UNASSIGNED: Malnutrition is prevalent among cancer patients, smartphone-based self-administered nutritional assessment tools offer a promising solution for effective nutritional screening. This study aims to retrospectively analyze the relationships between nutritional status evaluated by the digital tool (R+ Dietitian) and clinicopathologic factors of cancer patients.
UNASSIGNED: Cancer patients who met the inclusion criteria were divided into two subgroups based on age, Nutritional Risk Screening-2002, Patient-Generated Subjective Global Assessment Short Form, body mass index, and hospital stays for comparison. Correlation and regression analysis were used to comprehensively assess the relationship between nutritional status and clinicopathologic factors.
UNASSIGNED: A total of 535 hospitalized cancer patients (58.32 ± 11.24 years old) were recruited. Patients identified with nutritional risk assessed by R+ Dietitian were significantly older, had lower body weight, lower body mass index, greater weight loss, and longer hospital stays (all of above, P < 0.01). Multiple logistic regression analysis indicated that serum prealbumin concentration (odds ratio: 0.992, 95% confidence interval: 0.987-0.997, P = 0.001), weight loss (odds ratio: 7.309, 95% confidence interval: 4.026-13.270, P < 0.001), and body mass index < 18.5 (odds ratio: 5.882, 95% confidence interval: 2.695-12.821, P < 0.001) predicted nutritional risk indicated by Nutritional Risk Screening-2002 score ≥3. Hemoglobin concentration (odds ratio: 0.983, 95% confidence interval: 0.970-0.996, P = 0.011), weight (odds ratio: 1.111, 95% confidence interval: 1.056-1.169, P < 0.001), weight loss (odds ratio: 7.502, 95% confidence interval: 4.394-12.810, P < 0.001), body mass index (odds ratio: 0.661, 95% confidence interval: 0.564-0.775, P < 0.001), and energy intake (odds ratio: 0.996, 95% confidence interval: 0.995-0.997, P < 0.001) predicted nutritional risk indicated by Patient-Generated Subjective Global Assessment Short Form score ≥4. Multiple linear regression analysis revealed that Patient-Generated Subjective Global Assessment Short Form scores ≥3 (b = 2.032, P = 0.008) were significantly associated with longer hospital stays.
UNASSIGNED: The nutritional risks assessed by R+ Dietitian accurately reflected the characteristics of malnutrition in cancer patients and predicted hospital stay and cost, indicating the applicability of R+ Dietitian to improving the efficiency of nutritional management for cancer patients.

UNASSIGNED: As a chronic wasting disease, cancer can lead to metabolic and physiological changes in patients, resulting in severe malnutrition. Therefore, accurate assessment of nutritional status and adoption of scientifically sound nutritional interventions are of great importance for patients with cancer. This study aimed to assess the necessity of implementing the Nutrition Risk Screening 2002 (NRS 2002) tool in conjunction with the Patient-Generated Subjective Global Assessment (PG-SGA) in patients with cancer.
UNASSIGNED: This retrospective study collected the clinical data of cancer patients from November 2011 to December 2018 in the Department of Oncology, Cancer Center, First Hospital of Jilin University. The NRS 2002 and the PG-SGA were used as screening tools for malnutrition. Clinical characteristics and laboratory results were detected. Anthropometric indices including hand-grip strength (HGS), visceral fat area (VFA), calf circumstance (CC), and appendicular skeletal muscle mass index (ASMI) were also collected. The diagnostic results from the NRS 2002 were compared to the malnutrition diagnosis using the PG-SGA.
UNASSIGNED: Of the 2,645 patients included in this retrospective study, the nutritional risk was found in 1763 (66.6%) patients based on the PG-SGA, and in 240 (9.1%) patients based on the NRS 2002, respectively. Among the 240 patients evaluated by the NRS 2002 for risk of malnutrition, 230 were also assessed by the PG-SGA as malnourished. There were no significant differences observed in the clinical characteristics and laboratory parameters between the two groups.
UNASSIGNED: The PG-SGA is effective and had a higher positive rate in screening malnutrition for patients with cancer. The NRS 2002 is not necessary for patients who are to be assessed with the PG-SGA.

