DOI: https://doi.org/10.14710/jgi.11.1.49-56

Determining the Valid Tools to Screen Malnutrition in Cancer Patients: A Comparison to Patient Generated-Subjective Global Assessment (PG-SGA)

1Department of Nutrition and Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia

2Department of Nutrition and Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia, Indonesia

Received: 4 Jun 2022; Published: 2 Dec 2022.

Citation Format:
Abstract

Background: Nutrition screening tools are necessary to predict the risk of malnutrition for cancer patients. 

Objectives: This study aimed to investigate the validity of nutrition screening tools in identifying malnutrition among cancer patients.

Materials and Methods: This cross-sectional study involved 175 oncology patients in Dr. Sardjito General Hospital. Malnutrition risk of participants was screened using Nutrition Risk Screening (NRS) 2002, Simple Nutrition Screening Tool (SNST), Malnutrition Screening Tool (MST), Nutriscore, and the Royal Marsden Nutrition Screening Tool (RMNST). Patient Generated-Subjective Global Assessment (PG-SGA) was used as a gold standard. Nutritional assessments, including Body Mass Index (BMI), Mid-Upper Arm Circumference (MUAC), albumin, hemoglobin, Total Leucocytes Count (TLC), and Hand Grip Strength (HGS), were used to evaluate nutritional status.

Results: The NRS 2002, SNST, MST, Nutriscore and RMNST identified nutritional risk in 64.6%; 58.9%; 49.1%; 30.3%; 84.6%, respectively. The SNST obtained the highest level of AUC discrimination (0.8) compared to NRS 2002 (0.7); MST (0.7); Nutriscore (0.7); and RMNST (0.7). There was a significant association between nutrition screening with nutritional parameters except for TLC (P>0.005). Patients who were at risk of malnutrition had a lower average of objective assessment tools.

Conclusion: All the nutritional screenings were valid to screen for malnutrition risk among cancer patients. Nutritional screening has a strong correlation with nutritional assessment. The lower risk detected by nutrition screening, the poorer the nutrition status measured by nutrition assessments. 

Fulltext View|Download
Keywords: validity, nutrition screening tools, PG-SGA, cancer
Funding: Universitas Gadjah Mada

Article Metrics:

Article Info
Section: Articles
Language : EN
Recent articles
Nanocellulose as a Functional Ingredient in the Management of Metabolic Syndrome: A Review The Influence of Aia Tempayang on Interleukin-2 (IL2) Levels on Female Rattus Norvegicus Sprague Dawley Strains in Breast Cancer Prevention Body Mass Index is The Most Associated Anthropometry Indicators of Obesity with Insulin Resistance in Female College Students More recent articles
Most cited articles
Keragaman pangan, pola asuh makan dan kejadian stunting pada balita usia 24-59 bulan Pengaruh pendidikan gizi terhadap pengetahuan, praktik gizi seimbang dan status gizi pada anak sekolah dasar Determinan kejadian stunting pada bayi usia 6 bulan di Kota Semarang Back-Matter Pola makan dan indikator lemak tubuh pada remaja More cited articles
  1. Curtis LJ, Bernier P, Jeejeebhoy K, Allard J, Duerksen D, Gramlich L, et al. Costs of hospital malnutrition. Clin Nutr [Internet]. 2017;36(5):1391–6. Available from: http://dx.doi.org/10.1016/j.clnu.2016.09.009
  2. Gupta D, Vashi PG, Lammersfeld CA, Braun DP. Role of nutritional status in predicting the length of stay in cancer: A systematic review of the epidemiological literature. Ann Nutr Metab. 2011;59:96–106
  3. Planas M, Álvarez-Hernández J, León-Sanz M, Celaya-Pérez S, Araujo K, García de Lorenzo A. Prevalence of hospital malnutrition in cancer patients: a sub-analysis of the PREDyCES® study. Support Care Cancer. 2016;24(1):429–35
  4. Fontes D, Generoso S de V, Toulson Davisson Correia MI. Subjective global assessment: A reliable nutritional assessment tool to predict outcomes in critically ill patients. Clin Nutr [Internet]. 2014;33(2):291–5. Available from: http://dx.doi.org/10.1016/j.clnu.2013.05.004
  5. Mahakalkar C, Modi S, Yeola M, Kaple M, Patwardhan M, Laddha P. Malnutrition in hospitalised patients; a real concern in surgical outcomes. Int J Res Med Sci [Internet]. 2014;2(1):250. Available from: http://www.msjonline.org/index.php/ijrms/article/view/2116
  6. Lim SL, Ong KCB, Chan YH, Loke WC, Ferguson M, Daniels L. Malnutrition and its impact on cost of hospitalization, length of stay, readmission and 3-year mortality. Clin Nutr [Internet]. 2012;31(3):345–50. Available from: http://dx.doi.org/10.1016/j.clnu.2011.11.001
  7. Thomas MN, Kufeldt J, Kisser U, Hornung HM, Hoffmann J, Andraschko M, et al. Effects of malnutrition on complication rates, length of hospital stay, and revenue in elective surgical patients in the G-DRG-system. Nutrition. 2015;xxx:1–6
  8. Patel V, Romano M, Corkins MR, DiMaria-Ghalili RA, Earthman C, Malone A, et al. Nutrition screening and assessment in hospitalized patients: A survey of current practice in the united states. Nutr Clin Pract. 2014;29(4):483–90
  9. Jensen GL, Compher C, Sullivan DH, Mullin GE. Recognizing malnutrition in adults: Definitions and characteristics, screening, assessment, and team approach. J Parenter Enter Nutr. 2013;37(6):802–7
  10. Shaw C, Fleuret C, Pickard JM, Mohammed K, Black G, Wedlake L. Comparison of a novel, simple nutrition screening tool for adult oncology inpatients and the Malnutrition Screening Tool (MST) against the Patient-Generated Subjective Global Assessment (PG-SGA). Support Care Cancer. 2014;
  11. Arribas L, Hurtós L, Sendrós MJ, Peiró I, Salleras N, Fort E, et al. NUTRISCORE: A new nutritional screening tool for oncological outpatients. Nutrition. 2016;
  12. Susetyowati, Hadi H, Hakimi M, Asdie AH. Development, Validation and Reliability of the Simple Nutrition Screening Tool (SNST) for Adult Hospital Patient in Indonesia. Pakistan J Nutr. 2014;13(3):157–63
  13. Singh K, Singh S, Kaur G, Bose K. MID-UPPER ARM CIRCUMFERENCE AS AN INDICATOR OF UNDERNUTRITION AMONG OLD AGE HOME AND COMMUNITY BASED ELDERLY IN PUNJAB, INDIA. Care Weekly. 2019: http://dx.doi.org/10.14283/cw.2019.5
  14. Bharadwaj S, Ginoya S, Tandon P, Gohel TD, Guirguis J, Vallabh H, et al. Malnutrition: Laboratory markers vs nutritional assessment. Gastroenterol Rep. 2016;4(4):272–80
  15. Khusun H, Yip R, Schultink W, Dillon DHS. World Health Organization Hemoglobin Cut-Off Points for the Detection of Anemia Are Valid for an Indonesian Population. J Nutr. 1999;129(9):1669–74
