Nutritional Risk Screening 2002 as a Predictor of Postoperative Outcomes in Patients Undergoing Abdominal Surgery: A Systematic Review and Meta-Analysis of Prospective Cohort Studies

Sun, Zhen; Kong, Xinjuan; Xue, Jie; Deng, Run-Jun; Tian, Zibin

doi:10.1371/journal.pone.0132857

Cited by 68 publications

(76 citation statements)

References 23 publications

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“…Gou [19], in turn, evaluated 337 patients who underwent stomach cancer surgery in a single center and found that complications were more frequently observed in the NRS ≥ 3 group (p < 0.05). A metaanalysis of 11 prospective studies performed by Sun et al [5] likewise confirmed the effectiveness of the scale in the risk assessment of surgical complications (p < 0.00001) and postoperative mortality (p < 0.00001) among patients treated with digestive tract surgery; those with a score of < 3 were also shown to require shorter hospitalization times (p = 0.009) (Tab. V).…”

Section: Discussionmentioning

confidence: 64%

“…In their metaanalysis of 128 randomized clinical trials, Kondrup et al [7] validated the patient-and treatment-related risk factors for malnutrition and proposed the NRS scale as a tool for their assessment. Its effectiveness has been confirmed by a number of studies [5,7,[16][17][18][19]. Budzyński et al [17], for instance, analyzed annual admissions to a selected full-profile centre (more than 15,000 patients, 20,000 hospitalizations) and confirmed the utility of the NRS 2002 in the prognosis of both 14-and 30-day readmission (OR, respectively: 2.44, p < 0.0001 and 2.37 p < 0.001) and in-hospital mortality (OR 13.95, p < 0.001).…”

Section: Discussionmentioning

confidence: 76%

“…Importantly, malnutrition requires longer hospital stays, and, as a consequence, a more lengthy and expensive treatment process [4,[10][11][12][13], which may take up to twice as long as in properly nourished patients with the same diagnosis [2]. Its impact on postoperative events in digestive tract surgeries has been investigated by numerous clinical studies [3][4][5][6]. Associated complications may include slower, abnormal wound healing and often require the postponement of combined therapy, which negatively affects the final outcome of therapy [13].…”

Section: Discussionmentioning

confidence: 99%

“…The choice of an appropriate assessment method (i.e. one that would be easy to use and have a high predictive value) has been the subject of a plethora of studies and metaanalyses thus far [4,5]. The abundance of available tools goes to show that no ideal one-size-fits-all solution has yet been found [4,15].…”

Section: Discussionmentioning

confidence: 99%

“…Its causes include the loss of appetite, reduced food intake, metabolic changes due to the tumor and cancer-related chronic inflammation, as well as the side effects of cancer treatment, including surgery and chemo-and radiotherapy. In operated patients with GI cancers, malnutrition is an independent risk factor for an increased incidence of complications, nosocomial infections, and perioperative mortality [1][2][3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

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Utility of nutritional evaluation for the clinical risk assessment of postoperative complications. Does oncology need the NRS 2002 scale?

Potyrała

Ogonowska²,

Toboła³

et al. 2017

Nowotwory. Journal of Oncology

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Introduction. Malnutrition accompanies many cancers, especially those of the gastrointestinal tract, and significantly raises the risk of postoperative complications in cancer surgery. In Poland, hospitals are legally obliged to evaluate the nutritional status of their patients; one of the assessment tools used for this purpose is the NRS 2002 scale. Aim. The primary objective of the study is to analyze the utility of the NRS 2002 scale in the risk assessment of postoperative complications in gastrointestinal cancers. In addition, the authors propose to determine whether the legal requirement to conduct nutritional assessments among hospitalized patients is complied with in clinical practice and to evaluate the risk of malnutrition in the study group. Materials and methods. A detailed assessment was conducted on 226 patients who underwent surgery for upper (95 patients) and lower (131 patients) GI tract cancers in 2015. The risk of complications was analyzed based on the nutritional risk score (NRS 2002) and the levels of albumin and total proteins in the serum before surgery. Compliance with the obligation to carry out nutritional assessments was evaluated on breast and GI cancer patients treated with surgery at the Institute of Oncology in Warsaw in two successive years.Results. An NRS 2002 score of ≥ 3 was shown to predict postoperative complications for both upper GI tract (p < 0.001) and colorectal cancers (p < 0.001). In upper GI cancers, complications were also more frequently observed at lower albumin (p = 0.018) and total protein (p = 0.025) levels in the serum. Conclusion. The analysis shows that the NRS 2002 scale is useful in predicting the risk of postoperative complications in the treatment of upper and lower GI tract cancers. NOWOTWORY J Oncol 2017; 67, 3: 174-179

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Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Utility of nutritional evaluation for the clinical risk assessment of postoperative complications. Does oncology need the NRS 2002 scale?

