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Comparison of the performance of the GLIM criteria, PG-SGA and mPG-SGA in diagnosing malnutrition and predicting survival among lung cancer patients: A multicenter study

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机构: [1]Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, 400042, China [2]Cancer Center, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China [3]Department of Medical Oncology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, 350014, China [4]Department of Clinical Nutrition, The First Hospital of Hebei Medical University, Shijiazhuang, 050031, China . [5]Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China [6]Department of General Surgery, Xiangya Hospital, Central South University, Changsha, 410008, China [7]Department of Oncology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China [8]The Fourth Affiliated Hospital, Harbin Medical University, Harbin, 150001, China [9]Department of Gastrointestinal Surgery, First Affliated Hospital of Guangxi Medical University, Nanning, 530021, China [10]Department of Radiotherapy, Sichuan Cancer Hospital& Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and [11]Department of Digestive Diseases, Xjing Hospital, Fourth Military Medical University, Xi'an, 710032, China [12]Department of Clinical Nutrition, The First Affiliated Hospital of Kunming Medical University, Kunming, 650032, China [13]Department of Integrated Traditional Chinese and Western Medicine, Zhejiang Cancer Hospital & Key Laboratory of Traditional Chinese Medicine ncology, Zhejiang Cancer Hospital, Hangzhou, 310022, China [14]Department of Colorectal Surgery, The Second Affliated Hospital of Harbin Medical University, Harbin, 150001, China [15]Department of Palliative Care/Geriatric Oncology, Chongqing University Cancer Hospital, Chongqing, 400030, China [16]Department of Traditional Chinese Medicine, Tangdu Hospital, Fourth Military Medical University, Xi'an, 7 10038, China [17]Cancer Center of the First Hospital ofJjilin University, Changchun, 130021, China [18]Department of Epidemiology, Collge of Public Health, Zhengzhou University, Zhengzhou, 450001, China [19]Department of Gastrointestinal Surgery/Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University
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The present study aimed to compare the ability of the GLIM criteria, PG-SGA and mPG-SGA to diagnose malnutrition and predict survival among Chinese lung cancer (LC) patients.This was a secondary analysis of a multicenter, prospective, nationwide cohort study, 6697 LC inpatients were enrolled between July 2013 and June 2020. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), area under the curve (AUC), and quadratic weighted Kappa coefficients were calculated to compare the ability to diagnose malnutrition. There were 754 patients who underwent follow-up for a median duration of 4.5 years. The associations between the nutritional status and survival were analyzed by the Kaplan-Meier method and multivariable Cox proportional hazard regression models.The median age of LC patients was 60 (53, 66), and 4456 (66.5%) were male. There were 617 (9.2%), 752 (11.2%), 1866 (27.9%), and 3462 (51.7%) patients with clinical stage Ⅰ, Ⅱ, Ⅲ, and Ⅳ LC, respectively. Malnutrition was present in 36.1%-54.2% (as evaluated using different tools). Compared with the PG-SGA (used as the diagnostic reference), the sensitivity of the mPG-SGA and GLIM was 93.7% and 48.3%; the specificity was 99.8% and 78.4%; and the AUC was 0.989 and 0.633 (P < 0.001). The weighted Kappa coefficients were 0.41 for the PG-SGA vs. GLIM, 0.44 for the mPG-SGA vs. GLIM, and 0.94 for the mPG-SGA vs PG-SGA in patients with stage Ⅰ-Ⅱ LC. These values were respectively 0.38, 0.39, and 0.93 in patients with stage Ⅲ-Ⅳ of LC. In a multivariable Cox analysis, the mPG-SGA (HR = 1.661, 95%CI = 1.348-2.046, P < 0.001), PG-SGA (HR = 1.701, 95%CI = 1.379-2.097, P < 0.001) and GLIM (HR = 1.657, 95%CI = 1.347-2.038, P < 0.001) showed similar death hazard ratios.The mPG-SGA provides nearly equivalent power to predict the survival of LC patients as the PG-SGA and the GLIM, indicating that all three tools are applicable for LC patients. The mPG-SGA has the potential to be an alternative replacement for quick nutritional assessment among LC patients.Copyright © 2023 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

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大类 | 2 区 医学
小类 | 1 区 营养学
最新[2023]版:
大类 | 2 区 医学
小类 | 1 区 营养学
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Q1 NUTRITION & DIETETICS
最新[2023]版:
Q1 NUTRITION & DIETETICS

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第一作者机构: [1]Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, 400042, China
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