Comparison of different nutritional assessments in detecting malnutrition among gastric cancer patients

Abstract

AIM: To evaluate the prevalence of preoperative and postoperative malnutrition and the relationships be- tween objective and subjective nutritional assessment of gastric cancer patients. METHODS: From October 2005 to July 2006, we stud- ied 80 patients with no evidence of recurrent disease and no loss to follow-up after curative surgery for gas- tric cancer. In this group, 9 patients underwent total gastrectomy and 71 patients subtotal gastrectomy. At admission, 6 and 12 mo after surgery, the patients were assessed on the subjective global assessment (SGA), nutritional risk screening (NRS-2002), nutritional risk index (NRI) and by anthropometric measurements and laboratory data. Differences between the independent groups were assessed with the Student’s t test and one- way analysis of variance. Spearman’s rank correlation coefficients were calculated to evaluate the association between the scores and variables. RESULTS: The prevalence of malnutrition at admission was 31% by SGA and 43% by NRS-2002. At admission, the anthropometric data were lower in the malnourished groups defined by the SGA and NRS-2002 assessments, but did not differ between the groups using the NRI as- sessment. Body weight (BW), body mass index (BMI), triceps skin fold and midarm circumference were signifi- cantly reduced, but the total lymphocyte count, albu- min, protein, cholesterol and serum iron levels did not decrease during the postoperative period. Six months after surgery, there was a good correlation between the nutritional assessment tools (SGA and NRS-2002) and the other nutritional measurement tools (BW, BMI, and anthropometric measurements). However, 12 mo after surgery, most patients who were assessed as malnour- ished by SGA and NRS-2002 had returned to their pre- operative status, although their BW, BMI, and anthro- pometric measurements still indicated a malnourished status. CONCLUSION: A combination of objective and subjec- tive assessments is needed for the early detection of the nutritional status in case of gastric cancer patients after gastrectomy. © 2010 Baishideng. All rights reserved. Key words: Gastrectomy; Malnutrition; Nutritional assess- ment; Nutritional risk screening; Postoperative follow up; Subjective global assessment