OBJECTIVE: To explore the effect of standard nutritional support based on nutritional risk screening on nutrition conditions and living quality in glioma patients after surgery.
METHODS: The clinical information of 100 patients with glioma treated at the Sichuan Provincial People\'s Hospital from April 2021 to April 2022 was reviewed retrospectively. Among them, 39 patients received routine nutritional support during the perioperative period (routing group) and 61 patients received standard nutritional support (standard group). The relevant clinical data were collected, and the postoperative albumin (ALB) level, prealbumin (PA) level, hemoglobin (Hb) level, patient-generated subjective global assessment (PG-SGA) score, Kanofsky performance score (KPS), and short-term prognosis were compared between the two groups. Finally, factors affecting the efficacy of nutritional support in patients with glioma were analyzed.
RESULTS: 14 days after the surgery, the levels of ALB, PA, and Hb of the standard group were significantly higher than those in the routing group (all P < 0.05). The PG-SGA scores of the two groups decreased with time, and the PG-SGA scores of the standard group were significantly lower than those of the routing group at 30 d and 60 d after the operation (intergroup effect: F = 9.077, P = 0.003, time effect: F = 75.28, P < 0.001, and interaction effect: F = 3.111, P = 0.047). The KPS scores of the two groups increased with time, and the KPS scores of the standard group were significantly higher than those of the routing group at 30 d and 60 d after operation (intergroup effect: F = 4.458, P = 0.044, time effect: F = 31.333, P < 0.001, and interaction effect: F = 3.507, P = 0.032). Within 6 months after discharge, the tumor recurrence rate of the standard group was significantly lower than that in the routing group (P < 0.05). After 60 days of the surgery, nutritional support therapy worked well in 32 patients, and the results of the logistic regression analysis displayed that age was an independent factor affecting the efficacy of nutritional support in post-operative glioma patients.
CONCLUSIONS: Standard nutritional support based on nutritional risk screening can improve the nutrition condition and living quality of post-operative glioma patients and is worthy of clinical application.

[This corrects the article DOI: 10.3389/fnut.2022.1033265.].

UNASSIGNED: Malnutrition in cancer patients often remains undetected and underestimated in clinical practice despite studies revealing prevalences from 20 to 70%. Therefore, this study aimed to identify patient groups exposed to an increased nutritional risk in a university oncological outpatient center.
UNASSIGNED: Between May 2017 and January 2018 we screened oncological patients there using the malnutrition universal screening tool (MUST). Qualitative data were collected by a questionnaire to learn about patients\' individual information needs and changes in patients\' diets and stressful personal nutrition restrictions.
UNASSIGNED: We included 311 patients with various cancers. 20.3% (n = 63) were found to be at high risk of malnutrition, 16.4% (n = 51) at moderate risk despite a mean body mass index (BMI) of 26.5 ± 4.7 kg/m2. The average age was 62.7 (± 11.8) with equal gender distribution (52% women, n = 162). In 94.8% (n = 295) unintended weight loss led to MUST scoring. Patients with gastrointestinal tumors (25%, n = 78) and patients >65 years (22%, n = 68) were at higher risk. Furthermore, there was a significant association between surgery or chemotherapy within six months before survey and a MUST score ≥2 (OR = 3.6). Taste changes, dysphagia, and appetite loss were also particular risk factors (OR = 2.3-3.2). Young, female and normal-weight patients showed most interest in nutrition in cancer. However, only 38% (n = 118) had a nutritional counseling.
UNASSIGNED: This study confirms that using the MUST score is a valid screening procedure to identify outpatients at risk of developing malnutrition. Here one in five was at high risk, but only 1% would have been detected by BMI alone. Therefore, an ongoing screening procedure with meaningful parameters should be urgently implemented into the clinical routine of cancer outpatients as recommended in international guidelines.

