Combining the Patient-Generated Subjective Global Assessment (PG-SGA) and Objective Nutrition Assessment Parameters Better Predicts Malnutrition in Elderly Patients with Colorectal Cancer

• 作者: Wen Jun Wang Ting Ting Li Xu Wang Wei Li Jiu Wei Cui
• 来源期刊: 肿瘤营养学杂志（英文）
• 年，卷（期）: 2020,（1）
• 所属期刊栏目: Research
• 页码范围: 22-30
• 页数: 9页
• 语种: 中文
• DOI: 10.34175/jno202001003

摘要

Background Malnutrition is common in colorectal cancer (CRC) patients, especially in elderly patients. The Patient-Generated Subjective Global Assessment (PG-SGA) is a widely used tool developed to detect malnutrition. The aim of this study was to compare the value of the PG-SGA and objective nutrition assessment parameters, in order to identify a better predictive index for malnutrition in elderly patients with CRC. Methods A total of 131 elderly patients (age ≥ 60 years) with CRC were included and were evaluated for their individual nutritional status using the PG-SGA. Anthropometric and serological indicators were also assayed within 48 h of admission to the hospital. Body composition analysis was implemented by bioelectrical impedance analysis (BIA) instrument. The Chi-squared test, univariate and multivariate logistic regression analysis, or Spearman's rank correlation analysis were used to determine the differences among the above indices and parameters with regard to predicting malnutrition. Results According to the PG-SGA score, the incidence of total malnutrition in elderly patients with CRC was 80.92％ (PG-SGA score ≥ 2), which increased with age. It was found that 28％ of the patients with PG-SGA classification A (PG-SGA score 0-1) had a low fat-free mass index (FFMI). Compared with those with PG-SGA A, patients with PG-SGA C PG-SGA score ≥ 9) showed an increased neutrophil to lymphocyte ratio (NLR) and an increased platelet and lymphocyte ratio (PLR) (median = 1.78 VS. 2.35, P = 0.015 and median = 108.8 VS. 141.6, P = 0.001, respectively). In terms of objective nutrition assessment parameters, severely malnourished CRC patients had significantly lower values of serum albumin (ALB), and retinol conjugated protein (RBP) than those who were well-nourished [(38.35 ± 4.84 ) g/L VS. (40.56 ± 3.44) g/L, P = 0.039 and (30.31±15.83) mg/L VS. (39.01 ± 11.95) mg/L, P = 0.033, respectively]. The Spearman's rank correlation analysis showed that the PG-SGA findings had positive correlations with the NLR and PLR; while it had negative correlations with the FFMI, body mass index (BMI), ALB, prealbumin, and RBP. Conclusions In clinical practice, a comprehensive nutritional diagnosis, including the PG-SGA score and these objective indicators, can avoid the under-diagnosis of malnutrition, and is more suitable to detect malnutrition (as well as its causes) in elderly patients with CRC.