在低收入和中等收入国家接受癌症手术的患者中验证营养查工具
Jana Sremanakova1, Stephen R Knight2,3, Marie Carmela M Lapitan4
1Faculty of Medicine, Biology and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom.
Frontiers in nutrition
|June 20, 2025
概括
建议在低收入和中等收入国家进行手术前营养查时使用患者生成主观全球评估 (PG-SGA) 简体表格. 该工具在识别手术癌症患者的营养不良风险方面表现出良好的灵敏度和特异性.
科学领域:
- 手术瘤学手术瘤学
- 营养科学 营养科学
- 全球健康 全球健康
背景情况:
- 营养不良影响了低收入和中等收入国家 (LMICs) 大约三分之一的手术患者.
- 精确的营养查对于手术前的有效干预至关重要.
- 验证查工具对于改善LMIC患者的治疗结果至关重要.
研究的目的:
- 为了评估营养查工具的有效性和可靠性,在LMICs中预定进行手术的癌症患者.
- 将营养不良普遍查工具 (MUST) 和患者生成的主观全球评估 (PG-SGA) 的性能与参考标准进行比较.
- 确定在资源有限的环境中进行术前营养评估的最合适工具.
主要方法:
- 一项涉及167名在加纳,印度和菲律宾接受手术的成年癌症患者的横截面研究.
- 营养状况使用人体测量测量,MUST和完整的PG-SGA进行评估.
- 使用布兰德-阿尔特曼图,类内相关系数 (ICC) 和接收器操作特征 (ROC) 曲线分析的数据.
- 在人类测量中评估了测量器间的可靠性;对于MUST和PG-SGA简式 (SF) 计算的灵敏度和特异性与完整的PG-SGA相比.
主要成果:
- 被认为有营养不良风险的参与者比例为53.3% (MUST),47.3% (PG-SGA SF) 和66% (全PG-SGA).
- 与PG-SGA相比,MUST和PG-SGA SF的ROC曲线下的面积 (AUROC) 分别为0.78和0.76.
- MUST显示85%的灵敏度和25%的特异性;PG-SGA SF显示93%的灵敏度和42%的特异性.
- 对于人体测量测量来说,优秀的评价者间协议 (ICC>0.9).
结论:
- 无论是MUST还是PG-SGA SF,都表现出很好的灵敏度来检测LMIC中手术癌症患者的营养不良风险.
- 与MUST相比,PG-SGA SF的特异性略高.
- 由于其敏感性和特异性的平衡,PG-SGA SF被推为在LMIC中进行手术前营养查的有效和可靠工具.
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