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van der Sijp MPL, van Eijk M, Krijnen P, Schipper IB, Achterberg WP, Niggebrugge AHP. Screening for malnutrition in patients admitted to the hospital with a proximal femoral fracture. Injury 2018; 49:2239-2243. [PMID: 30270013 DOI: 10.1016/j.injury.2018.09.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 09/15/2018] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The prevalence of malnutrition in patients admitted with a proximal femoral fracture is considered high and the negative effects on health are well-studied. The SNAQ and the MNA-SF are two screening tools routinely used during admission of acute medical patients. The aim of this study is to compare the screening capacity of the SNAQ score and the MNA-SF, and to evaluate their predictive values for malnutrition using the ESPEN criteria. MATERIALS AND METHODS A single-centre study with data routinely collected prospectively from the original patient records was performed in the Haaglanden Medical Centre Bronovo in the Netherlands. All patients with a proximal femoral fracture consecutively admitted between December 19th 2016 and December 21st 2017 were included. The Intraclass Correlation Coefficient was used to assess the agreement between the malnutrition screening tools and the predictive values were calculated to compare the SNAQ with the MNA-SF using the ESPEN diagnostic criteria as the reference standard. RESULTS Data was available from 437 patients. Of all patients admitted with a proximal femoral fracture 16.9% was diagnosed as malnourished by the ESPEN criteria. When screened, 20.1% (SNAQ score) to 47.8% (MNA-SF) of all patients were classified as either at risk for malnutrition or as malnourished. A moderate agreement was found between the MNA-SF and the SNAQ (κ = 0.68). The sensitivity, specificity, PPV and NPV of the SNAQ score were 71.6%, 90.4%, 60% and 94% respectively, compared to 100%, 62.8%, 35.4% and 100% for the MNA-SF. DISCUSSION The SNAQ has been proven to be a very specific screening tool and the positive predictive value tends to be higher than that of the MNA-SF. However, 28.4% of all malnourished patients with a proximal femoral fracture had a negative screening test when using the SNAQ score. CONCLUSIONS No benefits were observed for the SNAQ over the MNA-SF as a screening tool for malnutrition in admitted patients with a proximal femoral fracture. Missing a significant portion of malnourished patients or those at risk and consequent under treatment of fragile older patients should be avoided. The well-validated MNA-SF seems more preferable as a screening tool for this patient population.
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Affiliation(s)
- Max P L van der Sijp
- Department of Public Health and Primary Care, Leiden University Medical Centre, P.O. Box 9600, 2300 RC, Leiden, the Netherlands.
| | - Monica van Eijk
- Department of Public Health and Primary Care, Leiden University Medical Centre, P.O. Box 9600, 2300 RC, Leiden, the Netherlands
| | - Pieta Krijnen
- Department of Trauma Surgery, Leiden University Medical Centre, P.O. Box 9600, 2300 RC, Leiden, the Netherlands
| | - Inger B Schipper
- Department of Trauma Surgery, Leiden University Medical Centre, P.O. Box 9600, 2300 RC, Leiden, the Netherlands
| | - Wilco P Achterberg
- Department of Public Health and Primary Care, Leiden University Medical Centre, P.O. Box 9600, 2300 RC, Leiden, the Netherlands
| | - Arthur H P Niggebrugge
- Department of Surgery, Haaglanden Medical Centre, P.O. Box 432, 2501 CK, The Hague, the Netherlands
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Guerdoux-Ninot E, Kilgour RD, Janiszewski C, Jarlier M, Meuric J, Poirée B, Buzzo S, Ninot G, Courraud J, Wismer W, Thezenas S, Senesse P. Meal context and food preferences in cancer patients: results from a French self-report survey. SPRINGERPLUS 2016; 5:810. [PMID: 27390650 PMCID: PMC4916076 DOI: 10.1186/s40064-016-2538-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 06/08/2016] [Indexed: 01/01/2023]
