A Study Comparing The Value Of Three Nutritional Screening Tools In Predicting Complications After Radical Gastrectomy For Gastric Cancer

Objective: Selection of the Nutrition Risk Screening 2002(NRS 2002),the Malnutrition Universal Screening Tool(MUST)and the Nutrition Risk Index(NRI)3nutritional screening tools were assessed with perioperative relevant clinical data and postoperative complications of the patient An analysis was performed to compare nutritional screening tools that more accurately predict complications after radical gastrectomy for gastric cancer.Methods: 164 patients who underwent radical gastrectomy for gastric cancer and were hospitalized in Qingdao Municipal Hospital from July 2018 to July 2019 were selected,according to the The presence or absence of complications categorized patients into complication and no complication groups.The results of the NRS 2002,MUST,and NRI nutritional screening tool assessments were collected separately,and perioperative Other relevant clinical information,including preoperative factors such as patient age,gender,body mass index,recent 2-6 month weight loss,preoperative albumin,preoperative hemoglobin,history of previous abdominal surgery,Charlson comorbidity index;intraoperative factors,such as Whether or not lumpectomy,time of surgery,ASA classification;postoperative factors,including pathological TNM(pTNM)staging,postoperative Hospital days,total hospital costs,and postoperative complications.Singleand multifactorial logistic regression was used to analyze the factors related to postoperative complications after radical gastric cancer surgery and to determine the factors affecting postoperative Independent Risk Factors for Complications,Analysis Comparing the Screening of 3 Nutritional Screening Tools NRI,NRS2002 and MUST Relationship between outcomes and postoperative complications,plotting ROC curves for different nutritional evaluation methods for predicting postoperative complications,by area under the curve(AUC)Comparison of the predictive value of different nutritional evaluation methods for postoperative complications RESULTS: 1.A total of 164 cases were collected in this study,with an average age of63.91±10.289 years.116(72.6%)males and 45(27.4%)females with nutrition according to the NRS 2002 score.Risk 95(57.9%)cases,no nutritional risk 69(42.1%)cases;low risk 137 with MUST score(83.5%),moderate risk 12(7.3%),high risk 15(9.1%);scored with NRIs,88(53.7%)cases with risk(<97.5)and 76(46.3%)cases without risk(?97.5).2.Of all the patients included in this study,49(29.9%)had postoperative complications,as per Clavien-Dindo grading,of 49 patients,44 were grade I and II;3were grade III;and 2 were grade IV.Patients in the uncomplicated group had significantly lower postoperative length of stay and total hospital costs than those in the group withcomplications,and the difference was statistically significant(P<0.05).3.One-way analysis showed that the NRI score was <97.5(OR= 2.925,P= 0.003),NRS2002 score? 3(OR=2.292,P=0.022),age ? 70 years(OR=3.870,P=0.001)and hypoproteinemia(OR=3.414,P= 0.005),anemia(OR=3.987,P=0.049)are potential risk factors for the development of complications,multiple Factor analysis showed that age ? 70 years(OR=2.382,95% CI 1.228 to 4.620,p= 0.010),NRI score <97.5(OR=2.067,95% CI1.012? 4.221,p=0.044),NRS 2002 score ? 3(OR=1.171,95% CI 1.004 to 2.861,p=0.048),hypoproteinemia(OR=2.382,95% CI 1.228 to 4.620,p=0.010)is an independent risk factor for complications.4.Plotting NRIs ROC curve for score and NRS2002 score predicting postoperative complications,AUC value for NRI score(66.4%))was higher than the AUC value of the NRS 2002 score(63.1%);the NRI score at the optimal cutoff point predicted postoperative The sensitivity for complications was significantly higher than NRS 2002,and the specificity of the two evaluation methods was comparable.Conclusion: 1.The incidence of nutritional risk among gastric cancer patients ranged from16.4 % to 57.9 % with different nutritional risk screening tools.2.Age ? 70 years and hypoproteinemia are independent risk factors for post-radical gastric cancer complications.3.Compared to nutritional risk Screening 2002(NRS 2002)and the Malnutrition Universal Screening Tool(MUST),NRIs more accurately predict Complications occur,and it is recommended that clinicians use NRIs on admission to screen patients with gastric cancer for nutrition.