AIWW:a new nutrition-screening tool for the oncologic population  

作　　者：Yi-Zhong Ge Zhen-Ming Fu Qi Zhang Meng-Meng Song Guo-Tian Ruan Xi Zhang Xiao-Wei Zhang Xiang-Rui Li Kang-Ping Zhang Meng Tang Xiao-Yue Liu Ming Yang Tong Liu Hai-Lun Xie He-Yang Zhang Zi-Wen Wang Chun-Lei Hu Shi-Qi Lin Rui Zhang Hong-Xia Xu Wei Li Chun-Hua Song Ming Liu Jun-Qiang Chen Kun-Hua Wang Li Bo Ming-Hua Cong Zeng-Ning Li Zeng-Qin Guo Xiao-Bin Wang Bin-Yan Wang Benjamin Xu Xian-Hui Qin Xi-Ping Xu Rocco Barazzoni Qing-Hua Yao Min Weng Xian Shen Han-Ping Shi The Investigation on Nutrition Status and Clinical Outcome of Common Cancers(INSCOC)Group 

机构地区：[1]Department of Gastrointestinal Surgery/Department of Clinical Nutrition,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China [2]The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University,Wenzhou 325000,China [3]National Clinical Research Center for Geriatric Diseases,Xuanwu Hospital,Capital Medical University,Beijing 100053,China [4]Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition,Beijing 100038,China [5]Key Laboratory of Cancer FSMP for State Market Regulation,Beijing 100038,China [6]Cancer Center,Renmin Hospital of Wuhan University,Wuhan 430060,China [7]Department of Colorectal Surgery,Cancer Hospital of University of Chinese Academy of Sciences,Zhejiang Cancer Hospital,Hangzhou 310022,China [8]Department of Clinical Nutrition,Daping Hospital,Army Medical University(Third Military Medical University),Chongqing 400042,China [9]Cancer Center of the First Hospital of Jilin University,Changchun 130021,China [10]Department of Epidemiology,College of Public Health,Zhengzhou University,Zhengzhou,450001,China [11]Department of Colorectal Surgery,the Second Affiliated Hospital of Harbin Medical University,Harbin 150081,China [12]Department of Gastrointestinal Surgery,First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China [13]Yunnan University,Kunming 650091,China [14]General Surgery Clinical Medical Center of Yunnan Province,Kunming 650032,China [15]Affiliated Hospital of Yunnan University,Kunming 650091,China [16]Comprehensive Oncology Department,Cancer Hospital,Chinese Academy of Medical Sciences,Beijing 100021,China [17]Department of Clinical Nutrition,The First Hospital of Hebei Medical University,Shijiazhuang 050031,China [18]Department of Medical Oncology,Fujian Cancer Hospital,Fujian Medical University Cancer Hospital,Fuzhou 350014,China [19]Department of Population,Family and Reproductive Health,Johns Hopkins University Bloomberg School of Public Health,Baltimore MD 21228,USA [20]Shen

出　　处：《Science China(Life Sciences)》2023年第8期1831-1840,共10页中国科学（生命科学英文版）

基　　金：supported by the Key Research and Development Program of Beijing Municipal Science and Technology Commission(D181100000218004);General Surgery Clinical Medical Center of Yunnan Province(ZX2019-03-03);the National Key Research and Development Program of China(2022YFC2009600)。

摘　　要：Malnutrition is a common comorbidity among patients with cancer.However,no nutrition-screening tool has been recognized in this population.A quick and easy screening tool for nutrition with high sensitivity and easy-to-use is needed.Based on the previous 25 nutrition-screening tools,the Delphi method was made by the members of the Chinese Society of Nutritional Oncology to choose the most useful item from each category.According to these results,we built a nutrition-screening tool named age,intake,weight,and walking(AIWW).Malnutrition was defined based on the scored patient-generated subjective global assessment(PG-SGA).Concurrent validity was evaluated using the Kendall tau coefficient and kappa consistency between the malnutrition risks of AIWW,nutritional risk screening 2002(NRS-2002),and malnutrition screening tool(MST).Clinical benefit was calculated by the decision curve analysis(DCA),integrated discrimination improvement(IDI),and continuous net reclassification improvement(c NRI).A total of 11,360 patients(male,n=6,024(53.0%)were included in the final study cohort,and 6,363 patients had malnutrition based on PG-SGA.Based on AIWW,NRS-2002,and MST,7,545,3,469,and1,840 patients were at risk of malnutrition,respectively.The sensitivities of AIWW,NRS-2002,and MST risks were 0.910,0.531,and 0.285,and the specificities were 0.768,0.946,and 0.975.The Kendall tau coefficients of AIWW,NRS-2002,and MST risks were 0.588,0.501,and 0.326,respectively.The area under the curve of AIWW,NRS-2002,and MST risks were0.785,0.739,and 0.630,respectively.The IDI,c NRI,and DCA showed that AIWW is non-inferior to NRS-2002(IDI:0.002(-0.009,0.013),c NRI:-0.015(-0.049,0.020)).AIWW scores can also predict the survival of patients with cancer.The missed diagnosis rates of AIWW,NRS-2002,and MST were 0.09%,49.0%,and 73.2%,respectively.AIWW showed a better nutritionscreening effect than NRS-2002 and MST for patients with cancer and could be recommended as an alternative nutritionscreening tool for this population.

关 键 词：nutrition-screening AIWW NRS-2002 MST CANCER 

分 类 号：R730.5[医药卫生—肿瘤] R459.3[医药卫生—临床医学]