A Comparison of the Nutritional Risk Screening 2002 Tool With the Subjective Global Assessment Tool to Detect Nutritional Status in Chinese Patients Undergoing Surgery With Gastrointestinal Cancer

Abstract

The objectives of this study were to describe the nutritional status of Chinese patients with gastrointestinal cancer undergoing surgery and to compare the ease of use, diversity, and concordance of the Nutritional Risk Screening 2002 with the Subjective Global Assessment in the same patients. A total of 280 gastrointestinal cancer patients admitted for elective surgery were evaluated by the Nutritional Risk Screening 2002 (NRS 2002) and Subjective Global Assessment (SGA) tools within 48 hours of admission from April to October 2012. Related opinions about ease of using the tools were obtained from 10 nurses. The prevalence of patients at nutritional risk with the SGA and NRS 2002 was 33.9% and 53.2% on admission. In the total group, ≤70 age group, and >70 age group, respectively, consistency was observed in 214 (76.4%), 175 (91.1%), and 39 (44.3%); and kappa values were 0.54 (p < .001), 0.81 (p < .001), and 0.085 (p = .096). McNemar paired chi-square test showed a significant difference between the NRS 2002 and SGA in the total group and >70 age group (p < .001); however, no difference was observed in the ≤70 age group (p = .14). Nurses reported ease of use of the NRS 2002 as a "very easy" or "easy" to complete (3-5 minutes) and the SGA as an "easy" or "fair" tool to complete (5-10 minutes). The diversity and concordance between the SGA and NRS 2002 were varied in different age groups. The NRS 2002 is more suitable in nursing practice than the SGA to identify the nutritional status of patients with gastrointestinal cancer undergoing surgery, but it appeared to detect more patients at nutritional risk in the >70 age group.

Perioperative nutrition management as an important component of surgical capacity in low‐ and middle‐income countries

“…Reports have indicated that the prevalence of hospital malnutrition is as high as 50% in HICs and approximately 70% in LMICs . Studies in LMICs show that the prevalence of pre‐operative malnutrition among surgical patients is also high (Table ) . Of these studies, 16 were from Latin American countries, 7 from China, 3 from Vietnam, 3 from Turkey, 2 from India and 1 from Thailand.…”

The ability of the Global Leadership Initiative on Malnutrition (GLIM) to diagnose protein–energy malnutrition in patients requiring vascular surgery: a validation study

“…Sn, Sp, positive predictive value and negative predictive value were determined against the results of the PG-SGA (the reference standard) to determine the diagnostic accuracy of the GLIM in diagnosing patients with malnutrition according to recommendations (19) . As the PG-SGA results in three categories of nutritional status, PG-SGA B and PG-SGA C categories were amalgamated resulting in two categories of 'well nourished' and 'malnourished' to enable Sn and Sp analysis which is common practice in the literature (21)(22)(23) . The recommended cut points for Sn and Sp for determining diagnostic accuracy were set at 80 % as per de van der Shueren et al (19) .…”

An evaluation of the validity of nutrition screening and assessment tools in patients admitted to a vascular surgery unit

“…To facilitate comparison with the reference standard and in keeping with clinical practice, two levels of risk were considered for each screening tool namely 'at risk' (aggregating participants with high or moderate risk of malnutrition) and 'not at risk'. Similarly, the PG-SGA global rating was classified into 'malnourished' and 'not malnourished' with ratings B (moderately, suspected malnourished) and C (severely malnourished) aggregated into one group (malnourished) as is common practice in similar literature (16,43,44) . A priori values of ≥80 % for sensitivity and ≥60 % for specificity were used to indicate a valid instrument (14) .…”