Application's Comparison Of NRS-2002 And PG-SGA In The First Chemotherapy Of Patients With Advanced Digestive System Neoplasms

Objectives:The nutritional status of the patients with advanced digestive system neoplasms treated for the first time was surveyed by NRS-2002 and PG-SGA,and the applicability of the two methods was analyzed.The effects of nutritional risk and malnutrition on the incidence of post-chemotherapy side effects were analyzed.The relationship between nutritional risk and clinical outcomes(including total medical consumption and length of hospitalization)was assayed,in order to provide guidance for clinical prevention and treatment of malnutrition in advanced digestive system tumors.Methods:This was a prospective study.A total of 99 patients with advanced digestive system neoplasms being treated for the first time in the Department of Oncology,Department of General Surgery,or Department of Gastroenterology in Changzhi People's Hospital Affiliated to Shanxi Medical University from June to November in 2016 were selected as the study subjects.The informed consent from the patients and their families were gained within 48 hours after admission.The following data of patients were collected:(1)general information,including name,admission number,bed number,gender,age,date of admission,date of discharge,and hospitalization expenses;(2)the disease information including diagnosis,tumor location,and past treatment;(3)diet and activity;(4)results of physical examination: height,weight,and muscle condition;(5)results of laboratory indicators: hemoglobin,white blood cells,neutrophils,platelets,prealbumin,and albumin.NRS-2002 and PG-SGA were applied to evaluate.All statistics were performed using the SPSS 17.0 software package.Enumeration data were expressed as frequency and rate,and comparisons between groups were conducted by ?2 test.Measurement data were expressed as(mean ± standard deviation)or median,and comparisons between groups were conducted by t test or t,test,or Wilcoxon rank sum test.Consistency analysis was conducted by Kappa consistency test.P<0.05 was considered statistically significant.Results:1.The incidence of malnutrition was 50.50% from PG-SGA survey;the incidence of nutritional risk from NRS-2002 was 37.37%,with ?2 =8.471,P=0.002,and the difference was statistically significant.PG-SGA and NRS-2002 were tested by Kappa consistency test,showing k=0.657,P<0.001,so the difference was statistically significant.Based on NRS-2002,the positive predictive value of PG-SGA was 70% and the negative predictive value was 95.92%.2.The patients were grouped into non-nutrition risk group and nutrition risk group based on the results from NRS-2002,and BMI showed significant statistical difference between the two groups(P<0.001).If they were grouped based on the results from PG-SGA,there were significant differences between the non-nutrition risk group and nutrition risk group as for indicators as pre-albumin and albumin(P=0.032 and 0.014,respectively).3.The incidence of digestive tract responses,fatigue,and myelosuppression was respectively 72.7%,59.6%,and 60.6% in all patients.According to PG-SGA assay,the higher the nutritional risk,the higher the incidence of nausea or vomiting,and the difference was statistically significant(P<0.05).For patients with nutritional risk,the incidence of fatigue and myelosuppression after chemotherapy showed an increasing trend,but there was no statistical difference(P>0.05).4.According to results from PG-SGA and NRS-2002,the nutritional risk group had a longer hospital stay and total medical consumption than that of the non-nutritional risk group,and the difference was statistically significant(P<0.05).Conclusions:1.Both PG-SGA and NRS-2002 can be applied to the early screening of nutritional risk of patients with advanced digestive system neoplasms treated for the first time,but PG-SGA yielded a higher detection rate for malnutrition,which is more helpful to the discovery of chronic changes in the body?s nutritional status.2.The higher the nutritional risk of patients with neoplasms before chemotherapy,the higher the incidence of side effects of chemotherapy.3.Nutritional risk can predict the clinical outcome.