Malnutrition risk screening in adult oncology outpatients: An ASPEN systematic review and clinical recommendations

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS Journal of Parenteral and Enteral Nutrition Pub Date : 2024-10-16 DOI:10.1002/jpen.2688

Elaine B. Trujillo MS, RDN, Kunal C. Kadakia MD, Cynthia Thomson PhD, RDN, Fang Fang Zhang MD, PhD, Alicia Livinski MA, MPH, Kim Pollard RN, Todd Mattox PharmD, Anne Tucker PharmD, Valaree Williams MS, RDN, Declan Walsh MD, Steven Clinton MD, PhD, Aaron Grossberg MD, PhD, Gordon Jensen MD, PhD, Rhone Levin MEd, RDN, Jeannine Mills MS, RDN, Anurag Singh MD, Meredith Smith RN, Renee Stubbins PhD, RDN, Kathleen Wiley MSN, RN, Kristen Sullivan MPH, MS, Mary Platek PhD, RDN, Colleen K. Spees PhD, RDN

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Abstract

Background

Malnutrition screening is not widely practiced in outpatient cancer centers. This review aims to determine the validity of malnutrition screening tools and provide recommendations for clinical use.

Methods

Studies identified by a systematic review assessed the general validity of screening tools in adult oncology outpatients from five databases through 2022. The American Society for Parenteral and Enteral Nutrition (ASPEN) convened a working group of members from the Academy of Nutrition and Dietetics, Academy of Oncology Nurse and Patient Navigators, American Cancer Society, American Society for Clinical Oncology, American Society for Nutrition, American Society for Radiation Oncology, Association of Cancer Care Centers, and Oncology Nursing Society to answer the following questions: (1) should clinicians screen for malnutrition, (2) which malnutrition screening tools are recommended, and (3) what are the clinical applications for malnutrition risk screening in adult oncology outpatients?

Results

Twenty of 738 studies met the criteria and were reviewed. Six screening tools with specific cut-points demonstrated validity and are recommended, including the Mini Nutritional Assessment (≤23.5), Malnutrition Screening Tool (MST; MST ≥ 2 and patient-led MST ≥ 2), Malnutrition Universal Screening Tool (MUST; MUST ≥ 1 and MUST ≥ 2), Nutrition Risk Screening-2002 (NRS-2002; NRS-2002 ≥ 2 and NRS-2002 ≥ 3), NUTRISCORE ≥ 5, and Patient-Generated Subjective Global Assessment Short Form (PG-SGA SF; PG-SGA SF ≥ 7 and PG-SGA SF ≥ 8).

Conclusion

Six screening tools are valid for malnutrition risk identification in oncology ambulatory settings and recommended before treatment initiation and regularly thereafter, depending on treatment course. Research is needed to understand to what extent early diagnosis and management of malnutrition improves the clinical care of oncology patients.

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成人肿瘤门诊患者的营养不良风险筛查：ASPEN 系统综述和临床建议。

背景：营养不良筛查并未在癌症门诊中心广泛开展。本综述旨在确定营养不良筛查工具的有效性，并为临床使用提供建议：通过系统性综述确定的研究评估了截至 2022 年五个数据库中成人肿瘤门诊患者筛查工具的一般有效性。美国肠外肠内营养学会（ASPEN）召集了一个工作小组，成员来自营养与饮食学会、肿瘤护士与患者导航学会、美国癌症学会、美国临床肿瘤学会、美国营养学会、美国放射肿瘤学会、癌症护理中心协会和肿瘤护理学会，旨在回答以下问题：(1) 临床医生是否应该筛查营养不良；(2) 推荐使用哪些营养不良筛查工具；(3) 营养不良风险筛查在成人肿瘤门诊患者中有哪些临床应用？结果：在 738 项研究中，有 20 项符合标准并接受了审查。六种具有特定切点的筛查工具具有有效性，值得推荐，包括迷你营养评估（≤23.5）、营养不良筛查工具（MST；MST ≥ 2 和患者主导的 MST ≥ 2）、营养不良通用筛查工具（MUST；MUST ≥ 1 和 MUST ≥ 2）、营养风险筛查-2002（NRS-2002；NRS-2002 ≥ 2 和 NRS-2002 ≥ 3）、NUTRISCORE ≥ 5 和患者生成的主观全面评估简表（PG-SGA SF；PG-SGA SF ≥ 7 和 PG-SGA SF ≥ 8）：结论：六种筛查工具可用于在肿瘤科门诊环境中识别营养不良风险，建议在开始治疗前使用，并在治疗后根据疗程定期使用。需要开展研究，以了解营养不良的早期诊断和管理在多大程度上改善了肿瘤患者的临床护理。

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来源期刊

Journal of Parenteral and Enteral Nutrition 医学-营养学

CiteScore

7.80

自引率

8.80%

发文量

161

审稿时长

6-12 weeks

期刊介绍： The Journal of Parenteral and Enteral Nutrition (JPEN) is the premier scientific journal of nutrition and metabolic support. It publishes original peer-reviewed studies that define the cutting edge of basic and clinical research in the field. It explores the science of optimizing the care of patients receiving enteral or IV therapies. Also included: reviews, techniques, brief reports, case reports, and abstracts.