Korean Journal of Community Nutrition

Research Articles

[Korean]
[Republished study] Assessing Nutritional Status in Outpatients after Gastric Cancer Surgery: A Comparative Study of Five Nutritional Screening Tools: Jae Won Cho, Jiyoung Youn, Min-Gew Choi, Mi Young Rha, Jung Eun Lee; Korean J Community Nutr 2022;27(3):205-222. Published online June 30, 2022; DOI: https://doi.org/10.5720/kjcn.2022.27.3.205

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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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]
Assessing Nutritional Status in Outpatients after Gastric Cancer Surgery : A Comparative Study of Five Nutritional Screening Tools: Jae Won Cho, Jiyoung Youn, Min-Gew Choi, Mi Young Rha, Jung Eun Lee; Korean J Community Nutr 2021;26(4):280-295. Published online August 31, 2021; DOI: https://doi.org/10.5720/kjcn.2021.26.4.280

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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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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Original Articles

[English]
Nutritional Status and Dietary Change after Gastrectomy of Gastric Cancer Patients: Young Ok Park, So Yoon Yoon, Shin Sook Kang, Sang Mi Han, Eun Hee Kang; Korean J Community Nutr 2012;17(1):101-108. Published online February 29, 2012; DOI: https://doi.org/10.5720/kjcn.2012.17.1.101

Abstract PDF PubReader

The purpose of this survey is to investigate the nutritional status and dietary intake of gastrectomized cancer patients in Asan Medical Center. The subjects were 98 patients, who underwent a gastrectomy due to gastric cancer and were admitted to the General Surgery Department during March 2007 to December 2007. We examined general characteristics (sex, age, clinicopathological stage, type of operation), anthropometric data (height, weight change), biochemical data (red blood cell RBC, hemoglobin HGB, hematocrit HCT, mean corpuscular volume MCV, total lymphocyte count TLC, albumin, total cholesterol), dietary intake and dietary intake related symptoms. Weight loss of gastrectomized patients was 9.0 +/- 4.3% from preillness weight to visiting out-patient department (OPD) weight. Biochemical data (RBC, HGB, HCT, MCV, TLC, albumin, total cholesterol) significantly deteriorated after gastrectomy. However, outpatient visits were all restored to the normal range. Postoperative energy intake was 785.0 +/- 164.2 kcal, which corresponds to 41.6 +/- 9.6% of daily energy requirement. The cause of poor oral intake is mostly fear, abdominal pain and abdominal discomfort. Therefore, to control pre-or post-operative weight change in the future requires, focusing on the body weight to maintain a normal or usual nutrition by interventions and increased caloric intake during hospitalization for the development of nutrient-dense meals. In addition, as the main reason of the lack of intake of meals after the gastrectomy was fear, the patients should be actively encouraged to consider the importance of eating proper meals.

Citations

Citations to this article as recorded by

Comparison of blood biochemical characteristics and dietary intake by sex in gastric cancer patients over 40 years in Korea based on 7th (2016-2018) Korea National Health and Nutrition Examination Survey: a cross-sectional study
Hyeon-Ju Lee, Sung-Won Oh, Sook-Bae Kim
Korean Journal of Community Nutrition.2023; 28(1): 48. CrossRef
Oral Nutritional Supplements Reduce Body Weight Loss after Gastrectomy in Patients with Gastric Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Mijoo Choi, Jong-Yeup Kim, Hyun-Hi Kang, Eunju Park, Sung Ryul Shim
Nutrients.2023; 15(18): 3924. CrossRef
[Republished study] Assessing Nutritional Status in Outpatients after Gastric Cancer Surgery: A Comparative Study of Five Nutritional Screening Tools
Jae Won Cho, Jiyoung Youn, Min-Gew Choi, Mi Young Rha, Jung Eun Lee
Korean Journal of Community Nutrition.2022; 27(3): 205. CrossRef
Assessing Nutritional Status in Outpatients after Gastric Cancer Surgery: A Comparative Study of Five Nutritional Screening Tools
Jae Won Cho, Jiyoung Youn, Min-Gew Choi, Mi Young Rha, Jung Eun Lee
Korean Journal of Community Nutrition.2021; 26(4): 280. CrossRef
A Case Study on the Customized Nutrition Intervention for a Patient with Primary Gastrointestinal Non-Hodgkin Lymphoma Underlying Chronic Kidney Disease
Young-Hwa Song, Han-Na Kwon, Jeong-Im Hong, Juyeon Park, Ji-Yeon Kim, Hye-Jin Kim
Clinical Nutrition Research.2020; 9(4): 332. CrossRef
Change in Dietary Intake and Nutritional Status Using Mealworms as Hospital Meal in Postoperative Patie
Seong Hyeon Kim, Jin Young Shon, Jun Sung Park, Jong Won Kim, Jung Hyun Kang, Eun Young Yun, Jae Sam Hwang, Hyung Mi Kim
Journal of the Korean Dietetic Association.2016; 22(4): 292. CrossRef
Development of a Self-Care Performance Scale for Patients with Stomach Cancer after Gastrectomy
Min Kyung Jeon, Geum Ja Park
Asian Oncology Nursing.2016; 16(2): 67. CrossRef
Postoperative Changes in Body Weight, Anxiety, Depression, and Quality of Life after Radical Gastrectomy among Patients with Gastric Cancer
Jin Ha Kim, Ja Yun Choi
Asian Oncology Nursing.2014; 14(3): 139. CrossRef

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[English]
A Study on Nutritional Status after Gastrectomy of Gastric Cancer Patients in Jeonbuk Province: Mi Jin Jeong, Chan Young Kim, Sook Bae Kim; Korean J Community Nutr 2006;11(6):785-792. Published online December 31, 2006

Abstract PDF: The purpose of this study was to investigate the nutritional status before and after gastrectomy of gastric cancer patients in Jeonbuk Province. The subjects were 136 patients with gastrectomy of gastric cancer. We assessed the nutritional status before and after an operation by general characteristics (age, clinicopathological stage, type of operation, method of reconstruction), anthropometric characteristics (height, weight, skeletal muscle mass, body fat mass, body mass index (BMI), percent body fat, arm muscle circumference AMC, arm circumference AC) and biochemical characteristics (hemoglobin Hb, hematocrit Hct, mean corpuscular volume MCV, mean corpuscular hemoglobin MCH, total lymphocyte count TLC, serum albumin, serum transferrin). Mean ages were 60.0 yrs in males and 58.8 yrs in females. Age, clinicopathological stage, types of operation and reconstruction methods were not significantly different between males and females. Weight, skeletal muscle mass, body fat mass, BMI, percent body fat, AMC and AC significantly deteriorated by gastrectomy. There were severe weight losses in males and females after gastrectomy. Hemoglobin, Hct, MCV, MCH, TLC, albumin and transferrin significantly deteriorated by gastrectomy. After gastrectomy, subjects who were assessed as malnounrished in Hb and Hct were increased in male and those who were assessed as malnounrished in Hb were increased in females. These results suggest that a nutrition intervention, specially for energy, protein and iron, is necessary to improve the nutritional status of gastric cancer patients with gastrectomy.

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