Nutritional screening tools for adult cancer patients: A hierarchical Bayesian latent-class meta-analysis

Ruan, Xiaoli; Nakyeyune, Rena; Shao, Yi; Shen, Yi; Niu, Chen; Zang, Zhaoping; Miles, Toni P.; Liu, Fen

doi:10.1016/j.clnu.2020.09.033

Cited by 16 publications

(10 citation statements)

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“…Early screening to identify patients with sarcopenia and/or decreased muscle quality would allow earlier multimodal interventions to attenuate adverse body compositional changes [ 21 ]. Consequently, the purpose of any nutritional screening is to perform a baseline assessment of the nutritional status of the patients and to predict its worse or better clinical outcome depending on it [ 22 ].…”

Section: Detecting Malnutrition From the Very Beginning Of Cancer Care: Who Starts Well Is Half The Battlementioning

confidence: 99%

“…Thereafter, patients at risk for malnutrition need preplanned evaluations through the therapeutic course and frequently require active intervention or regular follow-up. Although a universal agreement on screening methods is still lacking, classical baseline first-level tools recommended by ESPEN may include: (a) adult MUST (Malnutrition Universal Screening Tool), that better works for community outpatients where severe confounding factors are limited; (b) NRS-2002 (Nutritional Risk Screening 2002), which is more accurate in determining under-nutrition in hospital-based patients; (c) Mini Nutritional Assessment (MNA), which may be of greater help in the baseline assessment of senior cancer patients; and (d) PG-SGA (Patient Generated Subjective Global Assessment), which seems to have best diagnostic performance with cancer patients in a recent Bayesian comparison analysis [ 22 ].…”

Section: Detecting Malnutrition From the Very Beginning Of Cancer Care: Who Starts Well Is Half The Battlementioning

confidence: 99%

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The Clinical Value of Nutritional Care before and during Active Cancer Treatment

Aprile¹,

Basile²,

Giaretta³

et al. 2021

Nutrients

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Malnutrition and muscle wasting are frequently reported in cancer patients, either linked to the tumor itself or caused by oncologic therapies. Understanding the value of nutritional care during cancer treatment remains crucial. In fact, cancer-associated sarcopenia plays a key role in determining higher rates of morbidity, mortality, treatment-induced toxicities, prolonged hospitalizations and reduced adherence to anticancer treatment, worsening quality of life and survival. Planning baseline screening to intercept nutritional troubles earlier, organizing timely reassessments, and providing adequate counselling and dietary support, healthcare professional may positively interfere with this process and improve patients’ overall outcomes during the whole disease course. Several screening tools have been proposed for this purpose. Nutritional Risk Screening (NRS), Mini Nutritional Assessment (MNA), Patient Generated Subjective Global Assessment (PG-SGA) are the most common studied. Interestingly, second-level tools including skeletal muscle index (SMI) and bioelectric impedance analysis (BIA) provide a more precise assessment of body composition, even if they are more complex. However, nutritional assessment is not currently used in clinical practice and procedures must be standardized in order to improve the efficacy of standard chemotherapy, targeted agents or even checkpoint inhibitors that is potentially linked with the patients’ nutritional status. In the present review, we will discuss about malnutrition and the importance of an early nutritional assessment during chemotherapy and treatment with novel checkpoint inhibitors, in order to prevent treatment-induced toxicities and to improve survival outcomes.

