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 Article

[English]
A Screening Tool for Identifying High-Risk Pregnant Women of Fe Deficiency Anemia : Process I: Jung A Park, Jin Sook Yoon; Korean J Community Nutr 2001;6(5):734-743. Published online December 31, 2001

Abstract PDF: Iron deficiency anemia is a worldwide public health problem relevant to unsound nutritional practice. While the prevalence of iron deficiency anemia is very common among pregnant women, appropriate nutritional service programs to improve the iron status are lacking in Korea. In an attempt to develop a nutritional screening tool to separate the high-risk subjects of iron deficiency, we carried out a nutritional survey for 115 Korean pregnant women whose gestational age ranged from 13 to 24 weeks. Each subject was interviewed with questionnaires for general characteristics and dietary habits. Food intake was measured by 24-hour recap method and 2 day record. Fasting blood was drawn for measuring hemoglobin and serum ferritin. It appeared that half of the pregnant women belonged to the anemia group and had insufficient dietary habits to provide adequate amounts of dietary iron. The first gravida and the working women had better hematological iron indicators than the second or more gravida and the housewives. It also appeared that women who had bigger family size and lower BMI in pre-pregnancy had poorer iron status. Among the food consumption habits, fruit dependent dietary habit was related to poor iron status. Sufficiently consumed green leafy vegetable and appropriate amount of food before morning sickness were positive factors of iron stares. Our results indicated that parity, BMI, current job, family size, food habits including consumption of fruits, green & yellow vegetables, and food habits before the onset of morning sickness are significant factors to contribute the Fe deficiency anemia during pregnancy.

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