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AIWW: a new nutrition-screening tool for the oncologic population

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机构: [1]Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China. [2]The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325000, China. [3]National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China. [4]Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China. [5]Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China. [6]Cancer Center, Renmin Hospital of Wuhan University, Wuhan, 430060, China. [7]Department of Colorectal Surgery, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, 310022, China. [8]Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, 400042, China. [9]Cancer Center of the First Hospital of Jilin University, Changchun, 130021, China. [10]Department of Epidemiology, College of Public Health, Zhengzhou University, 450001, Zhengzhou, China. [11]Department of Colorectal Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin, 150081, China. [12]Department of Gastrointestinal Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China. [13]Yunnan University, Kunming, 650091, China. [14]General Surgery Clinical Medical Center of Yunnan Province, Kunming, 650032, China. [15]Affiliated Hospital of Yunnan University, Kunming, 650091, China. [16]Comprehensive Oncology Department, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, 100021, China. [17]Department of Clinical Nutrition, The First Hospital of Hebei Medical University, Shijiazhuang, 050031, China. [18]Department of Medical Oncology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, 350014, China. [19]Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, 21228, USA. [20]Shenzhen Evergreen Medical Institute, Shenzhen, 518052, China. [21]Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA. [22]National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China. [23]Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, 100193, China. [24]Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, 34127, Italy. [25]Department of Integrated Chinese and Western Medicine, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, 310022, China. [26]Department of Clinical Nutrition, The First Affiliated Hospital of Kunming Medical University, Kunming, 650091, China. [27]Department of Gastrointestinal Surgery, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China.
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关键词: nutrition-screening AIWW NRS-2002 MST cancer

摘要:
Malnutrition is a common comorbidity among patients with cancer. However, no nutrition-screening tool has been recognized in this population. A quick and easy screening tool for nutrition with high sensitivity and easy-to-use is needed. Based on the previous 25 nutrition-screening tools, the Delphi method was made by the members of the Chinese Society of Nutritional Oncology to choose the most useful item from each category. According to these results, we built a nutrition-screening tool named age, intake, weight, and walking (AIWW). Malnutrition was defined based on the scored patient-generated subjective global assessment (PG-SGA). Concurrent validity was evaluated using the Kendall tau coefficient and kappa consistency between the malnutrition risks of AIWW, nutritional risk screening 2002 (NRS-2002), and malnutrition screening tool (MST). Clinical benefit was calculated by the decision curve analysis (DCA), integrated discrimination improvement (IDI), and continuous net reclassification improvement (cNRI). A total of 11,360 patients (male, n=6,024 (53.0%) were included in the final study cohort, and 6,363 patients had malnutrition based on PG-SGA. Based on AIWW, NRS-2002, and MST, 7,545, 3,469, and 1,840 patients were at risk of malnutrition, respectively. The sensitivities of AIWW, NRS-2002, and MST risks were 0.910, 0.531, and 0.285, and the specificities were 0.768, 0.946, and 0.975. The Kendall tau coefficients of AIWW, NRS-2002, and MST risks were 0.588, 0.501, and 0.326, respectively. The area under the curve of AIWW, NRS-2002, and MST risks were 0.785, 0.739, and 0.630, respectively. The IDI, cNRI, and DCA showed that AIWW is non-inferior to NRS-2002 (IDI: 0.002 (-0.009, 0.013), cNRI: -0.015 (-0.049, 0.020)). AIWW scores can also predict the survival of patients with cancer. The missed diagnosis rates of AIWW, NRS-2002, and MST were 0.09%, 49.0%, and 73.2%, respectively. AIWW showed a better nutrition-screening effect than NRS-2002 and MST for patients with cancer and could be recommended as an alternative nutrition-screening tool for this population.© 2023. Science China Press.

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出版当年[2022]版:
大类 | 1 区 生物学
小类 | 1 区 生物学
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大类 | 1 区 生物学
小类 | 1 区 生物学
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Q1 BIOLOGY
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Q1 BIOLOGY

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第一作者机构: [1]Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China. [2]The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325000, China. [3]National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China. [4]Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China. [5]Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China.
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通讯机构: [1]Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China. [2]The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325000, China. [3]National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China. [4]Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China. [5]Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China.
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