社, 2009: 1620．.
18.	Drescher T, Singler K, Ulrich A, et al. Comparison of two malnutrition risk screening methods (MNA and NRS 2002) and their association with markers of protein malnutrition in geriatric hospitalized patients [J]. Eur J Clin Nutr, 2010, 64(8): 887893.
19.	Cardinal TR, Wazlawik E, Bastos JL, et al. Standardized phase angle indicates nutritional status in hospitalized preoperative patients [J]. Nutr Res, 2010, 30(9): 594600.
20.	Bozzetti F, SCRINIO Working Group. Screening the nutritional status in oncology: a preliminary report on 1 000 outpatients [J]. Support Care Cancer, 2009, 17(3): 279284.
21.	梁晓坤, 蒋朱明, Nolan MT, 等．北京教学医院普通外科住院患者营养风险、营养不足、超重、肥胖及营养支持状况 [J]．中华临床营养杂志, 2009, 17(2): 7578．.
22.	Guo W, Ou G, Li X, et al. Screening of the nutritional risk of patients with gastric carcinoma before operation by NRS 2002 and its relationship with postoperative results [J]. J Gastroenterol Hepatol, 2010, 25(4): 800803.
23.	Zhang YX, Wang SR. Distribution of body mass index and the prevalence changes of overweight and obesity among adolescents in Shandong, China from 1985 to 2005 [J]. Ann Hum Biol, 2008, 35(5): 547555.
24.	Jiang ZM, Chen W, Zhan WH, et al. Parenteral and enteral nutrition application in west， middle and east China: A multicenter investigation for 15 098 patients in 13 metropolitans using Nutritional Risk Screening 2002 tool [J]. Clin Nutr, 2007, 2(Suppl 2): 133134.
25.	崔丽英, 张树田, 于康, 等. 北京大医院住院患者营养风险、营养不良(不足)、超重和肥胖发生率及营养支持应用状况 [J]．中国临床营养杂志, 2008, 16(6): 341345．.

1. Kondrup J, Rasmussen HH, Hamberg O, et al; Ad Hoc ESPEN Working Group. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials [J]. Clin Nutr, 2003, 22(3): 321336.
2. Gur AS, Atahan K, Aladag I, et al. The efficacy of Nutrition Risk Screening2002 (NRS2002) to decide on the nutritional support in general surgery patients [J]. Bratisl Lek Listy, 2009, 110(5): 290292.
3. Kondrup J, Allison SP, Elia M, et al. ESPEN Guidelines for nutrition screening 2002 [J], Clin Nutr, 2003, 22 (4): 415421.
4. Raslan M, Gonzalez MC, Dias MC, et al. Comparison of nutritional risk screening tools for predicting clinical outcomes in hospitalized patients [J]. Nutrition, 2010, 26(78): 721726.
5. 蒋朱明, 陈伟, 朱赛楠, 等. 我国东、中、西部大城市三甲医院营养不良(不足)、营养风险发生率及营养支持应用状况调查 [J]．中国临床营养杂志, 2008, 16(6): 335337.
6. 蒋朱明, 于康, 朱赛楠, 等. 我国东中西部中小医院住院患者营养不足、营养风险、超重和肥胖发生率及营养支持应用状况调查 [J]. 中国临床营养杂志, 2008, 16(6): 338340.
7. 中华人民共和国卫生部疾病控制司. 中国成人超重和肥胖症预防控制指南 [M]. 北京: 人民卫生出版社, 2006: 146.
8. Bruce RS, Blackburn GI， Joseph Vitale， et al． Prevalence of malnutrition in general medical patients [J]． JAMA, 1976, 235(4): 15671570.
9. Twomey C, Briet F, Jeejeebhoy KN. Adeverse effect of malnutrition on lymphocyte mitochondrialcomplex I activity in humans [J]. Clin Nutr, 1994,18（1）: 48.
10. van der Hulst RR, von Meyenfeldt MF, van Kreel BK, et al. Gut permeability, intestinal morphology, and nutritional depletion [J]. Nutrition, 1998, 14(1): 16.
11. 张明鸣, 周勇, 伍晓汀. 生长激素短期应用对胃肠外科手术后患者营养状况和血清IGF1的影响 [J]. 中国普外基础与临床杂志, 2009, 16(12): 968973.
12. Schwegler I, von Holzen A, Gutzwiller JP, et al. Nutritional risk is a clinical predictor of postoperative mortality and morbidity in surgery for colorectal cancer [J]. Br J Surg, 2010, 97(1): 9297.
13. Burden ST, Hill J, Shaffer JL, et al. Nutritional status of preoperative colorectal cancer patients [J]. J Hum Nutr Diet， 2010, 23(4): 402407.
14. Caccialanza R, Klersy C, Cereda E, et al. Nutritional parameters associated with prolonged hospital stay among ambulatory adult patients [J]. CMAJ, 2010, 182(17): 18431849.
15. Schiesser M, Müller S, Kirchhoff P, et al. Assessment of a novel screening score for nutritional risk in predicting complications in gastrointestinal surgery [J]. Clin Nutr, 2008, 27(4): 565570.
16. 袁琮韦华, 李俊生, 嵇振岭, 等. 全肠外营养及早期肠内营养在胃癌全胃切除术后患者中的对比研究 [J]. 中国普外基础与临床杂志, 2010, 17（4）: 357362.
17. 中华医学会．住院患者营养风险筛查．临床诊疗指南肠外肠内营养学分册(2008版) [M]．北京: 人民卫生出版社, 2009: 1620．.
18. Drescher T, Singler K, Ulrich A, et al. Comparison of two malnutrition risk screening methods (MNA and NRS 2002) and their association with markers of protein malnutrition in geriatric hospitalized patients [J]. Eur J Clin Nutr, 2010, 64(8): 887893.
19. Cardinal TR, Wazlawik E, Bastos JL, et al. Standardized phase angle indicates nutritional status in hospitalized preoperative patients [J]. Nutr Res, 2010, 30(9): 594600.
20. Bozzetti F, SCRINIO Working Group. Screening the nutritional status in oncology: a preliminary report on 1 000 outpatients [J]. Support Care Cancer, 2009, 17(3): 279284.
21. 梁晓坤, 蒋朱明, Nolan MT, 等．北京教学医院普通外科住院患者营养风险、营养不足、超重、肥胖及营养支持状况 [J]．中华临床营养杂志, 2009, 17(2): 7578．.
22. Guo W, Ou G, Li X, et al. Screening of the nutritional risk of patients with gastric carcinoma before operation by NRS 2002 and its relationship with postoperative results [J]. J Gastroenterol Hepatol, 2010, 25(4): 800803.
23. Zhang YX, Wang SR. Distribution of body mass index and the prevalence changes of overweight and obesity among adolescents in Shandong, China from 1985 to 2005 [J]. Ann Hum Biol, 2008, 35(5): 547555.
24. Jiang ZM, Chen W, Zhan WH, et al. Parenteral and enteral nutrition application in west， middle and east China: A multicenter investigation for 15 098 patients in 13 metropolitans using Nutritional Risk Screening 2002 tool [J]. Clin Nutr, 2007, 2(Suppl 2): 133134.
25. 崔丽英, 张树田, 于康, 等. 北京大医院住院患者营养风险、营养不良(不足)、超重和肥胖发生率及营养支持应用状况 [J]．中国临床营养杂志, 2008, 16(6): 341345．.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Research on Nutritional Risk and Application of Nutrition Support in Hospitalized Patients with Gastric Cancer

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