Objective According to literature,cancer patients have the highest incidence of malnutrition among hospital patients(40%-80%).Despite this high prevalence,this condition is still under-diagnosed.The aim of this study ...Objective According to literature,cancer patients have the highest incidence of malnutrition among hospital patients(40%-80%).Despite this high prevalence,this condition is still under-diagnosed.The aim of this study was to conduct a systematic literature review and meta-analysis to assess the diagnostic performance of the Malnutrition Screening Tool(MST),a simple tool that can be applied in a busy setting where a comprehensive assessment at screening would be impractical.Methods PubMed,EMBASE and Cochrane central register of controlled trials were systematically searched to identify records relevant to the research question.The QUADAS-2 was used to assess the quality of each included study and the meta-analysis was conducted using the hierarchical bivariate model in STATA.Results Seven records were included in this study and the overall sensitivity specificity,diagnostic odds ratio(DOR).The pooled sensitivity and specificity generated after the meta-analysis in STATA were 0.78(95%CI:0.64-0.88)and 0.82(95%CI:0.76-0.87),respectively.The corresponding DOR was 16.33(95%CI:7.08-37.67).The positive likelihood ratio(LR+)was+4.39(95%CI:3.02-6.38),and the negative likelihood ratio(LR-)were 0.27(95%CI:0.16-0.47)and the 1/LR-3.72(2.14-6.46).Conclusion These results showed that the MST provides weak diagnostic evidence when used to screen for malnutrition in adult cancer patients.展开更多
目的对国内外筛查和预测脑卒中患者营养不良风险的评估工具进行范围综述,为临床营养筛查和相关研究提供参考依据。方法检索中国知网、维普中文科技期刊数据库、万方医学数据库、中国生物医学文献服务系统、PubMed、CINAHL护理学全文数...目的对国内外筛查和预测脑卒中患者营养不良风险的评估工具进行范围综述,为临床营养筛查和相关研究提供参考依据。方法检索中国知网、维普中文科技期刊数据库、万方医学数据库、中国生物医学文献服务系统、PubMed、CINAHL护理学全文数据库、Web of Science核心数据库,检索时限为自建库至2023年5月24日。由2名研究人员按照纳入排除标准独立进行文献筛选和资料提取,使用预测模型研究的偏倚风险适用性评估工具(PROBAST)和诊断准确性研究的质量评价工具(QUADAS-2)对所纳入的文献进行偏倚风险和适用性评价。结果共纳入13篇文献,包括1篇预测模型的构建及验证,12篇营养筛查工具的验证;各研究存在高偏倚风险,筛查工具适用性适中。结论现有营养不良评估工具对于脑卒中患者筛查偏倚风险较高,适用性适中,缺乏特异性。未来应开展脑卒中患者营养不良预测工具研究,构建高适用性的筛查工具。展开更多
Malnutrition in Head and neck cancer (HNC) patients can be present at the moment of diagnosis. The nutritional status is determinant for the treatment success and quality of life of the patients. The nutritional statu...Malnutrition in Head and neck cancer (HNC) patients can be present at the moment of diagnosis. The nutritional status is determinant for the treatment success and quality of life of the patients. The nutritional status gradually declines during treatment and the majority of patients undergoing treatment will need nutritional therapy. On the other hand, HNC, like other cancers, can induce a paraneoplastic syndrome that leads to cachexia. This cachexia status is most of the times the cause of death or the cause of treatment failure. So, early identification of malnutrition high risk patients is crucial to start an adequate nutrition support intervention in HNC patients. This study aims to identify HNC patients who present malnutrition or higher risk of malnutrition;to signalize variables that support early identification of high-risk patients of becoming malnourished and to establish a dynamic relationship between malnutrition risk in these patients and Quality of Life (QoL) impacts. For six months consecutive outpatients with HNC admitted at the Head & Neck Unity of Oncology Portuguese Institute—Porto were asked to participate in the research (n = 114). The European Organisation for Research and Treatment of Cancer (EORTC) cancer-specific HRQoL questionnaire-QLQ-C30 and Malnutrition Universal Screening Tool, MUST were used. At the moment of first presentation, 32 patients (28.1%) presented high-risk of malnutrition. HNC patients with oral cavity and oropharynx tumour locations, older, with low literacy or with BMI under 18.5 at the moment of diagnosis, represent a high-risk group. When HNC is considered, a dynamic and bi-directional connection between malnutrition and QoL is observed. A significant (p Emotional and social functional scales and all symptom scales—including pain, presented significant differences between high and medium risk of malnutrition patients. Fatigue, pain, insomnia, appetite loss and financial difficulties were domains directly related to high risk of malnutrition patients. Pain scores were significantly higher (43.23) in the high-risk patients when compared to medium risk patients (11.67). Nutrition support should be considered at any stage of the pathway —especially in high risk group—in order to optimize tumour treatment results, reduction of adverse effects of therapy and improving both QoL and survival.展开更多
