Study of nutritional status assessment and diet of colorectal cancer inpatients

• Main Authors: Mei-Yu Tu, 凃美瑜
• Other Authors: Bor-Hon Lee
• Format: Others
• Language: zh-TW
• Published: 2007
• Online Access: http://ndltd.ncl.edu.tw/handle/12815128964892063511

碩士 === 台南科技大學 === 生活應用科學研究所 === 95 === The most frequent problem the colorectal inpatients face is concerning nutrition and intake and rarely deeply investigated in Taiwan. Therefore, the general surgery subjects of colorectal cancer in a southern medical center were evaluated regarding nutritional status and food intake for understanding the relationship compared between the nutrient intake and colorectal cancer. First, in light of the Taiwan Nutrient Data Laboratory database as the main resource, the questionnaire based on the types of foods and lifestyle was designed for the risk factors of colorectal cancer. For the food frequency questionnaire, the 45 patients of colorectal cancer proved colonoscopically and pathologically were in the study group; the 45 healthy testers of no history of related illness after age and sex matching, in the control group. The Subjective Global Assessment (SGA)-, Malnutrition Universal Screening Tool (MUST)-, and Nutritional Risk Index (NRI)- assessed nutrition related problems in the study group were assessed, based on the basic data, symptom severity, physical examination, and blood biochemistry. Resultantly, the MUST-assessed sensitivity and specificity of the colorectal cancer participants who had rectal cancer and whose average age was 62.1 ± 11.5 years were 93.8% and 82.8%.However, the MUST had a higher positive predictive rate (75%) and a negative predictive rate（96%）; the SGA and MUST（k = 0.724， P < 0.001）, significantly different consistent coefficients. The 6 subjects （13%） had a 10% weight loss preoperatively within 6 months; the 11 subjects（24%）, a 5-10% weight loss. During the average hospital days (17.1 ± 10.6), the average weight loss was 3.02 ± 1.39 kg; the number of the patients with the 5-10% weight loss, 15（33%）; that of those with the weight loss greater than 10%, 1 (2.2%). For the malnutrition risk assessment, the three screening tools focused upon the weight loss. In the findings, the more weight loss the patients had, the more hospital days they spent（P = 0.039）. In the Spearman correlation analysis using the nutritional status compared with the hospital days and medical cost: the worse the SGA-, MUST-, and NRI-assessed nutritional status was, the more hospital days the patients spent; the SGA-assessed nutritional status compared with the medical cost for hospitalization was significantly different. Additionally, in the analysis, after the SGA-, MUST-, and NRI-assessed nutritional status was compared with the associated variables like the preoperative weight, preoperative body mass index (BMI), cortex thickness, albumin, prealbumin, transferrin, total lymphocyte count, Hemoglobin, and Zinc, the worst the SGA- and MUST- assessed nutritional status was, the smaller the significant different variables were. In the food frequency questionnaire, the relative risk between the source of fatty acids and their intake was identified: the increase in saturated fatty acids in red meat increased cancer risk （OR=1.09；95%CI=1.01-1.18；P < 0.05）; fruit fiber intake decreased cancer risk （OR=0.84；95%CI=0.74-0.95；P < 0.05）. Moreover, the pre-cancer sufferer intake of fish, meat, beans, and eggs in the colorectal cancer group was much higher than the average intake in the control group. The intake of dairy products and vegetables was lower in the former group than the latter group. Conclusively, to eat more saturated fatty acids in red meat might increase the risk of colorectal cancer which was decreased by the more fruit fiber diet. The nutritional status screening of in-hospital colorectal cancer patients who pre-operated had some limitations of medical support and time. Still, it was proposed that to use MUST to quickly screen in-patient patients’ nutrition risk or to be the instrument of in-hospital malnutrition patients and if there is a need depending upon the clinical condition to offer blood test as the aid of assessing patients’ malnutrition.