• Title/Summary/Keyword: initial nutritional status

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Relationship between Nutritional Status and Clinical Outcome in 120 Hepatoma Patients (간암환자의 영양상태와 치료결과와의 관련성)

  • Han, Bu;Kim, Young-ok
    • The Korean Journal of Food And Nutrition
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    • v.13 no.5
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    • pp.434-439
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    • 2000
  • This study was conducted to investigate the association between initial nutritional status and treatment outcome of hepatoma patients. Initial nutritional status was measured based on weight, serum albumin and total lymphocyte counts. Treatment outcome was measured in the three categories such as complication, treatment status at discharge and mortality. The study subjects were 120 patients with hepatoma cancer admitted at a university hospital in Seoul. The information about initial nutritional status and treatment outcome was collected from medical records. Chi-square test was used to test the association between initial nutritional status and treatment outcome As a result. 76.6% of the subjects were classified as the nutritional risk group based on initial nutritional states. Prevalence of complication was higher in nutritional risk group I and II than that in non-risk group(p<0.05). Death rare of the nutritional risk group was significantly higher than that of non-risk group(p<0.001). The findings suggest the strong association between the initial nutritional status and treatment outcome of hepatoma cancer.

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A study on Nutritional status and Support in Critically ill patients (서울시내 1 개병원 중환자의 영양상태와 영양지원 실태에 관한 연구)

  • Choe, Mi-Suk;Kim, Jeong-Nam
    • Journal of the Korean Dietetic Association
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    • v.1 no.1
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    • pp.21-30
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    • 1995
  • Critically ill patients admitted in ICU and NCU were studied with respect to their nutritional status and support to them at initial period, and the effect of nutritional support after 3 weeks. The nutritional support was supplied to these patients with the enteral and parenteral nutrition. The results of biochemical test and status of nutritional support on 52(29 males, 23 females) critically ill patients were based on medical records and the anthropometry was measured on 28 patients. The subjects were in mild malnutrition. Their initial calorie intakes were 85% of BEE, 57% of total energy requirements and 49% of protein requirement were provided. Two groups, one group of serum albumin level more than 3.5g/dl and the other group of serum albumin level less than 3.5g/dl, were significant different in total calorie and protein intakes. After 3 weeks, inappropriate nutritional support in the group of normal nutrition results in significant decreasing of serum albumin level but, there were no changes in the group of malnutrition. Nutritional support is one of the mainstays in the management of these critically ill patients and is aimed at preventing malnutrition. Therefore, timely nutritional support is heavily required in cases of critically ill patients whether their initial nutritional status is normal or not.

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Effect of Nutritional Support on Underweight Patients (저체중 환자를 대상으로한 영양보충 효과에 관한 연구)

  • 백인경
    • Journal of Nutrition and Health
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    • v.24 no.6
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    • pp.496-505
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    • 1991
  • Underweight patients were studied with respect to changes in their nutritional status before and after administration of nutritional beverage. Patients with renal hepatic or endocrine disease gastrectomy malabsorption and weight gain over past 6 months were excluded. Ten patients were participated as controls and were allowed to eat ad libitu, Twenty patients were served as case and were administered in addition to their usual diet 400ml of nutritio-nal beverage(Greenbia) high in calorie and protein for 8 weeks. In the beginning of the study most underweight patients showed depressed nutritional status in terms of calorie intake quality of protein intake and the levels of visceral protein status and serum micronut-rients. The controls consumed less amounts of calories proteins vitamins and minerals while those given the nutritional beverage exceeded their estimated energy requirement(105%) and consumed a mean of 96g protein per day. Those given nutritional beverage for 8 weeks showed significant increase in body weight(3%) hemoglobin(3.2%) hematocrit(5.4%) serum transferrin(19.4%) iron(30.1%) and zinc(20.9%) In the controls however significant improvement was not observed in any parameters compared with initial values. significant improvement was not observed in any parameters compared with initial values. This study suggests that patients with underweight can show mild nutritional deprivation nutritional support can improve their unbalanced status and prevent severe malnutrition.