Malnutrition is common, and is a significant contributing factor to morbidity and mortality in the oncology setting. Previous research suggests that dietetic services in rural oncology clinics need to be well organize...Malnutrition is common, and is a significant contributing factor to morbidity and mortality in the oncology setting. Previous research suggests that dietetic services in rural oncology clinics need to be well organized, timely and flexible with routine screening processes. In the absence of routine nutrition screening, it is hypothesized that oncology patients are only referred to dietetic services when malnutrition is overt or advanced. The aim of this study was to describe and compare dietetic services in two rural Australian oncology clinics and investigate nutrition screening and referral practices to determine if oncology patients at nutritional risk were appropriately referred. A retrospective file audit of medical and treatment records was conducted for a sample of oncology patients to determine the proportion of patients at risk of malnutrition by using the Malnutrition Screening Tool retrospectively. Dietetic treatment statistics and key stakeholders were consulted to compare dietetic service provision across the two sites. Seventy-eight percent of patients (n = 129) were retrospectively determined to be at nutritional risk during the study period, however, only 66% of these patients were referred to a dietitian. Dietetic treatment statistics varied across the two sites ranging from 26 to 62 treated patients, an average of 2.4 to 4.5 dietetic interventions per patient and an average difference in patient intervention time of 62 minutes during the 12-month study period. This study confirmed findings from previous research, highlighting that without routine nutrition screening in oncology, at least one third of patients at nutritional risk were failing to be identified and referred to dietetic services for appropriate treatment. Routine nutrition screening should be implemented to standardise and prioritise dietetic service provision, and oncology specific funding should be allocated to the dietetic service to ensure that staffing is adequate to provide a timely service.展开更多
文摘Objective According to literature,cancer patients have the highest incidence of malnutrition among hospital patients(40%-80%).Despite this high prevalence,this condition is still under-diagnosed.The aim of this study was to conduct a systematic literature review and meta-analysis to assess the diagnostic performance of the Malnutrition Screening Tool(MST),a simple tool that can be applied in a busy setting where a comprehensive assessment at screening would be impractical.Methods PubMed,EMBASE and Cochrane central register of controlled trials were systematically searched to identify records relevant to the research question.The QUADAS-2 was used to assess the quality of each included study and the meta-analysis was conducted using the hierarchical bivariate model in STATA.Results Seven records were included in this study and the overall sensitivity specificity,diagnostic odds ratio(DOR).The pooled sensitivity and specificity generated after the meta-analysis in STATA were 0.78(95%CI:0.64-0.88)and 0.82(95%CI:0.76-0.87),respectively.The corresponding DOR was 16.33(95%CI:7.08-37.67).The positive likelihood ratio(LR+)was+4.39(95%CI:3.02-6.38),and the negative likelihood ratio(LR-)were 0.27(95%CI:0.16-0.47)and the 1/LR-3.72(2.14-6.46).Conclusion These results showed that the MST provides weak diagnostic evidence when used to screen for malnutrition in adult cancer patients.
