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[Republished study] Assessing Nutritional Status in Outpatients after Gastric Cancer Surgery: A Comparative Study of Five Nutritional Screening Tools
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Jae Won Cho, Jiyoung Youn, Min-Gew Choi, Mi Young Rha, Jung Eun Lee
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Korean J Community Nutr 2022;27(3):205-222. Published online June 30, 2022
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DOI: https://doi.org/10.5720/kjcn.2022.27.3.205
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 Abstract
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- Objectives
This study examined the characteristics of patients according to nutritional status assessed by five nutritional screening tools: Patient-Generated Subjective Global Assessment (PG-SGA), NUTRISCORE, Nutritional Risk Index (NRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) and to compare the agreement, sensitivity, and specificity of these tools.
Methods
A total of 952 gastric cancer patients who underwent gastrectomy and chemotherapy from January 2009 to December 2012 were included. The patients were categorized into malnutrition and normal status according to five nutritional screening tools one month after surgery. The Spearman partial correlation, Cohen’s Kappa coefficient, the area under the curve (AUC), sensitivity, and specificity of each two screening tools were calculated.
Results
Malnutrition was observed in 86.24% of patients based on the PG-SGA and 85.82% based on the NUTRISCORE. When NRI or CONUT were applied, the proportions of malnutrition were < 30%. Patients with malnutrition had lower intakes of energy and protein than normal patients when assessed using the PG-SGA, NUTRISCORE, or NRI. Lower levels of albumin, hemoglobin, total lymphocyte count, and total cholesterol and longer postoperative hospital stays were observed among patients with malnutrition compared to normal patients when NRI, PNI, or CONUT were applied. Relatively high agreement for NUTRISCORE relative to PG-SGA was found; the sensitivity was 90.86%, and the AUC was 0.78. When NRI, PNI, and CONUT were compared, the sensitivities were 23.72% for PNI relative to NRI, 44.53% for CONUT relative to NRI, and 90.91% for CONUT relative to PNI. The AUCs were 0.95 for NRI relative to PNI and 0.91 for CONUT relative to PNI.
Conclusions
NUTRISCORE had a high sensitivity compared to PG-SGA, and CONUT had a high sensitivity compared to PNI. NRI had a high specificity compared to PNI. This relatively high sensitivity and specificity resulted in 77.00% agreement between PNI and CONUT and 77.94% agreement between NRI and PNI. Further cohort studies will be needed to determine if the nutritional status assessed by PG-SGA, NUTRISCORE, NRI, PNI, and CONUT predicts the gastric cancer prognosis.
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Citations
Citations to this article as recorded by  - Report on the Current Trend of Commercial Enteral/Parenteral Nutrition in Outpatient
Hyun Ji Lee, Hyo Jung Park, Seon Young Chung, Myung Sook Min, Ok Soon Jeong, Ja Kyung Min
Journal of Korean Society of Health-System Pharmacists.2023; 40(2): 211. CrossRef
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- [Korean]
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Assessing Nutritional Status in Outpatients after Gastric Cancer Surgery : A Comparative Study of Five Nutritional Screening Tools
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Jae Won Cho, Jiyoung Youn, Min-Gew Choi, Mi Young Rha, Jung Eun Lee
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Korean J Community Nutr 2021;26(4):280-295. Published online August 31, 2021
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DOI: https://doi.org/10.5720/kjcn.2021.26.4.280
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Abstract
PDF
- Objectives
This study aimed to examine the characteristics of patients according to their nutritional status as assessed by five nutritional screening tools: Patient-Generated Subjective Global Assessment (PG-SGA), NUTRISCORE, Nutritional Risk Index (NRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) and to compare the agreement, sensitivity, and specificity of these tools.
Methods: A total of 952 gastric cancer patients who underwent gastrectomy and chemotherapy from January 2009 to December 2012 at the Samsung Medical Center were included. We categorized patients into malnourished and normal according to the five nutritional screening tools 1 month after surgery and compared their characteristics. We also calculated the Spearman partial correlation, Cohen’s Kappa coefficient, the area under the curve (AUC), sensitivity, and specificity of each pair of screening tools.
