Brief Article
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Jul 14, 2010; 16(26): 3310-3317
Published online Jul 14, 2010. doi: 10.3748/wjg.v16.i26.3310
Comparison of different nutritional assessments in detecting malnutrition among gastric cancer patients
Seung Wan Ryu, In Ho Kim
Seung Wan Ryu, In Ho Kim, Department of Surgery and Division of Gastrointestinal Surgery, The Keimyung University School of Medicine, Daegu 700-712, South Korea
Author contributions: Ryu SW performed the majority of experiments and wrote the manuscript; Kim IH designed the study and wrote the manuscript.
Supported by The Bisa Research Grant of Keimyung University in 2006
Correspondence to: Dr. In Ho Kim, Department of Surgery and Division of Gastrointestinal Surgery, The Keimyung University School of Medicine, Daegu 700-712, South Korea.
Telephone: +82-53-2507386 Fax: +82-53-2507322
Received: December 2, 2009
Revised: January 27, 2010
Accepted: February 3, 2010
Published online: July 14, 2010

AIM: To evaluate the prevalence of preoperative and postoperative malnutrition and the relationships between objective and subjective nutritional assessment of gastric cancer patients.

METHODS: From October 2005 to July 2006, we studied 80 patients with no evidence of recurrent disease and no loss to follow-up after curative surgery for gastric cancer. In this group, 9 patients underwent total gastrectomy and 71 patients subtotal gastrectomy. At admission, 6 and 12 mo after surgery, the patients were assessed on the subjective global assessment (SGA), nutritional risk screening (NRS-2002), nutritional risk index (NRI) and by anthropometric measurements and laboratory data. Differences between the independent groups were assessed with the Student’s t test and one-way analysis of variance. Spearman’s rank correlation coefficients were calculated to evaluate the association between the scores and variables.

RESULTS: The prevalence of malnutrition at admission was 31% by SGA and 43% by NRS-2002. At admission, the anthropometric data were lower in the malnourished groups defined by the SGA and NRS-2002 assessments, but did not differ between the groups using the NRI assessment. Body weight (BW), body mass index (BMI), triceps skin fold and midarm circumference were significantly reduced, but the total lymphocyte count, albumin, protein, cholesterol and serum iron levels did not decrease during the postoperative period. Six months after surgery, there was a good correlation between the nutritional assessment tools (SGA and NRS-2002) and the other nutritional measurement tools (BW, BMI, and anthropometric measurements). However, 12 mo after surgery, most patients who were assessed as malnourished by SGA and NRS-2002 had returned to their preoperative status, although their BW, BMI, and anthropometric measurements still indicated a malnourished status.

CONCLUSION: A combination of objective and subjective assessments is needed for the early detection of the nutritional status in case of gastric cancer patients after gastrectomy.

Keywords: Gastrectomy, Malnutrition, Nutritional assessment, Nutritional risk screening, Postoperative follow up, Subjective global assessment