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Section: Detecting Malnutrition From the Very Beginning Of Cancer Care: Who Starts Well Is Half The Battlementioning

confidence: 99%

Section: Detecting Malnutrition From the Very Beginning Of Cancer Care: Who Starts Well Is Half The Battlementioning

confidence: 99%

The Clinical Value of Nutritional Care before and during Active Cancer Treatment

Aprile¹,

Basile²,

Giaretta³

et al. 2021

Nutrients

View full text Add to dashboard Cite

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“…The Academy of Nutrition and Dietetics indicates that MST is the tool that should be used in any patient, regardless of age, clinical history, or place where it is performed, based on Table 9 [195]. With reference to the groups of patients, in cancer patients, SGA and PG-SGA are the most widely used tools [157,[196][197][198][199], although some authors also find MNA-SF [200], MST [201], MUST [35], SGA, or NRS [202] useful. In acute hospitalized patients, the most commonly used tools are the NRS-2002 and the MUST score [203,204].…”

Section: Discussionmentioning

confidence: 99%

“…It is a method that includes screening, assessment, monitoring, and triaging for interventions [153]. It is currently the method of choice in cancer patients [154][155][156][157]. Available online: https://nutritioncareincanada.…”

mentioning

confidence: 99%

Malnutrition Screening and Assessment

et al. 2022

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Malnutrition is a serious problem with a negative impact on the quality of life and the evolution of patients, contributing to an increase in morbidity, length of hospital stay, mortality, and health spending. Early identification is fundamental to implement the necessary therapeutic actions, involving adequate nutritional support to prevent or reverse malnutrition. This review presents two complementary methods of fighting malnutrition: nutritional screening and nutritional assessment. Nutritional risk screening is conducted using simple, quick-to-perform tools, and is the first line of action in detecting at-risk patients. It should be implemented systematically and periodically on admission to hospital or residential care, as well as on an outpatient basis for patients with chronic conditions. Once patients with a nutritional risk are detected, they should undergo a more detailed nutritional assessment to identify and quantify the type and degree of malnutrition. This should include health history and clinical examination, dietary history, anthropometric measurements, evaluation of the degree of aggression determined by the disease, functional assessment, and, whenever possible, some method of measuring body composition.

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“…To date, there is no gold standard to assess disease-associated nutritional deficiencies [ 43 ]. The international literature describes various screening tools, laboratory analyses, and physical tools such as bioelectrical impedance analysis (BIA).…”

Section: Discussionmentioning

confidence: 99%

Nutritional Status in Patients with Medication-Related Osteonecrosis of the Jaw (MRONJ)

et al. 2021

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Medication-related osteonecrosis of the jaw (MRONJ) is a potentially severe side effect of mostly antiresorptive drugs. The aim of this prospective clinical study was to evaluate the nutritional status in MRONJ patients scheduled for surgical treatment (intraoral soft tissue closure). The following parameters were evaluated: body weight, body height, BMI, nutritional risk index (NRI), bioelectric impedance analysis (BIA), vitamins A, B12, D3, E, K1, folic acid, iron, total protein, transferrin, ferritin, prealbumin, albumin, and zinc. All subjects were admitted to hospital four to five days before surgery and sip-fed with Nutritia Fortimel Compact Protein in addition to regular oral food intake. During surgery, a nasogastric tube was inserted and only removed on hospital discharge five days postoperatively. A total of 58 patients could be included. Half of the MRONJ patients were identified to be at risk for malnutrition. Deficiencies regarding protein levels were revealed, whereas hardly any relevant deficits of micronutrients were noted. The intraoral wound healing four weeks post-surgery was highly satisfactory with a low dehiscence rate of intraoral mucosal sites. Of all parameters analyzed, the dehiscence rate at the last follow-up four weeks post-surgery was significantly influenced by vitamin K, transferrin, and ferritin levels (p = 0.030, p = 0.004, and p = 0.023, respectively). In conclusion, perioperative dietary counselling and appropriate nutritional therapy are important supportive measures in MRONJ patients scheduled for intraoral soft tissue closure.

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Nutritional screening tools for adult cancer patients: A hierarchical Bayesian latent-class meta-analysis

Cited by 16 publications

References 50 publications

The Clinical Value of Nutritional Care before and during Active Cancer Treatment

The Clinical Value of Nutritional Care before and during Active Cancer Treatment

Malnutrition Screening and Assessment

Nutritional Status in Patients with Medication-Related Osteonecrosis of the Jaw (MRONJ)

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