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The Relationship of Powerlessness, Sense of Belonging and Nutritional Status in the Elderly (노인의 무력감, 소속감과 영양상태의 관계)

  • Park, Seon-Hwa;So, Hee-Young
    • The Korean Journal of Rehabilitation Nursing
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    • v.11 no.2
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    • pp.81-89
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    • 2008
  • Purpose: The aim of this study was to explore the relationship between powerlessness, sense of belonging and nutritional status of the elderly. Method: The study sample was 100 living at home and institutions. Data were collected by interview from Oct. to Dec. in 2003. The instruments were helplessness scale developed by Jung (1998), sense of belonging scale SOBI-A and nutritional initial screening. Results: The mean score of powerlessness was $2.71{\pm}0.30$, sense of belonging was $2.87{\pm}0.19$ and nutritional status was $4.42{\pm}3.34$. There was a statistically significant differences in powerlessness according to age (F=3.185, p=0.027), health status (F=6.945, P=0.002), religion (F=5.941, P=0.001), current spouse (t=-0.384, p=0.026), in sense of belonging according to age (F=4.40, P=0.006), length of education (F=10.64, P=<.0001) and in nutritional status according to age (F=3.34, P=0.022), health status (F=2.86, P=0.027). There was a statistically significant correlation between powerlessness and nutritional status (r=0.219, p=0.029). Conclusions: Nurses are able to decrease powerlessness or increase sense of belonging and nutritional status of the elderly by developing the health promotion program, improving perceived health status and empowering social interaction of the elderly specifically living at institutions.

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Assessment of early nutritional state in critical patients with intoxication and the effect of nutritional status on prognosis (중독 중환자에서의 초기 영양상태평가와 예후와의 관계)

  • Ko, Dong-wan;Choi, Sangcheon;Min, Young-gi;Lee, Hyuk jin;Park, Eun Jung
    • Journal of The Korean Society of Clinical Toxicology
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    • v.19 no.2
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    • pp.93-99
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    • 2021
  • Purpose: Nutritional status and support in critically ill patients are important factors in determining patient recovery and prognosis. The aim of this study was to analyze the early nutritional status and the methods of nutritional support in critically ill patients with acute poisoning and to evaluate the effect of nutritional status on prognosis. Methods: A retrospective study was conducted in tertiary care teaching hospital from January 2018 to December 2020. in an emergency department of university hospital, 220 patients who were stayed more than 2 days of poisoning in intensive care unit were enrolled. Results: 155 (70.5%) of patients with acute poisoning had low-risk in nutritional risk screening (NRS). Patients with malignancy had higher NRS (low risk 5.2%, moderate risk 18.5%, high risk 13.2%, p=0.024). Patients of 91.4% supplied nutrition via oral route or enteral route. Parenteral route for starting method of nutritional support were higher in patients with acute poisoning of herbicide or pesticide (medicine 3.2%, herbicide 13.8%, pesticide 22.2%, p=0.000). In multivariate logistic regression analysis, herbicide or pesticide intoxication, higher risk in NRS and sequential organ failure assessment over 4.5 were affecting factor on poor recovery at discharge. Conclusion: NRS in patients intoxicated with herbicide or pesticide were higher than that in patients intoxicated with medicine intoxication. Enteral nutrition in patients intoxicated with herbicide or pesticide was less common. Initial NRS was correlated with recovery at discharge in patient with intoxication. It is expected to be helpful in finding patients with high-risk nutritional status in acute poisoning patients and establishing a treatment plan that can actively implement nutritional support.

Nutrition Intervention in a Gastric Cancer Patient With Gastrectomy for 12 Months: A Case Report

  • So Young Youn;Bo Eun Kim;Eun Mee Kim
    • Clinical Nutrition Research
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    • v.12 no.1
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    • pp.1-6
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    • 2023
  • Gastrectomy is the most effective method of treating gastric cancer, but it is commonly associated with weight loss, nutritional deficiencies, and the increased risk of malnutrition due to post-surgery complications, including gastric stasis, dumping syndrome, malabsorption, and maldigestion. Malnutrition is a risk factor for postoperative complications and poor prognosis. To prevent it and guarantee a quick recovery after surgery, continuous and individualized nutrition intervention should be performed both before surgery and postoperatively. The Department of Dietetics at Samsung Medical Center (SMC) performed nutritional status assessment before gastrectomy, initial nutritional assessment within 24 hours of admission, description of therapeutic diet after surgery, nutrition counselling before discharge, and nutritional status assessment and individual nutrition counselling after 1, 3, 6, and 12 months from surgery. This is a case report of a patient who underwent gastrectomy as well as intensive nutrition intervention in SMC.