Results: We observed 86.24% malnutrition based on the PG-SGA and 85.82% based on the NUTRISCORE among gastric cancer patients in our study. When we applied NRI or CONUT, however, the malnutrition levels were less than 30%. Patients with malnutrition as assessed by the PG-SGA, NUTRISCORE, or NRI had lower intakes of energy and protein compared to normal patients. When NRI, PNI, or CONUT were used to identify malnutrition, lower levels of albumin, hemoglobin, total lymphocyte count, total cholesterol, and longer postoperative hospital stays were observed among patients with malnutrition compared to those without malnutrition. We found relatively high agreement between PG-SGA and NUTRISCORE; sensitivity was 90.86% and AUC was 0.78. When we compared NRI and PNI, sensitivity was 99.64% and AUC was 0.97. AUC ranged from 0.50 to 0.67 for comparisons between CONUT and each of the other nutritional screening tools.
Conclusions: Our study suggests that PG-SGA and NRI have a relatively high agreement with the NUTRISCORE and PNI, respectively. Further cohort studies are needed to examine whether the nutritional status assessed by PG-SGA, NUTRISCORE, NRI, PNI, and CONUT predicts the gastric cancer prognosis.
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Citations
Citations to this article as recorded by - Effects of Continuous Nutrition Care on Nutritional Status and Dietary Habits of Patients With Colorectal Cancer Receiving Adjuvant Chemotherapy After Surgery
Jina Son, Ha I Kang, Eun young Jung, Hae won Ryu, Kyung-Ha Lee
Clinical Nutrition Research.2023; 12(2): 99. CrossRef
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- [English]
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Comparison of 24-hour Recalls with a Food Frequency Questionnaire in Assessing Coffee Consumption: The Health Examinees (HEXA) Study
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An Na Kim, Jiyoung Youn, Hyun Jeong Cho, Taiyue Jin, Sangah Shin, Jung Eun Lee
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Korean J Community Nutr 2020;25(1):48-60. Published online February 29, 2020
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DOI: https://doi.org/10.5720/kjcn.2020.25.1.48
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Abstract
PDF
 PubReader ePub
- OBJECTIVES
Most cohort studies used food frequency questionnaires (FFQ) to evaluate coffee consumption as it assesses habitual dietary patterns, whereas some studies have used the 24-hour recalls (24HR) as it elicits in-depth description of foods and the amount eaten. The aim of this study was to compare FFQs and 24HR to assess the consumption of various types of coffee.
METHODS
We included 25,904 participants aged 40 years or older from the Health Examinees (HEXA) Study of the Korean Genome and Epidemiologic Study (KoGES). Each participant completed one FFQ and one-day (n=11,280) or two-day 24HR (n=14,624). We classified coffee types into: black coffee, coffee with sugar and cream, and coffee with sugar alone or cream alone. We compared the proportions of nondrinkers, black coffee, and coffee with sugar and cream through FFQ and 24HR.
RESULTS
Among those who completed one FFQ and one-day 24HR, 39.4% of “nondrinkers†on one-day 24HR reported that they did not drink coffee on their FFQs. Whereas among those who complete two-day 24HR, 71.2% of “nondrinkers†on two-day 24HR said that they did not drink coffee on their FFQs. Among those who completed one FFQ and oneday 24HR, 58.3% marked “black coffee†on one-day 24HR said that they drank black coffee on their FFQs. Among those who complete two-day 24HR, 58.8% marked “black coffee†on two-day 24HR said that they drank black coffee on their FFQs. The kappa coefficients and percent agreements were 0.4 and 59.6%, respectively, for the comparison of coffee intake between FFQ and one-day 24HR, and 0.6 and 72.8%, respectively, for the comparison of coffee intake between FFQ and two-day 24HR.
CONCLUSIONS
We found discrepancies between FFQs and 24HR in the types of coffee consumed. Such limitations should be considered when using the 24HR data to examine the effect of coffee consumption on disease development.
