Comparison of Three Nutritional Screening Tools to Predict Malnutrition Risk and Detect Distinctions Between Tools in Cancer Patients Receiving Radiochemotherapy

Abstract

The aim of this study was to compare three screening tools for malnutrition in patients with head and neck cancers or central nervous system tumors (CNS) who are undergoing radiochemotherapy. The study evaluated 124 adult cancer patients. The Subjective Global Assessment (SGA), Mini-Nutritional Assessment (MNA), and Nutritional Risk Screening 2002 (NRS-2002) were chosen to assess the risk of malnutrition. The prevalence of patients at nutritional risk was 31% with SGA, 31% with MNA and 23% with NRS-2002 in all patients. The agreement between SGA and MNA was substantial (κ = 0.886, P < 0.001); the agreement between SGA and NRS-2002 was moderate (κ = 0.713, P < 0.001); and the agreement between MNA and NRS-2002 was also moderate (κ = 0.795, P < 0.001). In subgroup analysis, SGA and MNA substantially (κ = 0.973, P < 0.001), SGA and NRS-2002 moderately (κ = 0.722, P < 0.001), and MNA and NRS-2002 moderately (κ = 0.747, P < 0.001) agreed in head and neck cancer patients. In CNS tumor patients, SGA and MNA slightly (κ = 0.390, P = 0.005), SGA and NRS-2002 fairly (κ = 0.457, P =0.001), and MNA and NRS-2002 substantially (κ = 0.878, P < 0.001) agreed. The best agreement in tools was observed between SGA with MNA in all patients. Further studies in different tumor groups will enhance our understanding of current tools for malnutrition detection of radiotherapy patient.

Ethical Approval and Consent to Participate

This study was approved by Marmara University School of Medicine Ethical Committee (Protocol no. 09.2017.026).

Acknowledgments

The authors thank Assoc. Prof. PhD. Esra Akdeniz from Marmara University School of Medicine Department of Biostatistics and Arzu Calisgan from MedStats Consulting for their valuable contributions on statistical analysis.

Disclosure Statement

The authors report no conflicts of interest. This research received no grant from any funding agency in the public, commercial, or not-for-profit sectors.

Notes on Contributors

All the authors were involved in the conception and design of the study; acquisition, analysis, and interpretation of data; drafting the manuscript and revising it critically for important intellectual content; and giving final approval of the version to be published.