Abstract
This study aims to evaluate and compare the use of patient-generated subjective global assessment (PG-SGA) and mini nutritional assessment (MNA) as a preoperative nutritional assessment tool in elderly cancer patients. This was a prospective study carried out on 47 patients, 45 years and above suffering from cancer and admitted to Padmashree Dr. D.Y. Patil Medical College and Hospital, Pune. The patients were evaluated with PG-SGA and MNA tools at the time of admission and baseline data were collected. All patients had undergone surgeries as per indications. Postoperatively, the surgical outcomes and adverse events were noted and statistically evaluated. The average age of the study sample was 61.46 years and 29 patients were females. The patients classified by PG-SGA were ten in group A and 37 in group B and C. The patients classified by MNA were five in no risk group and 42 in group with patients at risk and malnourished. When evaluated with PG-SGA in group B and C, wound infections and requirement of change of antibiotic were seen in 86.4 % patients and their average day of onset of infection was 5.6 days. Antibiotics were administered to these patients for an average of 14.2 days and their average duration of stay was 29 days. On the other hand, the evaluation of patients with MNA, at risk and malnourished patients, wound infections, and requirement of change of antibiotic were seen in 81 % of patients and their average day of onset of infection was 5.6 days. Antibiotics were administered to these patients for an average of 13.8 days and their average duration of stay was 27 days. The results were statistically significant. The mini nutritional assessment is more exhaustive in identifying patients at risk and is useful in screening populations to identify frail elderly persons allowing us to intervene earlier, thereby improving the patient prognosis. The patient-generated subjective global assessment is a more comprehensive tool for elderly cancer patients, which identifies a more extensive range of nutrition impact symptoms and predicts the postoperative outcomes more accurately. Authors recommend its usage in evaluating the aforementioned subset of patients.
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References
Edington J, Kon P, Martyn CN (1996) Prevalence of malnutrition in patients in general practice. Clin Nutr 15:60–63
Guigoz Y, Vellas B, Garry PJ (1996) Assessing the nutritional status of the elderly: the mini nutritional assessment as part of the geriatric evaluation. Nutr Rev 54:S59–S65
Fallon C, Bruce I, Eustace A et al (2002) Nutritional status of community dwelling subjects attending a memory clinic. J Nutr Health Aging 6(Supp):21
Kagansky N, Berner Y, Koren-Morag N, Perelman L, Knobler H, Levy S (2005) Poor nutritional habits are predictors of poor outcomes in very old hospitalized patients. Am J Clin Nutr 82:784–791
Sieber CC (2006) Nutritional screening tools—how does the MNA compare? J Nutr Health Aging 10(6):488–494
Seiler WO (2001) Clinical pictures of malnutrition in ill elderly subjects. Nutrition 17:496–498
Morley JE, Thomas DR (1999) Anorexia and ageing: pathophysiology. Nutrition 15:499–503
Dey DK, Rothenberg E, Sundh V, Bosaeus I, Steen B (2001) Body mass index, weight change and mortality in the elderly. A 15-year longitudinal population study of 70-year olds. Eur J Clin Nutr 55:482–492
Jalali R (2004) Examining the aged’s nutritional condition in Kermanshah Iran, 2003. Asia Pac J Clin Nutr 13:S113
Soini H, Routasalo P, Lagstrom H (2004) Characteristics of the mini nutritional assessment in elderly home-care patients. Eur J Clin Nutr 58:64–70
Murphy MC, Brooks CN, New SA, Lumbers ML (2000) The use of mini nutritional assessment (MNA) tool in elderly orthopaedic patients. Eur J Clin Nutr 54:555–562
Saletti A, Johansson L, Cedesholm T (1999) Mini nutritional assessment in elderly subjects receiving home nursing care. J Hum Nutr Dietet 12:381–387
Van Nes M-C, Herrmann FR, Gold G, Michel JP, Rizzoli R (2001) Does mini nutritional assessment predict hospitalization outcomes in older people? Age Ageing 30:221–226
Pepersack T, Corretge M, Beyer I, Namias B, Andre S, Benoit F et al (2002) Examining the effect of intervention to nutritional problems of hospitalised elderly: a pilot project. J Nutr Health Ageing 6(5):306–310
Bleda MJ, Bolibar I, Pares R, Salva A (2002) Reliability of the mini nutritional assessment (MNA) in institutionalised elderly people. J Nutr Health Ageing 6(2):134–137
Ruiz-Lopez MD, Artacho R, Olivia P, Moreno-Torres R, Bolanos J, Teresa C, Lopez MC (2003) Nutritional risk in institutionalised older women determined by the mini nutritional assessment test: what are the main factors? Nutrition 19:767–771
Cansado P, Ravsco P, Camilo M (2009) A longitudinal study of hospital undernutrition in the elderly: comparison of four validated methods. J Nutr Health Ageing 13(2):159–164
Amirkalali B, Sharifi F, Fakhrzadeh H, Mirarefin M, Ghaderpanahi M, Larijani B (2010) Evaluation of the mini nutritional assessment in the elderly, Tehran, Iran. Public Health Nutr 13(9):1373–1379
Bauer J, Capra S, Fergusson M (2002) Use of the scored Patient Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. Eur J Clin Nutr 56:779–785
Leilli G, Montanari M, Gilli G, Scapoli D, Antonietti C (2003) Treatment of the cancer anorexia–cachexia syndrome: a critical reappraisal. J Chemother 15(3):220–225
Ottery FD (1994) Cancer cachexia: prevention, early diagnosis and management. Cancer Pract 2(2):123–131
Heredia M, Canales S, Saez C, Testillano M (2008) The nutritional status of patients with colorectal cancer undergoing chemotherapy. Farm Hosp 32(1):35–37
Isenring E, Bauer J, Capra S (2003) The scored patient-generated subjective global assessment (PG-SGA) and its association with quality of life in ambulatory patients receiving radiotherapy. Eur J Clin Nutr 57:305–309
Reilly JJ, Hull SF, Albert N, Waller A, Bringardener S (1988) Economic impact of malnutrition: a model system for hospitalised patients. J Parenter Enteral Nutr 12:371–376
Naber TH, Schermer T, deBree A, Nusteling K, Eggink L, Kruimel JW, Bakkeren J, van Heereveld H, Katan MB (1997) Prevalence of patients in nonsurgical hospitalized patients and its association with disease complications. Am J Clin Nutr 66(5):1232–1239
Gill C (2007) The role of nutritional supplements in the treatment of cachexia in cancer patients—the registered dietician’s perspective. Cancer related nutrition. US Oncological Disease pp. 92–94
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Dubhashi, S.P., Kayal, A. Preoperative Nutritional Assessment in Elderly Cancer Patients Undergoing Elective Surgery: MNA or PG-SGA?. Indian J Surg 77 (Suppl 2), 232–235 (2015). https://doi.org/10.1007/s12262-012-0780-5
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DOI: https://doi.org/10.1007/s12262-012-0780-5