Observational Study
Copyright ©The Author(s) 2016.
World J Gastrointest Oncol. Jul 15, 2016; 8(7): 563-572
Published online Jul 15, 2016. doi: 10.4251/wjgo.v8.i7.563
Table 1 Subscores of the three nutritional risk screening tests used in the study
TestSubscoreNutritional risk score
MUSTBMI (score: 0-2)Unintentional weight loss (score: 0-2)Acute disease able to significantly reduce nutrient intake in the following 5 d (score: 2)≥ 2
NRS-2002Pre-test: BMI < 2 0.5; weight loss, reduced caloric intake, acute diseaseNutritional risk: Weight loss, BMI, caloric intake (score: 0-3)Severity of disease (score: 0-3)Age ≥ 70-yr-old (score: 1)> 3
MNAFirst part (six items: Caloric food intake, weight loss, motility, psychological stress, neuropsychological disease, BMI (score: 0-14)If subscore ≤ 11: Complete second partSecond part (12 items: Home and nutritional autonomy, drugs, bedsores, daily meals, brachial and calf circumference; (maximal score of 16)17-25
Table 2 Characteristics of the patients in the 19 gastroenterological units participating in the study
CentersnMFAge (average ± DS)AmbulatoryDHInpatientsMUSTNRSMNAWeight (kg)Weight loss (%)BMI
Bolzano2161.90%38.10%67.5 ± 17.20.00%0.00%100.00%-2.2 ± 1.516.8 ± 4.371.6 ± 16.4-4.7 ± 6.224.8 ± 4.4
Fiemme del Cavalese1757.1%42.9%56.2 ± 25.157.1%0.0%42.9%0.8 ± 1.31.7 ± 1.419.0 ± 9.966.9 ± 5.1-2.5 ± 6.923.1 ± 2.4
Pordenone1425.0%75.0%48.7 ± 24.0100.0%0.0%0.0%1.0 ± 1.2-22.0 ± 0.058.3 ± 12.70.0 ± 0.021.3 ± 3.6
Udine1050.0%50.0%51.6 ± 8.770.0%0.0%30.0%0.4 ± 0.7-13.0 ± 0.075.5 ± 16.0-2.0 ± 5.725.9 ± 5.2
Como1272.2%27.8%65.3 ± 17.90.022.2%77.8%1.7 ± 2.12.3 ± 1.518.6 ± 5.473.5 ± 22.7-7.6 ± 9.425.8 ± 6.7
Milano1764.0%36.0%64.9 ± 19.20.00.0%100.0%-1.7 ± 1.49.5 ± 3.169.4 ± 15.7-2.8 ± 7.425.2 ± 4.7
Torino3850.0%50.0%58.9 ± 16.10.055.3%44.7%1.6 ± 1.72.2 ± 2.215.8 ± 4.965.3 ± 16.6-0.9 ± 9.123.9 ± 4.5
Alto Vicentino di Santorso3240.6%59.4%68.2 ± 12.797.30.0%2.7%0.2 ± 0.60.5 ± 0.715.4± 4.671.3 ± 12.8-2.3 ± 4.925.0 ± 3.9
Bassano del Grappa2548.0%52.0%48.3 ± 17.960.00.0%40.0%0.5 ± 0.90.8 ± 1.417.6 ± 4.868.0 ± 14.50.1 ± 9.023.9 ± 4.3
Legnano1687.5%12.5%53.0 ± 16.10.00.0%100.0%-1.1 ± 1.615.2 ± 4.666.1 ± 13.5-4.2 ± 12.323.0 ± 2.7
Ravenna6641.5%58.5%57.4 ± 19.452.521.925.6%0.8 ± 1.31.3 ± 1.419.6 ± 2.867.7 ± 17.4-1.5 ± 7.224.3 ± 5.4
Ancona3339.460.658.9 ± 19100.00.00.00.1 ± 0.3-13.5 ± 4.870.8 ± 13.50.5 ± 2.525.7 ± 4.8
Napoli2653.846.159.1 ± 15.87.730.861.50.5 ± 0.91.3 ± 1.212.2 ± 2.767.9 ± 14.9-1.2 ± 3.824.7 ± 5.6
Foggia3339.460.657.7 ± 18.266.66,127.30.3 ± 0.90.4 ± 0.815.0 ± 3.376.5 ± 21.9-1.5 ± 3.028.6 ± 7.6
Trani5358.541.555.5 ± 18.162.110.327.60.5 ± 0.90.7 ± 1.113.4 ± 3.271.6 ± 14.51.1 ± 5.527.1 ± 5.5
Cosenza5853.946.158.8 ± 18.438.115.946.01.3 ± 1.72.1 ± 1.115.3 ± 3.767.0 ± 15.9-3.8 ± 7.924.5 ± 4.8
