title: Comparison of nutritional diagnosis methods and prediction of clinical outcomes in patients with neoplasms and digestive tract diseases.
abstract: OBJECTIVE
  Nowadays studies are advised to compare nutritional risk assessed by different instruments with clinical outcomes. This study compared nutritional diagnosis methods and identified the best predictor of clinical outcomes.
  
  
  METHODS
  This cross-sectional study included 500 hospitalized patients with neoplasms and digestive tract diseases (DTD). Their nutritional status was determined by nutritional risk screening (NRS), subjective global assessment (SGA), and anthropometry, and compared with the clinical outcomes. The Kappa coefficient measured the agreement between the methods. Associations between risk factors and clinical outcomes were investigated by Cox, univariate logistic, and multiple logistic regression analyses at a significance level of 5%.
  
  
  RESULTS
  In DTD and cancer patients, SGA and NRS presented good agreement, but agreement of either with anthropometry was poor. According to Cox regression, both SGA and NRS predicted complications in DTD patients. However, none of the instruments was capable of predicting complications in cancer patients or death in DTD patients. In cancer patients, SGA and age were considered risk factors for death. In DTD patients, age, SGA, and NRS predicted a long hospital stay. In cancer patients, long stays were associated with age and SGA.
  
  
  CONCLUSIONS
  SGA and NRS are highly sensitive for predicting complications in DTD patients. Old age and SGA predicted death in cancer patients. Advanced age and SGA also predicted long hospital stays for DTD and cancer patients, but NRS predicted long hospital stays only for DTD patients.
authors.affiliation: School of Nutrition, Pontifical Catholic University of Campinas, Puc, Campinas, SP, Brazil. Electronic address: valm@dglnet.com.br.
authors.forename: Vânia Aparecida
authors.initials: VA
authors.lastname: Leandro-Merhi
authors.affiliation: School of Medicine, Pontifical Catholic University of Campinas, Puc, Campinas, SP, Brazil.
authors.forename: José Luiz
authors.initials: JL
authors.lastname: Braga de Aquino
mesh_terms: D000886:Anthropometry; D003430:Cross-Sectional Studies; D005260:Female; D005767:Gastrointestinal Diseases / Q000178:diet therapy*; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D044342:Malnutrition / Q000175:diagnosis* / Q000178:diet therapy*; D008403:Mass Screening; D008875:Middle Aged; D009369:Neoplasms / Q000178:diet therapy*; D015596:Nutrition Assessment; D009752:Nutritional Status; D012307:Risk Factors
keywords: Anthropometry; Clinical outcomes; Digestive tract diseases; Neoplasms; Nutritional risk screening (NRS); Subjective global assessment (SGA)