Potyrała

Ogonowska²,

Toboła³

et al. 2017

Nowotwory. Journal of Oncology

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Tumour catabolism independent of malnutrition and inflammation in upper GI cancer patients revealed by longitudinal metabolomics

Renesse

Bechtolsheim

Jonas

et al. 2022

J cachexia sarcopenia muscle

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BackgroundThe detrimental impact of malnutrition and cachexia in cancer patients subjected to surgical resection is well established. However, how systemic and local metabolic alterations in cancer patients impact the serum metabolite signature, thereby leading to cancer-specific differences, is poorly defined. In order to implement metabolomics as a potential tool in clinical diagnostics and disease follow-up, targeted metabolite profiling based on quantitative measurements is essential. We hypothesized that the quantitative metabolic profile assessed by 1 H nuclear magnetic resonance (NMR) spectroscopy can be used to identify cancer-induced catabolism and potentially distinguish between specific tumour entities. Importantly, to prove tumour dependency and assess metabolic normalization, we additionally analysed the metabolome of patients' sera longitudinally post-surgery in order to assess metabolic normalization. Methods Forty two metabolites in sera of patients with tumour entities known to cause malnutrition and cachexia, namely, upper gastrointestinal cancer and pancreatic cancer, as well as sera of healthy controls, were quantified by 1 H NMR spectroscopy. Results Comparing serum metabolites of patients with gastrointestinal cancer with healthy controls and pancreatic cancer patients, we identified at least 15 significantly changed metabolites in each comparison. Principal component and pathway analysis tools showed a catabolic signature in preoperative upper gastrointestinal cancer patients. The most specifically upregulated metabolite group in gastrointestinal cancer patients was ketone bodies (3-hydroxybutyrate, P < 0.0001; acetoacetate, P < 0.0001; acetone, P < 0.0001; false discovery rate [FDR] adjusted). Increased glycerol levels (P < 0.0001), increased concentration of the ketogenic amino acid lysine (P = 0.03) and a significant correlation of 3-hydroxybutyrate levels with branched-chained amino acids (leucine, P = 0.02; isoleucine, P = 0.04 [FDR adjusted]) suggested that ketone body synthesis was driven by lipolysis and amino acid breakdown. Interestingly, the catabolic signature was independent of the body mass index, clinically assessed malnutrition using the nutritional risk screening score, and systemic inflammation assessed by CRP and leukocyte count. Longitudinal measurements and principal component analyses revealed a quick normalization of key metabolic alterations seven days post-surgery, including ketosis. Conclusions Together, the quantitative metabolic profile obtained by 1 H NMR spectroscopy identified a tumour-induced catabolic signature specific to upper gastrointestinal cancer patients and enabled monitoring restoration of metabolic homeostasis after surgery. This approach was critical to identify the obtained metabolic profile as an upper gastrointestinal cancer-specific signature independent of malnutrition and inflammation.

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Evaluation of Nutrition Risk in Patients Over 65 Years of Age With Nontraumatic Acute Abdominal Syndrome

et al. 2020

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Background: The objective of this study is to investigate the power of CRP/Albumin ratio, NRS-2002, mNUTRIC scores to predict nutritional needs and mortality in patients over 65 years of age diagnosed with acute abdominal syndrome in the emergency department and then transferred to the surgical intensive care unit. Material and Method: CRP/Albumin ratio, APACHE II, SOFA, NRS-2002 and mNUTRIC scores were calculated. The analysis of the data was conducted in IBM SPSS Statistics Base 22.0 package program. Results: In the analytical evaluation made for nutritional needs, AUC value for mNUTRIC was found to be: 0,683, 95% CI 0,611-0,755, p < 0.001. It was found out that mortality of patients had a statistically significant and moderate correlation with mNUTRIC score (r = 0.537; p < 0.001). In the analytical evaluation made for mortality, mNUTRIC's AUC value (AUC: 0.808, 95% CI 0.736-0.880, p < 0.001) was found to be the highest. When the cutoff value determined to predict mortality was taken as 3.5 for mNUTRIC score, sensitivity was 75.9% and specificity was 69.4%. Conclusion: The evaluation of the risk of malnutrition through nutritional risk tools in intensive care patients over 65 years of age with acute abdominal syndrome can also predict nutritional needs in the early period besides mortality. Based on our data, the fact that mNUTRIC score cutoff value in older patients hospitalized in intensive care is 3.5 and higher may be a predictor for ICU mortality.

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Nutritional Risk Screening 2002 as a Predictor of Postoperative Outcomes in Patients Undergoing Abdominal Surgery: A Systematic Review and Meta-Analysis of Prospective Cohort Studies

Cited by 68 publications

References 23 publications

Utility of nutritional evaluation for the clinical risk assessment of postoperative complications. Does oncology need the NRS 2002 scale?

Utility of nutritional evaluation for the clinical risk assessment of postoperative complications. Does oncology need the NRS 2002 scale?

Tumour catabolism independent of malnutrition and inflammation in upper GI cancer patients revealed by longitudinal metabolomics

Evaluation of Nutrition Risk in Patients Over 65 Years of Age With Nontraumatic Acute Abdominal Syndrome

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