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Comparison of the Impact of Malnutrition by Nutritional Assessment and Screening Tools on Operative Morbidity after Gastric Cancer Surgery
위절제 수술 후 합병증 발생에 있어 영양평가 및 검색 도구의 적합성 비교 연구
THE KOREAN SOCIETY FOR PARENTERAL AND ENTERAL NUTRITION 2011;4:7-15
Published online December 1, 2011
© 2011 The Korean Society for Parenteral and Enteral Nutrition.

Yoon Kim, M.S., R.D.1,2, Won Gyoung Kim, M.S., R.D.1,2, Hyuk Joon Lee, M.D., Ph.D.1,3,4, Mi Sun Park, M.S., R.D.1,2, Young Hee Lee, R.D.1,2, Seong Ho Kong, M.D.1,3, Han Kwang Yang, M.D., Ph.D.1,3,4
김 윤1,2ㆍ김원경1,2ㆍ이혁준1,3,4ㆍ박미선1,2ㆍ이영희1,2ㆍ공성호1,3ㆍ양한광1,3,4

1Nutritional Support Team, 2Department of Food Service and Nutrition Care, 3Division of Gastrointestinal Surgery, Seoul National University Hospital, 4Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
서울대학교병원 1영양집중지원팀, 2급식영양과, 3위장관외과, 4서울대학교 의과대학 외과학교실 및 암연구소
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Purpose: This study aimed to evaluate the agreement of Seoul National University Hospital-Nutrition Screening Index (SNUH-NSI) and Nutrition Risk Screening-2002 (NRS- 2002) with patient generated-Subjective Global Assessment (PG-SGA) and the association between nutrition risk determined by these screening tools and operative morbidity after a gastrectomy for gastric cancer.
Methods: This study enrolled 174 patients who had undergone a gastrectomy for gastric cancer at Seoul National University Hospital from March to July 2009. We assessed a nutrition risk by two nutrition screening tools (SNUH-NSI, NRS-2002) and a nutrition assessment tool (PG-SGA) at hospital admission. We collected general patient information, serum albumin level, cholesterol amount, total lymphocyte count, hemoglobin, and body mass index, operative method, hospital stay, and operative morbidity.
Results: The mean age was 59.1±11.6 years, and 8.6% (n=15) of patients were assessed as having severe malnutrition by the PG-SGA. Agreement between the PG-SGA, SNUH-NSI (Պ=0.498, P<0.001), and NRS-2002 (Պ= 0.439, P<0.001) was moderate. Patients with a high risk of malnutrition by PG-SGA, SNUH-NSI, or those with advanced gastric cancer showed more operative morbidity (P<0.05). There were no relationships between a high risk of malnutrition by NRS-2002 and operative morbidity. On multivariate analysis, malnutrition by PG-SGA (OR 2.159, 95% CI 0.693∼6.721) or SNUH-NSI (OR 2.630, 95% CI 0.906∼7.638) had a tendency to show higher operative morbidity, but it was not a significant independent risk factor.
Conclusion: Both SNUH-NSI and NRS-2002 had moderate agreement with PG-SGA. Severe malnutrition risk as assessed by SNUH-NSI had an association with operative morbidity as PG-SGA did. SNUH-NSI was expected to be a valuable and efficient screening tool to detect malnutrition risk as much as PG-SGA. (JKSPEN 2011;4(1): 7-15)
Keywords : Malnutrition, Nutrition screening, Nutrition assessment, Agreement, Operative morbidity
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