文摘目的对国内外筛查和预测脑卒中患者营养不良风险的评估工具进行范围综述,为临床营养筛查和相关研究提供参考依据。方法检索中国知网、维普中文科技期刊数据库、万方医学数据库、中国生物医学文献服务系统、PubMed、CINAHL护理学全文数据库、Web of Science核心数据库,检索时限为自建库至2023年5月24日。由2名研究人员按照纳入排除标准独立进行文献筛选和资料提取,使用预测模型研究的偏倚风险适用性评估工具(PROBAST)和诊断准确性研究的质量评价工具(QUADAS-2)对所纳入的文献进行偏倚风险和适用性评价。结果共纳入13篇文献,包括1篇预测模型的构建及验证,12篇营养筛查工具的验证;各研究存在高偏倚风险,筛查工具适用性适中。结论现有营养不良评估工具对于脑卒中患者筛查偏倚风险较高,适用性适中,缺乏特异性。未来应开展脑卒中患者营养不良预测工具研究,构建高适用性的筛查工具。
文摘Malnutrition in Head and neck cancer (HNC) patients can be present at the moment of diagnosis. The nutritional status is determinant for the treatment success and quality of life of the patients. The nutritional status gradually declines during treatment and the majority of patients undergoing treatment will need nutritional therapy. On the other hand, HNC, like other cancers, can induce a paraneoplastic syndrome that leads to cachexia. This cachexia status is most of the times the cause of death or the cause of treatment failure. So, early identification of malnutrition high risk patients is crucial to start an adequate nutrition support intervention in HNC patients. This study aims to identify HNC patients who present malnutrition or higher risk of malnutrition;to signalize variables that support early identification of high-risk patients of becoming malnourished and to establish a dynamic relationship between malnutrition risk in these patients and Quality of Life (QoL) impacts. For six months consecutive outpatients with HNC admitted at the Head & Neck Unity of Oncology Portuguese Institute—Porto were asked to participate in the research (n = 114). The European Organisation for Research and Treatment of Cancer (EORTC) cancer-specific HRQoL questionnaire-QLQ-C30 and Malnutrition Universal Screening Tool, MUST were used. At the moment of first presentation, 32 patients (28.1%) presented high-risk of malnutrition. HNC patients with oral cavity and oropharynx tumour locations, older, with low literacy or with BMI under 18.5 at the moment of diagnosis, represent a high-risk group. When HNC is considered, a dynamic and bi-directional connection between malnutrition and QoL is observed. A significant (p Emotional and social functional scales and all symptom scales—including pain, presented significant differences between high and medium risk of malnutrition patients. Fatigue, pain, insomnia, appetite loss and financial difficulties were domains directly related to high risk of malnutrition patients. Pain scores were significantly higher (43.23) in the high-risk patients when compared to medium risk patients (11.67). Nutrition support should be considered at any stage of the pathway —especially in high risk group—in order to optimize tumour treatment results, reduction of adverse effects of therapy and improving both QoL and survival.
文摘Malnutrition is common, and is a significant contributing factor to morbidity and mortality in the oncology setting. Previous research suggests that dietetic services in rural oncology clinics need to be well organized, timely and flexible with routine screening processes. In the absence of routine nutrition screening, it is hypothesized that oncology patients are only referred to dietetic services when malnutrition is overt or advanced. The aim of this study was to describe and compare dietetic services in two rural Australian oncology clinics and investigate nutrition screening and referral practices to determine if oncology patients at nutritional risk were appropriately referred. A retrospective file audit of medical and treatment records was conducted for a sample of oncology patients to determine the proportion of patients at risk of malnutrition by using the Malnutrition Screening Tool retrospectively. Dietetic treatment statistics and key stakeholders were consulted to compare dietetic service provision across the two sites. Seventy-eight percent of patients (n = 129) were retrospectively determined to be at nutritional risk during the study period, however, only 66% of these patients were referred to a dietitian. Dietetic treatment statistics varied across the two sites ranging from 26 to 62 treated patients, an average of 2.4 to 4.5 dietetic interventions per patient and an average difference in patient intervention time of 62 minutes during the 12-month study period. This study confirmed findings from previous research, highlighting that without routine nutrition screening in oncology, at least one third of patients at nutritional risk were failing to be identified and referred to dietetic services for appropriate treatment. Routine nutrition screening should be implemented to standardise and prioritise dietetic service provision, and oncology specific funding should be allocated to the dietetic service to ensure that staffing is adequate to provide a timely service.