Background and objectives Malnutrition is still widely prevalent in India. Various nutritional screening tools have been developed to screen for nutritional risk status but no one tool is considered the best. The Malnutrition Universal Screening Tool (MUST) is accepted by the European Society for Clinical Nutrition and Metabolism and validated for use in hospitalized adults. Hence, it was used in this study to estimate the prevalence of malnutrition in hospitalized adults and its association with socioeconomic inequality. Methods A sample of randomly selected 358 ambulatory hospitalized patients above 18 years of age was used in the study. Data pertaining to demography, socioeconomic status, medical history, and MUST were collected using a structured questionnaire. The height and weight of the patients were measured, and their BMI was determined. The patients were classified into five socioeconomic classes and their MUST scores were determined. Results Statistically significant (P < 0.05) increasing trend was observed in the height, weight, and BMI of patients with increasing socioeconomic status. Diabetes mellitus (39%) followed by hypertension (30%) were the predominant comorbid conditions. According to MUST, the overall prevalence of medium and high risk of malnutrition was 11% and 24%, respectively, and the socioeconomic class that was most impacted was Class 4 (1,130-2,259 INR per capita monthly income). Interpretation and conclusions Socioeconomic status influences the prevalence of malnutrition, comorbid conditions, and the anthropometric measurements of admitted patients. The prevalence of nutritional risk status irrespective of sex was found to be 34.91% (24.3% in males and 10.61% in women) in the study.

OBJECTIVE: Chemotherapy-related bacterial infection is a common side effect in patients receiving chemotherapy. The purpose of this study was to determine the risk factors and characteristics of bacterial infection in metastatic gastric or gastroesophageal junction (GEJ) adenocarcinoma patients treated with combined chemotherapy.
METHODS: Patients with metastatic gastric or GEJ adenocarcinoma were followed up from 2013 to 2016 at Peking University First Hospital in China. Patients were treated with multiple cycles of combined chemotherapy. The incidence rate of bacterial infection and patients\' clinical data were manually reviewed.
RESULTS: A total of 154 patients were eligible and were enrolled in this study. A median of 6 chemotherapy cycles were administered (range, 1-14 cycles). Chemotherapy-related bacterial infections were observed in 36 of 154 patients (23.4%). Pulmonary is the most common site of infections. Ninety-four percent of patients with bacterial infection during chemotherapy received broad-spectrum antibiotics. The independent risk factors for chemotherapy-related bacterial infection identified by multivariable analysis were Nutritional Risk Screening 2002 (NRS2002) ≥ 3 (P = 0.008), ≥ grade 3 neutropenia (P = 0.028), and Eastern Cooperative Oncology Group Performance Status (ECOG PS) ≥ 2 (P = 0.042).
CONCLUSIONS: Nearly a quarter of patients with metastatic gastric or GEJ adenocarcinoma who received combined chemotherapy had bacterial infection in this study. The proportion of broad-spectrum antibiotics used in patients with infection is very high. Improving nutritional status may help reduce the incidence of bacterial infection.