Effects of Nutritional Supplementation on Nutirtional Status in Patients with Nonalcoholic Liver Cirrhosis (비알콜성 간경변증 환자에서 영양보충에 따른 영양개선의 효과)

  • 안수현;김오연;이종호;김지영;한광협
    • Journal of Nutrition and Health
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    • v.36 no.6
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    • pp.577-588
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    • 2003
  • Severe protein-calorie malnutrition, common in patients with advanced liver disease, can seriously undermine the capacity for regeneration and functional restoration of liver. Nutritional supplementation for these patients can improve biochemical and hormonal abnormalities. However, these effects were not identified in patient with nonalcoholic liver cirrhosis. To determine effects of nutritional supplementation in patients with nonalcoholic liver cirrhosis, 77 subjects aged 29 to 69 years participated in this study for 12 weeks and were subdivided into three groups; normal diet group (Control group, n = 16), branched-chain amino acid supplementation group (BCAA group, n = 31), nutritional supplementation group (NS group, n = 30). Anthropometric parameters, hemoglobin, hematocrit, blood cell counts, serum levels of lipids, vitamins, minerals and fatty acid composition, and plasma amino acids were examined. The mean values of age and height, and the initial values of weight and body mass index (BMI) were not different among all groups. After 12 weeks, there were no significant changes in these values in Control group. Only NS group showed significant increases in weight, lean body mass, midarm circumference, triceps skinfold thickness. Serum transferrins were increased both in BCAA and NS groups. Plasma levels of branched-chain amino acids, urea amino acids and glutamic acid were also significantly increased in these groups, but plasma levels of ammonia, serum LDL cholesterol and atherogenic index were decreased. However, there were no significant changes in serum levels of vitamin and mineral and composition of fatty acids in phospholipids in these groups. These results showed that the nutritional supplementation for patients with nonalcoholic liver cirrhosis can more improve nutritional status in these people together with increases of weight, body fat and lean body mass, compared to only BCAA supplementation. To ascertain and investigate the appropriate nutritional supplementation for patients with nonalcoholic liver cirrhosis, further studies are necessary.

Initial Nutritional Status and Clinical Outcomes in Patients With Deep Neck Infection

  • Park, Marn Joon;Kim, Ji Won;Kim, Yonghan;Lee, Yoon Se;Roh, Jong-Lyel;Choi, Seung-Ho;Kim, Sang Yoon;Nam, Soon Yuhl
    • Clinical and Experimental Otorhinolaryngology
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    • v.11 no.4
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    • pp.293-300
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    • 2018
  • Objectives. The current study aims to determine the correlation between nutritional status upon presentation and disease severity, as well as treatment and survival outcomes. Methods. Patients who were diagnosed with deep neck infection, underwent at least one surgical drainage/debridement, and had more than 1 week of hospitalization at a tertiary medical center from 2007 to 2015 were retrospectively included. Thereafter, initial serum albumin, C-reactive protein (CRP), and body mass index (BMI) were reviewed. Results. A total of 135 patients were included in the final analysis. Accordingly, the proportion of patients with simultaneous mediastinitis (21.0%), necrotizing fasciitis (12.9%), disease extent >1 cervical level (72.6%), mean CRP (22.4 mg/dL), mean length of hospitalization (25.0 days), and mean 1-week follow-up CRP (7.2 mg/dL) was significantly higher in the hypoalbuminemia group (initial serum albumin <3.0 g/dL) than in the normoalbuminemia group (all P<0.05). No significant correlations had been observed according to BMI status. After adjusting for age and Charlson comorbidity index, odds ratios for the following outcomes were calculated in patients initially presenting with hypoalbuminemia: simultaneous mediastinitis (3.07), necrotizing fasciitis (7.89), disease extent >1 cervical level (2.12), initial serum CRP over 20 mg/dL (3.79), hospitalization of more than 14 days (4.10), 1-week follow-up CRP over 5 mg/dL (3.78), and increased duration for an over 50% decrease in initial CRP (2.70) (all P<0.05). Although intravascular albumin replenishment decreased the proportion of patients with hypoalbuminemia after 2 weeks (P<0.05), it did not significantly predict better treatment outcomes. Conclusion. Among the markers reflecting an individual's nutritional state, an initial serum albumin of less than 3.0 g/dL was an independent serologic marker predicting increased disease severity and complications in patients with deep neck infection.