Palermo1564.735.364.2 ± 10.10.00.0100.0-1.3 ± 0.613.0 ± 4.577.5 ± 21.3-1.3 ± 1.627.6 ± 6.7
Marsala1741.258.870.4 ± 9.588.20.011.80.6 ± 0.82.6 ± 0.918.0 ± 5.472.2 ± 12.4-2.2 ± 3.527.7 ± 3.7
Siracusa1060.040.067.9 ± 1.320.00.080.00.8 ± 1.22.6 ± 1.515.4 ± 4.661.8 ± 7.8-1.6 ± 4.923.9 ± 2.6
Total51351.448.659.8 ± 17.848.112.139.80.7 ± 0.51.5 ± 0.815.8 ± 2.969.7 ± 16.0-1.7 ± 6.925.3 ± 5.3
Table 3 Clinical features of evaluated patients according to age group n (%)
Total cohort (n = 513)< 65 yr (n = 289)≥ 65 yr (n = 218)P value
Age (yr) (Mean ± SD)59.8 ± 17.847.4 ± 12.876.1 ± 6.9< 0.0011
Male gender,260 (51.4)138 (47.8)122 (56.2)0.062
Setting< 0.0012
Inpatient204 (39.8)93 (32.2)110 (50.7)
Outpatient308 (60.2)196 (67.8)107 (49.3)
Disease< 0.0012
Acute414 (72.1)232 (71.8)177 (72.2)
Chronic96 (16.7)73 (22.6)22 (9.0)
Neoplastic64 (11.1)18 (5.6)46 (18.8)
Table 4 Prevalence and number of patients with chronic disease, acute disease and cancer according to age group
Chronic disease%< 65 yr≥ 65 yrP valueAcute disease%< 65 yr≥ 65 yrP valueCancer%< 65 yr≥ 65 yrP value
GERD8.9035180.123Dysphagia2.7790.199Esophagus0.7040.033
Achalasia0.20100.577Dyspepsia9.325300.046Stomach1.3350.219
Chronic gastropathy5.9017180.174Epigastralgia12.644310.44Small-large intestine35130.01
Chronic viral hepatitis4.201780.194Other abdominalgia17.753520.78Pancreas0.5120.394
Chronic alcoholic hepatitis3.201450.113Acute diarrhea2.5860.602Liver3.47130.036
NAFLD4.5013140.206Acute constipation1.5720.18Biliary tree2390.024
Other chronic hepatitis1.30350.211Digestive bleeding5.613200.027
Compensated cirrhosis14.7049380.441Acute hepatitis3.41370.315
Chronic pancreatitis1.20430.632Cirrhosis complicated11.539290.478
Non-IBD chronic diarrhea3.5011100.391Hematochezia3.57140.022
Crohn's disease6.603360.0002IBD exacerbation6.13330.0000033
Ulcerative colitis4.52430.00036Acute pancreatitis4.917120.515
Chronic constipation5.213180.053
Celiac disease1.71000.004
Table 5 Patients with nutritional abnormalities in the 19 gastroenterological centers participating in the study n (%)
Outpatients
Inpatients
P value
< 65 yr> 65 yr< 65 yr> 65 yr
Undernutrition8 (4.2)6 (5.7)24 (23.9)115 (15.6)21P < 0.001
2P
Risk of Malnutrition24 (12.2)43 (40.6)21 (24.7)64 (69.2)33P
Obesity34 (18.3)19 (17.5)15 (17.2)10 (10.5)NS
Overweight52 (26.5)46 (42.5)18 (20.7)27 (28.4)NS
Table 6 Prevalence of risk of malnutrition according to age group
Nutritional risk testTotal cohort (n = 513)< 65 yr (n = 289)65 yr (n = 218)P value
MUST0.45
< 2 (%)274 (89.0)172 (87.8)97 (90.7)
≥ 2 (%)34 (11.0)24 (12.2)10 (9.3)
NRS 20020.002
< 3 (%)112 (63.3)61 (75.3)51 (53.1)
≥ 3 (%)65 (36.7)20 (24.7)45 (46.9)
MNA 17%-25%115 (54.2)-115 (54.5)