Abstract
Purpose The present study examined patient self-reports of descriptions, experiences and consequences of meal disturbances and food preferences within a cultural context (i.e., French meal traditions) in various treated cancer patients along their disease trajectory. Methods Over 800 questionnaires were sent to 20 cancer treatment centres in France. During a 9-month period, 255 questionnaires were received from five centres. Inclusion criteria included those French patients over 18 years of age, could read and understand French, had an Eastern Cooperative Oncology Group score between 0 and 2, experienced treatment-induced nutrition changes and/or had decreased oral intake. Dietetic staff assessed clinical characteristics while patients completed a 17-item questionnaire. Results The majority of patients were diagnosed with breast, gastro-intestinal (GI) tract and head and neck cancers (62 %). Half of the patients (49 %) experienced weight loss >5 %. The main treatment-induced side effects were fatigue, nausea, dry mouth, hypersensitivity to odors and GI tract transit disorders. These discomforts affected eating and drinking in 83 % of patients, inducing appetite loss and selected food aversion. Food preference appeared heterogeneous. Food taste, odor and finally appearance stimulated appetite. Finally, dietary behaviors and satisfaction were driven by the extent to which food was enjoyed. Conclusions During oncologic treatments, eating and drinking were affected in more than three-quarters of patients. As recommended by practice guidelines, nutritional assessment and follow-up are required. Personalized nutritional counseling should include the role of the family, patient’s meal traditions, and food habits.
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Affiliation(s)
- Estelle Guerdoux-Ninot
- SIRIC Montpellier Cancer, Cancer Institute of Montpellier (ICM)-Val d'Aurelle, 208 avenue des Apothicaires, Parc Euromédecine, 34298 Montpellier Cedex 5, France ; Epsylon Research Unit EA 4556 Laboratory, Departments of Sport Sciences, Medicine and Psychology, University of Montpellier and University Paul Valery, Rue du Pr. Henri Serre, 34000 Montpellier, France
| | - Robert D Kilgour
- Department of Exercise Science, The Richard J. Renaud Science Complex, Room SP-165-17, Concordia University, Loyola Campus, 7141 Sherbrooke Street West, Montreal, QC H4B 1R6 Canada ; McGill Nutrition and Performance Laboratory (MNUPAL), McGill University Health Centre, Suite 105B, Place Vendome, 5252 de Maisonneuve Ouest, Montreal, QC H4A 3S5 Canada
| | - Chloé Janiszewski
- Department of Clinical Nutrition and Gastroenterology, Cancer Institute of Montpellier (ICM), Val d'Aurelle, 208 avenue des Apothicaires, Parc Euromédecine, 34298 Montpellier Cedex 5, France ; Department of Clinical Research, Cancer Institute of Montpellier (ICM), Val d'Aurelle, 208 avenue des Apothicaires, Parc Euromédecine, 34298 Montpellier Cedex 5, France
| | - Marta Jarlier
- Biostatistics Unit, Cancer Institute of Montpellier (ICM), Val d'Aurelle, 208 avenue des Apothicaires, Parc Euromédecine, 34298 Montpellier Cedex 5, France
| | - Jocelyne Meuric
- Department of Dietetic and Nutrition, Curie Institute of Paris, 26 rue d'Ulm, 75248 Paris Cedex 05, France ; Group of Nutrition and Dietary Committees of Anti-Cancer Centers (Interclan CLCC), Villejuif, France
| | - Brigitte Poirée
- Department of Dietetic, Centre Francois Baclesse of Caen, 3 avenue du Général Harris, BP5026, 14076 Caen, France ; Group of Nutrition and Dietary Committees of Anti-Cancer Centers (Interclan CLCC), Villejuif, France
