Comparison of different nutritional assessments in detecting malnutrition among gastric cancer patients

Table 1 Demographic characteristics of gastric cancer patients (mean ± SD) n (%)

	Subtotal gastrectomy (n = 71)	Total gastrectomy (n = 9)	P value
Age (yr)	58.5 ± 11.9	56.5 ± 13.2	0.641
Sex
Male	37 (52.1)	6 (66.7)	0.409
Female	34 (47.9)	3 (33.3)
Cancer Stage			0.003
I	57 (81.4)	5 (55.6)
II	8 (11.4)	0 (0)
III	2 (2.9)	3 (33.3)
IV	3 (4.3)	1 (11.1)
Complications			0.219
Major	2 (2.8)	1 (11.1)
Minor	24 (33.8)	1 (11.1)
Hospital stay (d)	12.8 ± 8.4	16.4 ± 6.8	0.223

P values were determined with the use of the Pearson χ² test and independent t test.

Table 2 Patient characteristics and anthropometric and laboratory data according to nutritional status (mean ± SD)

	SGA			NRS-2002			NRI
	Well-nourished (n = 55)	Malnourished (n = 25)	P value	Well-nourished (n = 45)	Malnourished (n = 35)	P value	Well-nourished (n = 55)	Malnourished (n = 25)	P value
Age (yr)	57.58 ± 11.5	60.00 ± 13.2	0.410	56.53 ± 9.9	60.65 ± 14.1	0.130	58.07 ± 12.3	58.92 ± 11.6	0.769
Weight (kg)	62.04 ± 9.1	59.30 ± 8.3	0.207	63.64 ± 8.4	58.03 ± 8.6	0.005	61.80 ± 9.0	59.83 ± 8.7	0.360
Weight loss (%)	1.03 ± 1.5	7.31 ± 4.5	0.000	0.89 ± 1.4	6.42 ± 4.6	0.000	2.71 ± 3.1	5.32 ± 5.9	0.047
TSF (mm)	17.88 ± 7.5	13.72 ± 6.5	0.020	18.25 ± 7.8	14.44 ± 6.4	0.020	16.99 ± 8.0	15.69 ± 6.2	0.435
MAC (cm)	27.95 ± 2.5	26.70 ± 2.3	0.040	28.37 ± 2.4	26.51 ± 2.2	0.001	27.81 ± 2.6	26.99 ± 2.1	0.155
BMI (kg/m2)	24.26 ± 2.7	22.47 ± 2.6	0.008	24.69 ± 2.4	22.42 ± 2.7	0.000	23.88 ± 2.9	23.29 ± 2.6	0.366
Albumin (g/dL)	3.86 ± 0.3	3.85 ± 0.3	0.924	3.87 ± 0.3	3.84 ± 0.3	0.618	4.02 ± 0.2	3.50 ± 0.1	0.000
Total protein (g/dL)	6.89 ± 0.6	6.75 ± 0.6	0.391	6.88 ± 0.6	6.80 ± 0.6	0.568	7.13 ± 0.5	6.23 ± 0.4	0.000
Total cholesterol (mg/dL)	169.65 ± 42.3	167.8 ± 42.5	0.863	166.04 ± 42.2	173.02 ± 42.2	0.466	176.4 ± 39.6	152.8 ± 43.6	0.026
TLC (× 103/mm3)	1856.6 ± 503	1905.9 ± 569	0.698	1874.7 ± 536	1868.6 ± 511	0.959	1903.9 ± 511	1801.8 ± 549	0.698

All P values were determined with the use of independent t test. SGA: Subjective global assessment; NRS-2002: Nutritional risk screening; NRI: Nutrition risk index; TSF: Triceps skinfold; MAC: Midarm circumference; BMI: Body mass index; TLC: Total lymphocyte count.

Table 3 Correlation coefficients and P values for patient data and nutritional assessment techniques

	SGA1		NRS-20022		NRI3
	r	P value	r	P value	r	P value
Age (yr)	0.118	0.297	0.246	0.028	0.035	0.758
Weight (kg)	-0.132	0.243	-0.314	0.005	-0.091	0.425
Weight loss (%)	0.754	0.000	0.690	0.000	0.199	0.166
TSF (mm)	-0.272	0.015	-0.234	0.037	-0.048	0.669
MAC (cm)	-0.228	0.042	-0.378	0.001	-0.170	0.132
BMI (kg/m2)	-0.279	0.012	-0.393	0.000	-0.109	0.335
Albumin (g/dL)	0.004	0.971	-0.043	0.703	-0.783	0.000
Total protein (g/dL)	-0.086	0.448	-0.062	0.583	-0.636	0.000
Total cholesterol (mg/dL)	-0.006	0.955	0.088	0.436	-0.285	0.010
TLC (× 103/mm3)	0.038	0.738	-0.008	0.943	-0.116	0.305

¹SGA rating: 0, not malnourished; 1, moderate malnutrition; 2, severe malnutrition;

²NRS-2002 rating: 0, no risk; 1, medium risk; 2, high risk;

³NRI rating: 0, not malnourished; 1, mild malnutrition; 2, moderate malnutrition; 3, severe malnutrition; All P values were determined with the use of Pearson’s correlation coefficient.

Table 4 Statistical comparison of nutritional assessments and screening tool values at hospital admission: NRS-2002 and NRI vs SGA

	NRS-2002			NRI
	Low	Medium/high	Total	Low	Medium/high	Total
SGA well-nourished	44	11	55	40	15	55
SGA malnourished	1	24	25	15	10	25
Total	45	35	80	55	25	80
Sensitivity	80.0% (44/55)			72.7% (40/55)
Specificity	96.0% (24/25)			40.0% (10/25)
	κ = 0.685, P = 0.000			κ = 0.127, P = 0.255

κ statistic: percent of agreement.

Table 5 Patient anthropometric and laboratory data after curative surgery for gastric cancer

	Preoperative	Postoperative	Postoperative	P value
	day 1	6 mo	12 mo
Weight (kg)	61.4 ± 8.8	55.4 ± 8.2	55.2 ± 8.6	0.000
TSF (mm)	17.0 ± 7.5	12.7 ± 6.5	12.1 ± 6.2	0.000
MAC (cm)	27.7 ± 2.5	25.1 ± 4.9	25.5 ± 2.4	0.000
BMI (kg/m2)	23.9 ± 2.7	21.4 ± 2.4	21.5 ± 2.4	0.000
Albumin (g/dL)	3.88 ± 0.3	4.28 ± 0.2	4.30 ± 0.2	0.000
Total protein (g/dL)	6.87 ± 0.6	7.18 ± 0.5	7.25 ± 0.5	0.000
Total cholesterol (mg/dL)	170.9 ± 37.4	168.2 ± 38.1	173.3 ± 31.4	0.679
TLC (× 103/mm3)	1863 ± 493	1799 ± 633	1752 ± 578	0.328
Serum iron (μg/dL)	72.9 ± 37.6	110.4 ± 52.8	118.2 ± 57.8	0.000
Serum ferritin (µg/L)	77.7 ± 75.3	74.9 ± 81.3	60.2 ± 64.4	0.358
Vitamin B12 (pg/mL)	686.5 ± 249	666.8 ± 281	709.1 ± 330	0.731

P values were determined with the use of ANOVA or the Kruskal-Wallis nonparametric test.