Nutritional Intervention Through Ketogenic Diet in GLUT1 Deficiency Syndrome

  • Young-Sun Kim;Woojeong Kim;Ji-Hoon Na;Young-Mock Lee
    • Clinical Nutrition Research
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    • v.12 no.3
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    • pp.169-176
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    • 2023
  • Glucose transporter type 1 (GLUT1) deficiency syndrome (DS) is a metabolic brain disorder caused by a deficiency resulting from SLC2A1 gene mutation and is characterized by abnormal brain metabolism and associated metabolic encephalopathy. Reduced glucose supply to the brain leads to brain damage, resulting in delayed neurodevelopment in infancy and symptoms such as eye abnormalities, microcephaly, ataxia, and rigidity. Treatment options for GLUT1 DS include ketogenic diet (KD), pharmacotherapy, and rehabilitation therapy. Of these, KD is an essential and the most important treatment method as it promotes brain neurodevelopment by generating ketone bodies to produce energy. This case is a focused study on intensive KD nutritional intervention for an infant diagnosed with GLUT1 DS at Gangnam Severance Hospital from May 2022 to January 2023. During the initial hospitalization, nutritional intervention was performed to address poor intake via the use of concentrated formula and an attempt was made to introduce complementary feeding. After the second hospitalization and diagnosis of GLUT1 DS, positive effects on the infant's growth and development, nutritional status, and seizure control were achieved with minimal side effects by implementing KD nutritional intervention and adjusting the type and dosage of anticonvulsant medications. In conclusion, for patients with GLUT1 DS, it is important to implement a KD with an appropriate ratio of ketogenic to nonketogenic components to supply adequate energy. Furthermore, individualized and intensive nutritional management is necessary to improve growth, development, and nutritional status.

Validation of initial nutrition screening tool for hospitalized patients (입원 환자용 초기 영양검색도구의 타당도 검증)

  • Kim, Hye-Suk;Lee, Seonheui;Kim, Hyesook;Kwon, Oran
    • Journal of Nutrition and Health
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    • v.52 no.4
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    • pp.332-341
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    • 2019
  • Purpose: Poor nutrition in hospitalized patients is closely linked to an increased risk of infection, which can result in complications affecting mortality, as well as increased length of hospital stay and hospital costs. Therefore, adequate nutritional support is essential to manage the nutritional risk status of patients. Nutritional support needs to be preceded by nutrition screening, in which accuracy is crucial, particularly for the initial screening. To perform initial nutrition screening of hospitalized patients, we used the Catholic Kwandong University (CKU) Nutritional Risk Screening (CKUNRS) tool, originally developed at CKU Hospital. To validate CKUNRS against the Patient-Generated Subjective Global Assessment (PG-SGA) tool, which is considered the gold standard for nutritional risk screening, results from both tools were compared. Methods: Nutritional status was evaluated in 686 adult patients admitted to CKU Hospital from May 1 to July 31, 2018 using both CKUNRS and PG-SGA. Collected data were analyzed, and the results compared, to validate CKUNRS as a nutrition screening tool. Results: The comparison of CKUNRS and PG-SGA revealed that the prevalence of nutritional risk on admission was 15.6% (n = 107) with CKUNRS and 44.6% (n = 306) with PG-SGA. The sensitivity and specificity of CKUNRS to evaluate nutritional risk status were 98.7% (96.8 ~ 99.5) and 33.3% (28.1 ~ 39.0), respectively. Thus, the sensitivity was higher, but the specificity lower compared with PG-SGA. Cohen's kappa coefficient was 0.34, indicating valid agreement between the two tools. Conclusion: This study found concordance between CKUNRS and PG-SGA. However, the prevalence of nutritional risk in hospitalized patients was higher when determined by CKUNRS, compared with that by PG-SGA. Accordingly, CKUNRS needs further modification and improvement in terms of screening criteria to promote more effective nutritional support for patients who have been admitted for inpatient care.