Farklı Beslenme Tarama Testleri Kullanılarak Ameliyat Öncesi Gastrointestinal Sistem Kanserli Hastaların Beslenme Durumunun Değerlendirilmesi
Şahin Kaya, Aysel
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This study was conducted in a total of 110 patients,46 female (41.8%) and 64 males (58.2%), aged 19 to 65 years who were admitted to T.R. Ministry of Health Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital with confirmed diagnosis of gastrointestinal system cancer, but not yet operated. Main objectives of this study were to determine the nutritional status of the patients with two different nutrition screening tools [Subjective Global Assessment (SGA) and Nutritional Risk Screening-2002 (NRS-2002)], to compare the two screening tools, and to describe the malnutrition status of patients with gastrointestinal system cancer preoperatively. A questionnaire consisting from 5 parts was applied. In the study, socio-demographic characteristics of the subjects were determined, anthropometric measurements (body weight, height, mid-upper arm circumference-MUAC, triceps skinfold thickness-TSFT) were done, biochemical parameters (total protein, albumin and C-reactive protein-CRP) were evaluated, 24- hour dietary recalls and frequency of foods consumed were determined. Also two screening tools, SGA and NRS-2002were applied. Mean (±SD) age was 54.6±7.4 years in men and 53.3±9.8 years in women. Body Mass Index (BMI) of subjects was 22.7±3.76 kg/m2 in men and 23.2±4.72 kg/m2 in women. According to calculated ideal body weight ratio, 54.7%of men and 56.5%of women were in normal range. Malnutrition status was evaluated with two screening tools. Using SGA, 49.1% of the patients has serious, 41.8% of patients had moderate degree of malnutrition and only 9.1% of the patients had a good nutritional status. According to NRS-2002screening tool, 54.6% of the patients was severely undernourished, 33.6% was severely ill and 11.8% was found mildly undernourished. Mean energy (±S)intake of subjects was 1104.9±359.3 kcal in men and 1145.9±489.9 kcal in women, and percentage of .patients meeting the recommended daily allowances was 47.2%and 58.1%, respectively for men and women according to RDA, respectively. Men met 54.1%of the protein requirement, while women met only 69.2%. According to NRS and SGA groups, there were statistically significant differences between groups in respect of currently weight, ideal body weight ratio, usual body weight ratio, weight loss percentage, BMI, MUAC, TSFT, mid-upper arm muscle area, mid-upper arm muscle circumference and mid-upper arm fat area (p<0.05). Although duration of hospital stay was similar in both screening tests, patients with longest hospital stay were determined in subjects with SGA-C and NRS-4 scores. Nutritional status of patients with SGA and NRS tests showed consistent similarity (κ=0.671 and p<0.001). In addition, similar increases were found between SGA and NRS scores. Consistency was found statistically significantly (r=0.786 and p=<0.001). In conclusion, one of the approved malnutrition screening tool should be preoperatively applied in patients with gastrointestinal system cancer and nutritional support treatment should be planned and administered preoperatively, when necessary.