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Citations
Citations to this article as recorded by - Association Between Instant Coffee Consumption and the Development of Chronic Obstructive Pulmonary Disease: Results From a Community-Based Prospective Cohort
Moon-Kyung Shin, Kyoung-Nam Kim
Journal of Korean Medical Science.2024;[Epub] CrossRef - Genetic variation rs1121980 in the fat mass and obesity-associated gene (FTO) is associated with dietary intake in Koreans
Young Goh, Jeong-Hwa Choi
Food & Nutrition Research.2022;[Epub] CrossRef - Coffee Consumption and the Risk of All-Cause and Cause-Specific Mortality in the Korean Population
Seong-Ah Kim, Li-Juan Tan, Sangah Shin
Journal of the Academy of Nutrition and Dietetics.2021; 121(11): 2221. CrossRef
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- [English]
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The Association between the Adherence to Dietary Guidelines for Breast Cancer Survivors and Health-related Quality of Life among Korean Breast Cancer Survivors
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Sihan Song, Jiyoung Youn, Myungsook Park, Eunkyung Hwang, Hyeong Gon Moon, Dong Young Noh, Jung Eun Lee
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Korean J Community Nutr 2015;20(2):129-140. Published online April 30, 2015
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DOI: https://doi.org/10.5720/kjcn.2015.20.2.129
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Abstract
PDFPubReader
- OBJECTIVES
We examined the association between the adherence to dietary guidelines for breast cancer survivors and health-related quality of life in a cross-sectional study of Korean breast cancer survivors.
METHODS
A total of 157 women aged 21 to 79 years who had been diagnosed with stage I to III breast cancers according to the American Joint Committee on Cancer (AJCC) and had breast cancer surgery at least 6 months before the baseline were included. We used a Korean version of the Core 30 (C30) and Breast cancer 23 (BR23) module of the European Organization for Research and Treatment Cancer Quality of Life Questionnaire (EORTC-QLQ), both of which have been validated for Koreans. Participants were asked about their adherence to dietary guidelines for breast cancer survivors, suggested by the Korean breast cancer society, using a 5-point Likert scale. We summed dietary guideline adherence scores for each participant and calculated the least squares means of health-related quality of life according to dietary guideline adherence scores using the generalized linear model.
RESULTS
Breast cancer survivors who had higher adherence to dietary guidelines for breast cancer survivors had lower constipation scores than those with lower adherence (p for trend=0.01). When we stratified by the stage at diagnosis, this association was limited to those who had been diagnosed with stage II or III breast cancers. Also, sexual functioning scores increased significantly with increasing adherence scores of dietary guidelines among those with stage II or III breast cancers (p for trend < 0.001). However, among those who had been diagnosed with stage I, higher scores of dietary guidelines were associated with higher scores of pain (p for trend=0.03) and breast symptoms (p for trend=0.05).
CONCLUSIONS
Our study suggested that the health-related quality of life levels of breast cancer survivors are associated with the adherence to dietary guidelines and may differ by the stage of the breast cancer.
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Citations
Citations to this article as recorded by - Application and evaluation of mobile nutrition management service for breast cancer patients
Ji Hee Choi, Seon-Joo Park, Hee Kwon, Hae-Jeung Lee
Journal of Nutrition and Health.2020; 53(1): 83. CrossRef - A Comparisons of Nutritional Intake and Diet Quality Index-International in Gynecological Cancer Survivors and Normal Women: Using the Korea National Health and Nutrition Examination Survey 2013~2016
Bo-Young Seo, Eun-Sil Her
Korean Journal of Community Nutrition.2020; 25(5): 406. CrossRef - Aspects of Health-Related Factors and Nutritional Care Needs by Survival Stage among Female Cancer Patients in South Korea
Yoonsun Lee, Hyunsoo Shin, Eunjoo Bae, Hyunjung Lim, Pei-Yi Chu
PLOS ONE.2016; 11(10): e0163281. CrossRef - Dietary Changes After Breast Cancer Diagnosis: Associations with Physical Activity, Anthropometry, and Health-related Quality of life Among Korean Breast Cancer Survivors
Sihan Song, Hyun Jo Youn, So-Youn Jung, Eunsook Lee, Zisun Kim, Jihyoung Cho, Young Bum Yoo, Hyeong-Gon Moon, Dong-Young Noh, Jung Eun Lee
Korean Journal of Community Nutrition.2016; 21(6): 533. CrossRef
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