  16. Sousa-Santos, A. R., & Amaral, T. F.Differences in handgrip strength protocols to identify sarcopenia and frailty - a systematic review. BMC geriatrics. 2017. 17(1), 238. https://doi.org/10.1186/s12877-017-0625-y
  17. Skipper A, Ferguson M, Thompson K, Castellanos VH, Porcari J. Nutrition screening tools: An analysis of the evidence. J Parenter Enter Nutr. 2012;36(3):292–8
  18. Nuraini A. Comparison of Simple Nutrition Screening Tool (SNST), Nutrition Risk Screening 2002 (NRS 2002), and Royal Marden Nutrition Screening Tool (RMNST) to Patient Generated-Subjective Global Assessment (PG-SGA) for Inpatient Cancer in Dr. Sardjito Hospital Yogy. Universitas Gadjah Mada; 2019
  19. Aziz MF. Gynecological cancer in Indonesia. J Gynecol Oncol. 2009;20(1):8–10
  20. Cavalcante Martins FF, de Pinho NB, de Carvalho Padilha P, Martucci RB, Rodrigues VD, Sales RC, et al. Patient-generated subjective global assessment predicts cachexia and death in patients with head, neck and abdominal cancer: A retrospective longitudinal study. Clin Nutr ESPEN [Internet]. 2019;31:17–22. Available from: https://doi.org/10.1016/j.clnesp.2019.03.013
  21. van Bokhorst-de van der Schueren MAE, Guaitoli PR, Jansma EP, de Vet HCW. Nutrition screening tools: Does one size fit all? A systematic review of screening tools for the hospital setting. Clin Nutr. 2014;33:39–58
  22. Baumgartner A, Zueger N, Bargetzi A, Medinger M, Passweg JR, Stanga Z, et al. association of nutritional parameters with clinical outcomes in patients with acute myeloid leukemia undergoing haematopoietic stem cell transplantation. Ann Nutr Metab. 2016;69:89–98
  23. Sarasati RM. Comparison between Nutrition Risk Screening 2002 (NRS 2002), Simple Nutrition Screening Tool (SNST) and Nutriscore to Anthropometry and Biochemical Assessment for Adult Cancer Patients Hospitalized in Dr. Sardjito Hospital Yogyakarta. Universitas Gadjah Mada; 2019
  24. Davies M. Nutritional screening and assessment in cancer-associated malnutrition. Eur J Oncol Nurs. 2005;9(SUPPL. 2):64–73
  25. Álvaro Sanz E, Garrido Siles M, Rey Fernández L, Villatoro Roldán R, Rueda Domínguez A, Abilés J. Nutritional risk and malnutrition rates at diagnosis of cancer in patients treated in outpatient settings: Early intervention protocol. Nutrition. 2019;57:148–53
  26. Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, Bozzetti F, et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr [Internet]. 2017;36(1):11–48. Available from: http://dx.doi.org/10.1016/j.clnu.2016.07.015
  27. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al. Sarcopenia: European consensus on definition and diagnosis. Age Ageing. 2010;39(4):412–23
  28. Gupta D, Lis CG. Pretreatment serum albumin as a predictor of cancer survival: A systematic review of the epidemiological literature. Nutr J. 2010;9(1):1–16
  29. Lidoriki I, Schizas D, Mpaili E, Vailas M, Sotiropoulou M, Papalampros A, et al. Associations between skeletal muscle mass index, nutritional and functional status of patients with oesophago-gastric cancer. Clin Nutr ESPEN. 2019;34:61–7
  30. Lind M, Vernon C, Cruickshank D, Wilkinson P, Littlewood T, Stuart N, et al. The hemoglobin level in anaemic cancer patients correlates positively with quality of life. Br J Cancer. 2002;86(8):1243–9
  31. Castanho IA, Lopes AJ, Koury JC, Tessarollo B, Silva AC, Nunes RA. Relationship between the phase angle and volume of tumours in patients with lung cancer. Ann Nutr Metab. 2013;62:68–74
  32. Sukkar SG. The impact of clinical nutrition on cancer therapy: A frequently underestimated perspective. A complementary approach to cancer patients. Med J Nutrition Metab. 2012;5(2):75–9

Last update:

  1. Comparison of Tools for Nutritional Assessment and Screening of Hospitalized Patients: A study on Surgical Patients

    Susetyowati SUSETYOWATI, Amalia Sarah SHOLIKHATI, Dinda Krisma CAHYANINGRUM, Azizah Isna RACHMAWATI, Adeodatus Yuda HANDAYA. Medeniyet Medical Journal, 38 (1), 2023. doi: 10.4274/MMJ.galenos.2023.64554

Last update: 2024-04-19 05:47:48

No citation recorded.