The effect of the COVID-19 infection on nutritional status is not well established. Worldwide epidemiological studies have begun to investigate the incidence of malnutrition during hospitalization for COVID-19. The prevalence of malnutrition during follow-up after COVID-19 infection has not been investigated yet. The primary objective of the present study was to estimate the prevalence of the risk of malnutrition in hospitalized adult patients with COVID-19, re-evaluating their nutritional status during follow-up after discharge. The secondary objective was to identify factors that may contribute to the onset of malnutrition during hospitalization and after discharge.
We enrolled 142 COVID-19 patients admitted to Careggi University Hospital. Nutritional parameters were measured at three different timepoints for each patient: upon admission to hospital, at discharge from hospital and 3 months after discharge during follow-up. The prevalence of both the nutritional risk and malnutrition was assessed. During the follow-up, the presence of nutritional impact symptoms (NIS) was also investigated. An analysis of the association between demographic and clinical features and nutritional status was conducted.
The mean unintended weight loss during hospitalization was 7.6% (p < 0.001). A positive correlation between age and weight loss during hospitalization was observed (r = 0.146, p = 0.08). Moreover, for elderly patients (>61 years old), a statistically significant correlation between age and weight loss was found (r = 0.288 p = 0.05). Patients admitted to an Intensive Care Unit (ICU) or Intermediate Care Unit (IMCU) had a greater unintended weight loss than patients who stayed in a standard care ward (5.46% vs 1.19%; p < 0.001). At discharge 12 patients were malnourished (8.4%) according to the ESPEN definition. On average, patients gained 4.36 kg (p < 0.001) three months after discharge. Overall, we observed a weight reduction of 2.2% (p < 0.001) from the habitual weight measured upon admission. Patients admitted to an ICU/IMCU showed a higher MUST score three months after discharge (Cramer\'s V 0.218, p = 0.035). With regard to the NIS score, only 7 patients (4.9%) reported one or more nutritional problems during follow-up.
The identification of groups of patients at a higher nutritional risk could be useful with a view to adopting measures to prevent worsening of nutritional status during hospitalization. Admission to an ICU/IMCU, age and length of the hospital stay seem to have a major impact on nutritional status. Nutritional follow-up should be guaranteed for patients who lose more than 10% of their habitual weight during their stay in hospital, especially after admission to an ICU/IMCU.

Early identification of patients at risk of malnutrition or who are malnourished is crucial in order to start a timely and adequate nutritional therapy. Yet, despite the presence of many nutrition screening tools for use in the hospital setting, there is no consensus regarding the best tool as well as inadequate adherence to screening practices which impairs the achievement of effective nutritional therapy. In recent years, artificial intelligence and machine learning methods have been widely used, across multiple medical domains, to aid clinical decision making and to improve quality and efficiency of care. Therefore, Yin and colleagues propose a machine learning based individualized decision support system aimed to identify and grade malnutrition in cancer patients by applying unsupervised and supervised machine learning methods on nationwide cohort. This approach, demonstrate the ability of machine learning methods to create tools to recognize malnutrition. The machine learning based screening serves as a first layer in a nutritional therapy workflow and provides improved support for decision making of health professionals to fit individualized nutritional therapy in at-risk patients.

Cancer is one of the leading causes of death for children; however, appropriate nutritional status can positively affect disease progression and outcome. The aim of this study was to present our self-developed nutritional risk screening method, relate it to another validated tool and to objective bio-impedance measures. We intended to recommend a screening algorithm which can be used in our pediatric oncology facilities.
We analysed data from 109 pediatric oncology patients (age 3-18) at the 2nd Department of Pediatrics, Semmelweis University between 2017 and 2018. The nutritional status was assessed by the Nutrition screening tool for childhood cancer (SCAN), Nutrition risk screening for pediatric cancer (NRS-PC) our own self-developed screening tool and Bio-impedance analysis (InBody 720 and S10). Classifier properties for low muscle mass measured by Bio-impedance analysis were compared for SCAN and NRS-PC in the overall sample and in the different phases of the disease.
The AUC of 0.67 [95% CI:0.58,0.75] of the SCAN was significantly lower (Z = -2.46, p = 0.014) than in the case of the NRS-PC (AUC = 0.75 [95% CI:0.67,0.82]), indicating that NRS-PC has better classifier properties to identify children with lower muscle mass. No significant difference was found in the different phases of the disease.
Based on our results, we suggest screening high BMI patients first with NRS-PC. However, in case of low BMI bio-impedance measures provide more precise information on muscle mass and nutritional risk. Further data are needed to decide whether the NRS-PC is sensitive enough in normal BMI patients.