MEDIX, God. 19 Br. 107/108  •  Pregledni članak  •  Gastroenterologija/Onkologija HR ENG

Evaluacija nutritivnog statusa u bolesnika s tumorima probavnoga traktaEvaluation of nutritional status in patients with tumors of the gastrointestinal tract

Irena Hrstić

Malnutricija je prepoznat klinički problem posljednjih 30 godina u većine hospitalnih bolesnika, ali ima i visoku prevalenciju u bolesnika s malignim bolestima. Gotovo 20–80% onkoloških bolesnika razvija neki od stupnjeva malnutricije u različitim fazama bolesti bilo tijekom ili izvan specifičnog onkološkog liječenja. Do danas, na žalost, ne postoji univerzalan i standardiziran pristup prevenciji i liječenju malnutricije u onkoloških bolesnika, niti u bolničkim, niti u izvanbolničkim uvjetima. Aktualno poznate testove procjene nutritivnoga statusa, kao i upitnike probira za rizik malnutricije uglavnom provodi specijalizirano medicinsko osoblje. Najčešće se upotrebljavaju podatci o gubitku tjelesne mase kao primarni indikator malnutricije. Gubitak >10% tjelesne mase upućuje na malnutriciju. Ostali često primjenjivani indikatori su serumska koncentracija albumina ili indeks tjelesne mase (ITM). Posljednjih godina u onkologiji se sve češće upotrebljavaju, ali i validiraju od ranije poznati, prilagođeni testovi probira za rizik malnutricije kao što su: PG-SGA i NRS 2002. Uzimajući u obzir tumore probavnoga sustava malnutricija ili rizik malnutricije, najčešće su prisutni u pojedinaca s karcinomom jednjaka ili gušterače. 

Ključne riječi:
gastrointestinalni tumori; NRS 2002; PG-SGA; procjena nutritivnog statusa; rizik malnutricije

Članak u cijelosti pročitajte u tiskanom izdanju MEDIX, God. 19 Br. 107/108

Malnutrition has been a recognized clinical problem in hospitalized patients for the last 30 years, with a higher prevalence in patients with malignant diseases. Approximately 20%-80% of cancer patients develop some degree of malnutrition in various stages of the disease, whether it is during or outside of a specific cancer treatment. To date, unfortunately, there is no universal or standardized approach to treating or preventing malnutrition in cancer patients, no matter if they are in the hospital or in outpatient care. Current tests for determining the nutritional status of cancer patients, as well as questionnaires and nutritional screenings are carried out by nursing professionals. The most commonly used data for determining malnutrition are the weight loss charts which are the primary indicators of malnutrition. Involuntary weight loss of >10% indicates malnutrition. Other indicators used in the assessment of malnutrition include serum albumin and body mass index (BMI). In recent years, oncologists have been increasingly using and validating previously known screening methods used in evaluating the risks of malnutrition, such as PG-SGA and NRS 2002, while taking into account that malnutrition is extremely prevalent in patients with tumors of the gastrointestinal tract, especially esophageal or pancreatic carcinoma patients. 

Key words:
gastrointestinal tumors, nutritional status assessment, risk for malnutrition, NRS 2002, PG-SGA