| | - Solange Buzzo
- Department of Dietetic, Centre Antoine Lacassagne of Nice, 33 Avenue de Valombrose, 06189 Nice Cedex 2, France ; Group of Nutrition and Dietary Committees of Anti-Cancer Centers (Interclan CLCC), Villejuif, France
| | - Grégory Ninot
- SIRIC Montpellier Cancer, Cancer Institute of Montpellier (ICM)-Val d'Aurelle, 208 avenue des Apothicaires, Parc Euromédecine, 34298 Montpellier Cedex 5, France ; Epsylon Research Unit EA 4556 Laboratory, Departments of Sport Sciences, Medicine and Psychology, University of Montpellier and University Paul Valery, Rue du Pr. Henri Serre, 34000 Montpellier, France
| | - Julie Courraud
- SIRIC Montpellier Cancer, Cancer Institute of Montpellier (ICM)-Val d'Aurelle, 208 avenue des Apothicaires, Parc Euromédecine, 34298 Montpellier Cedex 5, France
| | - Wendy Wismer
- Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB T6G 2P5 Canada
| | - Simon Thezenas
- Biostatistics Unit, Cancer Institute of Montpellier (ICM), Val d'Aurelle, 208 avenue des Apothicaires, Parc Euromédecine, 34298 Montpellier Cedex 5, France
| | - Pierre Senesse
- SIRIC Montpellier Cancer, Cancer Institute of Montpellier (ICM)-Val d'Aurelle, 208 avenue des Apothicaires, Parc Euromédecine, 34298 Montpellier Cedex 5, France ; Epsylon Research Unit EA 4556 Laboratory, Departments of Sport Sciences, Medicine and Psychology, University of Montpellier and University Paul Valery, Rue du Pr. Henri Serre, 34000 Montpellier, France ; Department of Clinical Nutrition and Gastroenterology, Cancer Institute of Montpellier (ICM), Val d'Aurelle, 208 avenue des Apothicaires, Parc Euromédecine, 34298 Montpellier Cedex 5, France ; Group of Nutrition and Dietary Committees of Anti-Cancer Centers (Interclan CLCC), Villejuif, France
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Isenring E, Zabel R, Bannister M, Brown T, Findlay M, Kiss N, Loeliger J, Johnstone C, Camilleri B, Davidson W, Hill J, Bauer J. Updated evidence-based practice guidelines for the nutritional management of patients receiving radiation therapy and/or chemotherapy. Nutr Diet 2013. [DOI: 10.1111/1747-0080.12013] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Elisabeth Isenring
- School of Human Movement Studies; University of Queensland; Brisbane Queensland Australia
- Department of Nutrition and Dietetics; Princess Alexandra Hospital; Brisbane Queensland Australia
| | - Rachel Zabel
- School of Human Movement Studies; University of Queensland; Brisbane Queensland Australia
| | - Melanie Bannister
- Department of Nutrition Services; The Wesley Hospital; Brisbane Queensland Australia
| | - Teresa Brown
- School of Human Movement Studies; University of Queensland; Brisbane Queensland Australia
- Department of Nutrition and Dietetics; Royal Brisbane and Women's Hospital; Brisbane Queensland Australia
| | - Merran Findlay
- Department of Nutrition and Dietetics; Royal Prince Alfred Hospital; Sydney New South Wales Australia
| | - Nicole Kiss
- Department of Nutrition and Dietetics; Peter MacCallum Cancer Centre; Melbourne Victoria Australia
| | - Jenelle Loeliger
- Department of Nutrition and Dietetics; Peter MacCallum Cancer Centre; Melbourne Victoria Australia
| | | | - Belinda Camilleri
- Department of Nutrition and Dietetics; Royal Prince Alfred Hospital; Sydney New South Wales Australia
| | - Wendy Davidson
- Department of Nutrition and Dietetics; Princess Alexandra Hospital; Brisbane Queensland Australia
| | - Jan Hill
- Patient Safety and Quality Improvement Service, Centre for Healthcare Improvement; Queensland Health; Brisbane Queensland Australia
| | - Judy Bauer
- School of Human Movement Studies; University of Queensland; Brisbane Queensland Australia
- Department of Nutrition Services; The Wesley Hospital; Brisbane Queensland Australia
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